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13-1165 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tihf 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: i3-00001165 Owner: Property Address: 81895 PRISM DR CROSS, BOBBIE & SOLIE, APN: 764-270-999-44 -300232- 81895 PRISM DRIVE Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 31500 Contractor: Applicant: Architect or Engineer: DESERT OUTDOORS INC 78065 MAIN ST STE #205 LA QUINTA, 92253 (760)39 Lic. No..:: 964 00 964474 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licen nder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business d Prof ssio als Code, and my License is in full force and effect. License Class: C27-1253 License No.: 964474 .3 Date: - � J 1 Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of . erjury that 1 am exempt from the.Contractor's State License Law for the following reason (Sec. 7031 .5, 6 siness and rofessions Code: Any city or county that requires a permit to construct, alter, improve, demolish, repo; 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.). (_ 1 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.). (_) 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 Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/18/13 MED VIN A 11 IbP1,2013 CITY OF LA QUINTA FINANCE DEPT. ------------------ WORKER'S COMPENSATION DECLARATION 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 the work for which this permit is issued. 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 NORGUARD INS Policy Number DEWC338066 I certify that, in the performance he work for which this permit is issued, I shall not employ any person In any manner so as i be ome subject to the workers' cumpensatiun laws of Califurnia, and agree that, if 1 should bed m subjec the workers' compensation provisions of Section 3700 of the Labor Code, I sh II thwi omply with those provisions. Date: � �' l Applicant: �— WARNING: FAILURE TO SECU•••rrqr•q•q•��,f[�EWORKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CFVMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT40N TOT E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR VSIOE, INTEREST, AND ATTORNEY'S FEES. V APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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 becom n 1 and void if work is not commenced within 180 days from date of issuance of such permit or ssati f work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above i or ati i correct. I agree to comply with all city and county ordinances and state laws relating to building cons tion d hereby authorize representatives of this county to'enter upon the above-mentioned property coon rposes. (-- Date: r J J Signature (Applicant or Agent):- • /7 Application Number . . . . . 13-00001165 Permit POOL 2013 Additional desc . Permit Fee . . . . 178.75 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date-. 3/17/14 Qty Unit Charge Per Extension 1.00 1178.7500 EA MISC POOL/SPA -------------------------------------------------------------7-------------- 178:75 Permit . . . . . . PLUMBING 2013 Additional desc . Permit Fee 11.92 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 3/17/14 Qty Unit Charge Per Extension 1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS ---------------------------------------------------------------------------- 11.92 Permit . . . ELECTRICAL 2013 Additional desc . Permit Fee . . . . 11.92 .,Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/17/14 Qty Unit Charge Per Extension 1.00 11.9200 EA ELEC APPLIANCES, RES 11.92 ---------------------------------------------------------------------------- Special Notes and Comments POOL; SPA, FIRE PIT AND ELECTRICAL SERVICE FOR ABOVE GROUND SPA AT REAR YARD (DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ABOVE GROUND SPA REQUIRED TO BE LOCATED PER LQMC REQUIREMENTS PRIOR TO FINAL INSPECTION. ALARMS AND.BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. ' September 16, 2013 2:34:14 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)- 2.00 PLAN CHECK, ELECTRICAL 11.92 PLAN CHECK, POOL 97.24 PLAN CHECK, PLUMBING 23.83 Fee summary Charged Paid Credited Due LQPERMIT LQPERMIT Application Number . . . . . '13 -00001165 Permit Fee Total 202.59 ---------- ---------- .00 ---------- .00 202.59 Plan Check Total .00 .00 .00 .00 Other Fee Total 134.99 .00 .00 134.99 Grand Total 337.58 .00 .00 337.58 LQPERMIT Bin # City of La Quinta Building er Safety Di kion P.O Box 1504,'78-49S Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 7 Project Address: 1S Owner's Name: A. P. Number. Address: gj 1 1 Legal Description: City, ST, Zip: LcQ , Contractor: �� ' Telephone -Apo • 4 Lo -Do Project Description: vel . '5 Address: ��(p5 ��' City, ST, Zip: LA Qu Telephone , 3 �� taR`> —k State Lia #:9 � City Lia #: Arch., Engr., Designer. � Address: City, ST, Zip. Telephone: State Lie. #: 3 �'�'� (p ;Y Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Name of Contact Person: Telephone # of Contact Person: —7 2j5 Estimated Value of Project: ( 'j OD APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. ..Called Contact Person Pian Cheek Balance Title 24 Calcs. Plans picked up Construction Flood (Main plan Pians resubmitted Mecharilcal Giading plan2" Review, ready for eorrectionsrasue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.XL H O.A. Approval Plans res IN ROUSE:- 7i6 .view, ready for correetio D eloper I act Fee Planning Approval Called Contact Person Pub. Wks. Appr D of penait issue School Fees Total Permit Fees I 7 ��3 to Ls w I 00M& SEP 10 x.013 CITY OF LA QUINTA COMMUNITY DEVELOPMENT FOR• CONSTRUCTION ERZ ■1 ■�_�► I ■1 � . i • ■u!�u Mimi. ■ u STANDARD R1 DETAIL � iii°�ii•nii•- •�:�s:"�c�:■G�•■G�•■��•� ��•�. • FIREPIT ■ DETAIL 7.71 MV 0 911-01 ��►fit/'� 1 � • ..sir/G �, � /. � � I I 41.4A�i +fhw'oiuMe 1 OF 1