BPOL2016-0104a
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPOL2016-0104
T-,dy 4 4aumrw.
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: 55350 CHERRY HILLS
APN: 775170029
Application Description: JACKSON / POOL CONSTRUCTION
Property Zoning:
Application Valuation: $48,600.00
Applicant:
DESERT MIRAGE POOLS & SPAS JUL 14 0
84267 MIRAMAR COURT
!TAClffa LA, CA 92236 CITY OFLAQUINTA
rcot,!5IIJMTY DFJELOWENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATIO
I hereby affirm under penalty of perjury that I am licensed un r pro v" io of Chapter
9 (commencing with Section 7000) of Division 3 of the Busin s and rof ssions Code,
and my License is in full force and effect.
License Class: C53 License No.: 999928
Date: 1Z - / W - / (J Contractor: _401— ' f
-T7
OWNER -BUILD R DECLA ION
I hereby affirm under penalty of perjury th I am ex pt from the Contractor's State
License Law for the following reason (Sec. 7 1.5, siness and Professions Code: Any
city or county that requires a permit to const ct Iter, 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, avid 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/14/2016
Owner:
ROBERT and SHARON JACKSON
Contractor:
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT
COACHELLA, CA 92236
(760)702-9222
Llc. No.: 999928
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 thiflc for which this permit is issued.
Ive 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:
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 infor tion i rect.
I agree to comply with all city and county ordinances and state laws r I tin o b Iding
construct:on, and hereby authorize representatives of this city to e W u nth
above-mentioned property for inspection purposes,
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY :AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 7/14/16
PAID BY METHOD RECEIPT # CHECK # CLTD BY
DESERT MIRAGE POOLS & SPAS CHECK R17134 1224 RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID'
PAID DATE
GAS SYSTEM, 5+ OUTLETS
101-0000-42401
0
$36.26
$36.26
7/14/16
- PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESERT MIRAGE POOLS & SPAS
CHECK
R17134
1224
RSE
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
PAID
PAID DATE
GAS SYSTi M, S+ OUTLETS P1- "
101-0000=42600
0
$24.17
$24.17
7/14/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESERT MIRAGE POOLS & SPAS
CHECK
R17134
1224
RSE
Total Paid for PLUMBING FEES: $60.43 $60.43
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$181.29
7/14/16
- PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESERT MIRAGE POOLS & SPAS
CHECK
R17134
1224
RSE
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
`PAID DATE
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$98.62
7/14/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESERT MIRAGE POOLS & SPAS
CHECK
R17134
1224
RSE
Total Paid for POOL / SPA: $279.91 $279.91
TOTALS:
Description: JACKSON / POOL CONSTRUCTION
Type: POOL Subtype: Status: ISSUED
Applied: 7/13/2016 R$
Approved: 7/14/2016 r7CL
Parcel No: 775170029 Site Address: 55350 CHERRY HILLS LA QUINTA,CA 92253
Subdivision: TR 25397 Block:- Lot: 29
Issued: 7/14/2016 RSi
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $48,600.00 Occupancy Type: Construction Type:
Expired: 1/10/2017 R&£
No. Buildings: 0 No. Stories: 0 No. Unites: 0.
,..,. GMRONOLOGY TYRO ,.., ...,STAFF"NAVIE
Details: POOL, SPA, FIRE PIT, AND FIRE BOWLS AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE
EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA
BUILDING CODE.
1
0
Applied to Approved I
Approved to Issued
Printed: Thursday, July 14, 2016 4:56:45 PM 1 of 2 CR
SYS7Eh1S
ADDITIONAL
CHRONOLOGY
,..,. GMRONOLOGY TYRO ,.., ...,STAFF"NAVIE
ACTIdSATE C
NOTES
CONTACTED JERRY PEREZ. PLANS APPROVED AND READY
TELEPHONE CALL
DUANE CLAYTON
7/14/2016
7/14/2016
FOR PICK UP..- ."PLEASE PROVIDE 2 - 8.5X11 PLAN COPIES UPON
PICK UP.
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
P40NE
FAX
EMAIL
APPLICANT
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR
COACHELLA
CA
92236
(425)9735-8777
jerry78peez@gmail.co
COURT
`.^.
m
CONTRACTOR
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR
COACHELLA
CA
92236
(425)985-8777
jerry78peez@gmail.co
COURT
m
OWNER
ROBERT and SHARON JACKSON
17827 159TH AVENUE
WOODINVILLE
WA
98072
(425)985-8777
NE
Printed: Thursday, July 14, 2016 4:56:45 PM 1 of 2 CR
SYS7Eh1S
Printed: Thursday, July 14, 2016 4:56:45 PM 2 of 2
SYSTEMS
FINANCIAL
INFORMATION
CLTD
DESCRIPTION
ACCOUNT QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECit #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306 0
$2.00
$2.00
7/14/16
R17134
122.4
CHECK
DESERT MIRAGE
RSE
POOLS & SPAS
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00
$2.00
BSA:
GAS SYSTEM, 5+
101-0000-42401
0
$36.26
$36.26
7/14/16
R17134
1224
CHECK
DESERT MIRAGE
RSE
OUTLETS
POOLS & SPAS
GAS SYSTEM, 5+
101-0000-42600
0
$24.17
$24.17
7/14/16
R17134
12k4.
CHECK
DESERT MIRAGE
RSE
OUTLETS PC
POOLS & SPAS
Total Paid for PLUMBING FEES:
$60.43
$60.43
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$181.29
7/14/16
R17134
1224
CHECK
DESERT MIRAGE
RSE.
POOLS 8s SPAS
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$98.62
7/14/16
R17134
1224
CHECK
DESERT MIRAGE
RSE
PC
POOLS & SPAS
Total Paid for POOL / SPA:
IUIALS,
$279.91
$342.34
$279.91
$342.34
Printed: Thursday, July 14, 2016 4:56:45 PM 2 of 2
SYSTEMS
Bin #
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per 't #E
Project Address:
Owner's Name: C YDS`
A. P. Number:
Address:
Legal Description: U
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City, ST, Zip: L , Vx
Contractor: Dcc�F.A'
AlLoop
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hone•
Telephone:
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Address: b
Project Description: l S
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City, ST, Zip: a
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Telephone: one• (760 70 Z 2 Z
0
A
State Lic. # : e
Z ,�-
City Lie. #.:
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Arch., Engr., Designer:
Y&A d C1
Address:
City., ST, Zip:
Telephone:
Construction strut ion TY e• ecu
P Occupancy:
P Y:
State Lic.# -
Project type (circle ne • New Add'n Alter Repair r Demo
Name of Contact Person:
JCS
q. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 7 v
o zZ
Estimated Value of Project: 4 COO 2f
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
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 resubmitted
Grading
IN IiOUSE:--
Review, ready for correctionsrssuc
Developer Impact Fee'
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees