13-1651 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001651
Property Address: 46590 CAMEO PALMS DR
APN:. 643-182-010- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Applicant:
T4hf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
Owner:
NATIONAL ALLY TRUST 1643182009
16033 BOLSA CHICA ST. #104-154
HUNTINGTON BEACH, CA 92649
Contractor:
LAGUNA FALLS CUSTOM POOL/S
P.O. BOX 2322
INDIO, CA 92202
(760)347-8977
LiC. No.: 818149
Date: 12/23/13
DEC j3�L8
CITY OF LA QUINTA
FINANCE DEPT
----------------------------------------------------------------------'---------------------------
CENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury the I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 70001 of Division 3 of the Business nd Professionals Code and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cl ss: C53 i 8149
)K, Date: I� Contractor:
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier NORGUARD INS Policy Number LAWC010355
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance othe work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to b ome subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become ubject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall f?Atiwith comp) se pro
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).:
Vale: 1- Z} �7 Applicant:
(_) 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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(sl licensed
pursuant to the Contractors' State License Law.).
(_ 1 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
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 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 theation is correct. I agree to comply with all
city and county ordinances and state laws relating t�buildkingstruc representatives
of this cou tyt enter upon the above-mentioned prn pur ses.
Date: 3 i 3 Signature (Applicant or Agent):
Application Number . . ... . 13-00001651
4
Permit . . . POOL 2013
_
Additional desc .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 6/21/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
----------------------------------------7-----------------------------------
Special Notes and Comments
POOL REMODEL W/SPA ADDITION AT REAR YARD
INCLUDING RELOCATION OF EQUIPMENT AND
ABANDONMENT OF EXISTING EQUIPMENT PIT
[DENISE POELTLER ENGINEERING] THIS
PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. ALARMS AND BARRIERS REQUIRED
TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2010 CALIFORNIA BUILDING
CODE.
December 23, 2013 8:21:05 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24
Fee summary Charged Paid Credited
-
Due
---------------------------------------------------------
Permit Fee Total 178.75 .00 .00
178.75
Plan Check Total .00 ..00 .00
.00
Other Fee Total 98.24 .00 .00
98.24
Grand Total 276.99 .00 .00
276.99
LQPERMIT
;
Bln.#
City. of U Quinta
Bulldog 8r Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: SCID Ca (yam . tL • yL
Owner's Name:.
A. P. Number.
Address: iib S%!7 �Ce/yU10 G�tn't Gr`'
Legal Description:
City, ST, Zip. L ( CA-
A
Contractor.
Contractor. LA-CJ1 NP f:A L L(r �pp `S
Telephone:
Address: k 7 3 6 ea /it 2
Project Description: &l„c) CA ---J �r- l %-r2- G' f
City, ST, Zip: A G( (a t A 9 220!
Telephone: 16o 3 '77:
_f ` f,. -_
D Q24, fl.4 zi I0
State Lic. # :
on �`rrti, P 6
Arch-, IW., Designer. rl)IN�
'Ala hl
Address: 777Zf- k Ffez- 44j
City., ST, Zip: &IoL L //
t T /J4J- a6L3
Telephone:
State Lic. #: ��Zja� f `::u
Name of Contact Person: Jokil,%q/:i
Construction Type:. PL.0 Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Valine of ProjectJ%1,.5000—
.5Q 0APPLICANT:
APPLICANT:DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG PERMITFEES
Plan Sets
/
Plan Check submitted. ((-tItem Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Coles.
Called Contact Person Plan Check Balance
Title 24 Calm
Plans picked up Construction
Flood plain plan
Plans resubmitted.'. Mechardeal
Grading plan
2" Review, ready for correctionsPrssue Electrical
Subcoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALL
H.O.A. Approval
Plans resubmitted Grading
AV HOUSE:-
'^' Review; ready for correctio eloper Impact Fee
Planning Approval
Called Contact Person .LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
r
UWKAcaaLi U4/eZ CO. 604
DEC 17 2013
CITY OF. LA QUIN -:A
COMMUNITY DEVEL CIPMETIT .
Existing +5' Wall
Existing +5' Wall
NEW 6'x8'spa
at zero elevation
21 ft.
NEW 6'x 8' Tanning Shelf
at -9" to match first step.
New 20' ft ill
Gas Line
Existing
Gas Meter
Existing 5' Self Closing
Self Latching Gate
0
EXISTING POOL
CITY O
BUILDING
E Demo floor, Filling
Existing and aboandoning
Equip Pit existing equipment pit.
Installing New Skimmer
Raising Floor from 8' to 6'
® & Split Main Drains
13.1661 ® ^ 28 ft. 8 In.
QUINTA
=E -W -DEPT.
STRUCTION
I DATE 12 '
m
Pop., ft4,U4tff --
EXISTING PATIO COVER
EXISTING RESIDENCE
"2m
l
Existing +5' Wall
— Electrical Main Panel
`l
a
,G
i
r
f
-r
f
Existing 5' Self Closing
✓elf Latching Gate
IN
4