BPOL2014-1006r. -
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&tiv, 4 lwQu;,rw
COMMUNITY DEVELOPMENT DEPARTMENT'
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/21/2014
Application Number:
BPOL2014-1006
Owner:
Property Address:
79825 RANCHO LA QUINTA DR
FRASER PETER
APN:
602220025
79825 RANCHO LA QUINTA DRIVE
Application Description:
POOL SPA FIREPIT &BBQ
92253, CA 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
DESERT OUTDOORS INC
DESERT OUTDOORS INC
78-065 MAIN STREET STE 205
78-065 MAIN STREET STE 205
LA QUINTA, CA 92253
LA QUINTA, CA 92253
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: C27, C53 License No.: 964474 (�
'Y
.t
X Date: "! Z- � � Contractor -- I�
:
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, 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.).
(_) 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:
(760)399-9600
Llc. No.: 964474
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
the work for which this permit is issued.
_ I 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: Z'� L 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 null 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.
11
Date: Z 1 Signature (Applicant or Agent):
FINANCIAL ••
`W DESCRIPTION r` . �' . t :" ACCOUNT ' ;
�..
•
' QT.Y
- .: "AMOUNT
Yf f«, ' PAIDs '
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$23.83
$0.00
-PAID BY.
METHOD
„`
.RECEIPT # '
".+ `,CHECK #.,,
CLTD BY
DESCRIPTION
'ACCOUNTt QTY
_^ AMOUNT
' : -PAID >'_
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$23.83
$0.00
j ,PAID BY
METHOD `' `�"• /
RECEIPT #
-,CHECK #' • `
CLTD BY
Total Paid for ELECTRICAL:
$47.66
$0.00
_ DESCRIPTION.,
- ACCOUNT, _
QTY
.AMOUNT
PAID ,,
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$11.92
$0.00
PAID BY
METHOD ';,
RECEIPT #�^
CHECK #
~ CLTD BY
DESCRIPTION" * ,
j ACCOUNT= c'
QTY"
AMOUNT
;+PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$23.83
$0.00
+' -PAID BY •+ ` -'
' METHOD
RECEIPT #; ,
CHECK #'
CLTD BY
Total Paid for PLUMBING FEES:
$35.75
$0.00
r lYy f : '6ESCRIPTION " +- '
' , ACCOUNT .:,�
; CITY
: `AMOUNT
PAID-- -
.PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$178.75
$0.00
`a PAID BY �` _ -"
='
=METHOD
tai.
y RECEIPT #_;. r' _
,
CHECK #.. '
. CLTD BYE'
DESCRIPTION .t%,.-ACCOUNT
'.,r .''+
QTY'
AMOUNT
`' PAID "
PAID DATE
SWIMMING POOL/SPA PC
101-0000-42600
0.
$97.24
$0.00
PAID BY + ..,
. Y
M ETHOD -
': •RECEIPT#'
'CHECK# _�
CLTD BY'-,
Total Paid for POOL/ SPA:
•
$275.99
40
$0.00
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BuRding 8t Safety Dh&on
P.O Box 1504,78-495 Calle Tampico
La.QWnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: g2+� L
Owner's Name:
A P. Number C2w
Address: g2 L
Legal Description:
City, ST, Zip: [.-CAZZ
Contractor: o
Telephone:?
Project Description:
Address: -7(DS r ea
City, ST, Zip: L V Cp,
Telephone ,
State Lic. # . -7 City Lic. #:
t
Arch., Engr., Designer
Address:
City, ST. Zip.
Telephone:
Y
State Lia #: 3' y'y (D
Name of Contact Person:
Construction Type:. Occupancy: .
Project type (circle one): New Add'n Alter Repair Demo
Sq.'Ft.: # Stories: #Units
Telephone # of Contact Person: —72j5 9
1 Estimated Value of Project 47 -
APPLICANT:
APPLICANT: DO NOT WRITE BELOW THIS UNE
11
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Pian Cheek submitted
Dem Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Pians resubmitted..
Mechanical
Ginding plan
Z'j Review, ready for correc6ansJUM
(
Electrical
Subeostactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correcdonslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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= BPOL2014=1006,t Address: 79825 RANCHO LA QUINTA DR `Apn: 602220025' $359.40
ELECTRICAL'*
•$47.66;
DEVICES, FIRST 20 PC
101-0000-42600
0
$23.83
DEVICES, FIRST 20
101-0000-42403
0
$23.83
PLUMBING FEES
,
`$35.75
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$23.83
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$11.92
'POO L%.SPA =
�.
r a $275.99
SWIMMING POOL/SPA
101-0000-42404
0
$178.75
SWIMMING POOL/SPA PC
101-0000-42600
0
$97.24
FA
Date Paid: Tuesday, July 22, 2014
Paid By: DESERT OUTDOORS INC
Cashier: PJU
Pay Method: CHECK 1562
Printed: Monday, July 21, 2014 2:34 PM 1 of 1
CVCTF AAC