14-0228 (RPL)ced!t 4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA' 92253 BUILDING & dETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/04/14
Application Number: 14-00000228 Owner:
Property Address: 78645 CARNES CIR TAJCHMAN JOSHUA R
APN: 604-223-026-69 -23268 - 78645 CARNES CIR
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
P;F1NA,t1qCE
Application valuation: 25000
Contractor: MAR 0 c; 2014Applicant: Architect or Engineer: VACATION POOLS INC
P.O. BOX 10940
INDIO, CA 92202 ITY OF LA QUINTAp��i�G(760>77.: 856pEPT.
I Lic. No.: 856835--._T1-
------------------
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 Professionals Code, and my License is in full force and effect.
License Class: C53 Licen NoI.: 856835
pate: ^ Contractor: N �/
OWNER -BUILDER DECLARATION
1 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 Icommencing 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).:
1—) 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 _ 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.).
(_ 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
--------------- - - -
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 STATE FUND PoI' Number 1948584-2013
_ I certify that, in the performance of the ork for which this permit is issued, I shall not employ any
person in any manner so s to beco a subject to the workers' compensation laws of California,
and agree that, if I sho become bject to the workers' mpensation provisions of Section
L 3700 of the Labor C e{l all f hwith comply Lose provisions.
00 Date. _ I a� Applicant:
WARNING: FAILURE TO S WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER 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 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 Mand void if work is not commenced
within 180 days from date of issuance of such permit, c sation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the infor tion is correct. 1 agree to comply with all
city and county ordinances and state laws relating to bui in construc on, and hereby authorize representatives
of this yquntyto enter upon the above-mentioned prop or inspe on purposes.
Date:,'//dv//% _`/�/ Signature (Applicant or Age
Application Number . . . . . 14-00000228
Permit . . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 8/31/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . WALL/FENCE PERMIT 2013
Additional desc . .
Permit Fee 47.19 Plan Check Fee
.00
Issue Date . . Valuation . . .
. 25000
Expiration Date 8/31/14
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
-----------'-----------------------------------------------------------------
Special Notes and Comments
POOL ONLY AT REAR YARD WITH EQUIPMENT
ENCLOSURE WALL (POOL ENGINEERING INC]
THIS PERMIT DOES NOT INCLUDE FIRE PIT,
BBQ OR HEATERS. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2013 CALIFORNIA BUILDING.
CODE.
March 4, 2014 9:20:56 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24
PLAN CHECK, WALLS
60.06
Fee summary Charged Paid Credited
---------------------------
Due
------------------------------
Permit Fee Total 225.94 .00 .00
225.94
Plan Check Total .00 .00 .00
.00
Other Fee Total 158.30 .00 .00
158.30
Grand Total '384.24 .00 .00
384.24
LQPERMIT
Din # G
City of La Q uin taR E C E IV E
Building 8t• Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 MAR 0 3 2014
Permit Application and Trackin Sheet
Q11- ITAITA�
Permit #
`!JBuilding
Proje6A
ct Address: `-'l �� �� {rN'�S
Owner's Name: Tq - DEVELOPMENT
A. P. Number: C
Address:
Legal Description:
City, ST, Zip:
Contractor: � Q CQ +�6 I.J %,tip S
Telephone:
Address: po Qd T q()p
Project Description:
City, ST, Zip: ` O (� i a-ON6
It YYl n'(e lq c,
Telephone: ?(oQ, -7% j - O
....................................................
State Lic. # : 5- 6? 873
City Lic. #..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
"'>'' z:;>e,>-'>.."'°"" "` '"
.....................................
............
Construction Type: Occupancy:
State Lic.
Project type circle one) ew Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
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 Calcs.
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
tad 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 HOUSE:-
'"' Review, ready for correction issu
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
:%qZ
'7 jq u t 4 — ?OOL, hA%---i a4" ip I I%;
PA
PA
PA
y-
\ with Umbrella Sleeve
PA
Mini Bobcat Access
this side
TAJ�HMAN
RE51 DENGE
,
VACATION POOLS, INC..
P.O. Soot 10000
Miw
New Pool Egyipment00 FE11
ML (7" 7M44M FWV" 7MS
with Sound Wall
Options I zr
\ Heater so
New Concrete Decking
648 sq,. ft.
xisting Covered
Patio to remain
Existing Gas and
Electric this side
PA
NOTE:
Landscape elements (Trees,
Shrubs, Vines and Lawn) and Patio
Furniture shown for illustration only.
Unless by separate bid.
CITY OFLA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE :OI IB
CONTRACTOR cannot assume
responsibility for damage to curbs,
sidewalks, driveways, cement slabs,
sewers, lawns, trees, fences, retaining
walls, sprinklers, wires, valves,
telephone or shrubs.
When access is made through a
neighbor's property it is understood
that you, the owner, have that
TAXHMAN RE5IDENCE •
neighbor's permission and assume full
i8-645 CARNE5 CIRCLE
responsibility.
LA QUINTA, CA Q2255
DATE 516NATURE
DATE: 02.26.14 REVI5ED: