BPOL2016-006678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPOL2016-0066
Property Address:
79792 RANDOLPH CT
APN:
604520001
Application Description:
OWEN LARSON / POOL
Property Zoning:
Application Valuation:
$25,000.00
Applicant:
MCRAE POOLS & SPAS
79105 DESERT STREAM DRIVE
LA QUINTA, CA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C53. C27 %% License No.: 823017
Date: / Y) Contractor: el9
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_I I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
.he or she did not build or improve for the purpose of sale.).
(- ) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_J I am exempt under Sec. ' B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/16/2016
Owner:
OWEN LARSON
, 92253
Contractor:
MCRAE POOLS & SPAS
79 105 DESERT STREAM DRIVE
LA QUINTA, CA 92253
(760)774-6343
Llc. No.: 823017
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of thpwork for which this permit is issued.
A— have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: C - w ' Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
.1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes hull and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: p Signature (Applicant or Agent):
a
t
FINANCIAL INFORMATION
a. DESCRIPTION a, g' ACCOUNT aE; .'sQTYY "r AMOUNT
PAID
;PAID DATE
-
. _ u
,
BSAS SB1473 FEE
101-0000-20306
0
$1.00.
$1.00
5/16/16
PAID BY,
y
METHOD"
* u ` RECEIPT # '
CHECK# .
�. CLTD BY'
e ,a
Y
MCRAE POOLS & SPAS
CASH
R15506
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
$1.00
` r�
' DESCRIPTION
,
` �+,: ACCOUNTx `
xQTYk
AMOUNTa-�
`PAID,t
s
.PAID DATE
r
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$181.29
5/16/16
PAID:BY ''xRECEI?T#�s
Y"e
CHECK#x^
CLTD BY;'
rZ
p^
MCRAE POOLS & SPAS
CASH
R15506
RSE
',
y
"
PAID DATE
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62'
$98.62
5/16/16
Vis' PAID BY
METHOD
Yom' -,,RECEIPT #7 F `u
*:9, CHECK#
> CLTD BY:
MCRAE POOLS & SPAS
CASH
R15506
RSE
Total Paid for POOL / SPA:
$279.91
$279.91
TOTALS::0$280.91
a
t
Description: OWEN LARSON / POOL
Type: POOL Subtype: Status: APPROVED
Applied: 5/16/2016 RSE�
Approved: 5/16/2016 RSEj
Parcel No: 604520001 Site Address: 79792 RANDOLPH CT LA QUINTA,CA 92253
Subdivision: TR 24197-5 Block: Lot: 1
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled: .
Valuation: $25,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No: Stories: 0 No. Unites: 0
w fNAMEdX �' � r ADbRESSl s" "!XITY
x
Details: POOL, SPA, AT.4 FOOT HIGH EQUIPMENT WALL [2 INCH GAS PIPING/#8 AWG IN 1 INCH'CONDUIT ELECTRICAL] THIS PERMIT DOES
NOT INCLUDE ELECTRICAL AT BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS.
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE. PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. -
ADDITIONAL SITES
Printed: Monday, May,16, 2016 3:01:14 PM 1 of 2 C
SYSTEti1S
CONDITIONS
CONTACTS
NAME TYPE
w fNAMEdX �' � r ADbRESSl s" "!XITY
x
STATW�' 21P "PHONES FAX
APPLICANT
MCRAE POOLS & SPAS
79 105 DESERT STREAM
LA QUINTA
CA 92253
DRIVE
CONTRACTOR
MCRAE POOLS & SPAS
79 105 DESERT STREAM
LA QUINTA
CA 92253
DRIVE
OWNER
OWEN LARSON
92253
Printed: Monday, May,16, 2016 3:01:14 PM 1 of 2 C
SYSTEti1S
'� v',•Permit Details PERMIT NUMBER
City of La Quinta BPOW016=00668
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Monday, May 16, 2016 3:01:14 PM 2 of 2
• pw.'YSTEiNS
CLTD
DESCRIPTION
ACCOUNT
CITY'
;" AMOUNT
PAID
PAID DATE::
RECEIP-T#
CHECK #, :
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306'
0
$1.00
$1.00
5/16/16
R15506
CASH
MCRAE POOLS & SPAS
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$181.29
5/16/16
R15506
CASH
MCRAE POOLS & SPAS
RSE
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$98.62
5/16/16
R15506
CASH
MCRAE POOLS & SPAS
'RSE
PC
Total Paid for POOL / SPA: $279.91 $279.91
• :0$21§0.91
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Monday, May 16, 2016 3:01:14 PM 2 of 2
• pw.'YSTEiNS
Bin #
City of La' Q uin to
Building Si Safety Division
78-495 Calle Tampieo.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #f
Project Address: % ��
Owner's Name:777Rr
A. P. Number:
Address: —'7
Legal Description:
City, ST, Zip:% S
Contractor:
TeleP ho n •
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Address:
Project Description: L C iD
City, ST, Zip-
ip:
Telephone:
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TelP0
State Lic. # : 23 Q
City Lie. #.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
e.
o truct•n
C s ton Type: P Occupancy:
State Lic.'#:
Project tYPa (circle ne • New A d'n Alter Repair Demo
Name of Contact Person:—
Sq. Ft.:
#. Stories: # Units:
Telephone # of Contact Person: %�Q ,'� Y 3 V
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES'
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready.for. corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for-corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans i*esubmitted
Grading
IN HOUSE:-
'"! Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
AP
PROVED
FOR CONSTRUCTION
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CITY OF LA QUUNTASUBCONT'
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JOB AuDmcS~--'---
persons'appoahng on this list or their employees aneauthohzed to workThis form shall be hosted on he job wilh the Building Inspection Card at all times in a conspicuous place. Only �
o 'this job. Any changes to this list must be approved by the Building Division prior uoonnnoenm'ntofvvork. Failure tocomply will result inastoppage ofwork and/or the voidance. '
of building permit. For �uu/u . "On File" isnot an acceptable
Com any Name
Classification
Exp
Carrier Name
Policy Number
Exp. Date
L icense Number
ExP. Date
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