BPOL2015-0112 Revision 1r rVOICE (760) 777-7125
78-495 CALLE TAMPICO V. 7 Qum&
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENTDEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT"
Date: 8/11/2015
Application Number: BPOL2015-0112• Owner:
Property Address: 44640 CALLE SANTA BARBARA BENJAMIN VANSKIKE
APN: 604381004 44640 CALLE SANTA BARBARA
Application Description: VANSKIKE RESIDENCE POOL & SPA I,P.;- LA QUINTA, CA 92253
Property Zoning: �Ev LS t 6 P
Application Valuation: $18,000.00
Applicant: Q Contractor:
MCRAE POOLS & SPAS D 4r -IA MCRAE POOLS & SPAS
79 105 DESERT STREAM DRIVE 79 10S DESERT STREAM DRIVE
LA QUINTA, CA 92253 AUG 1. LA'QUINTA, CA 92253
CITYOFLA OUINTA (760)774-6343
COMMUNITYOEVELopui:krr,�..—.._.- Llc. No.: 823017
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: C53, C27 License No.: 823017 11 r
/12 V./
Date: � � /� � is Contractor: 411 C. 0
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'Divisio
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 a
permit subjects the applicant to a civil penalty of not more than five hundred dolla s
.($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'Licerise, 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 Profession's 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.V.C. for this reason
Date:
Owner:
CONSTRUCTION LENDINCrAGENCY
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:
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'inany 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.
Dte:, Applicant: �—
J
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. Eikh,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.an.d 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.
ate: F A( ��! :Signature (Applicant or Age —
zuQF`e3a?" xv `Y.i, PM Js !':k iia: 1"F,�.. ,k� #£}5. y. :..e�""T�aK .. `,.-••^u" u R .f{ F yelj
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Description: VANSKIKE-RESIDENCE POOL & SPA
Type: POOL Subtypp: ISSUED
Applied: 6/2/2015 MFA.
;kpproved:,6/2/1015 KKI.
Parcel ,'No::_6-0z43810 . 04- S1ieAdclress.:44640 CALLE SANTA BARBARA.LA QUINTACA 92253.
Subdivision:. R 25953 Block...Lot: .12
issued:"04/2015 SlIH_
Lot Sq. Ft: 0. Building Zoning:
qFt,,C)
Final6d:...
Valuation:$18,000bd• Occupancy Type, Construction Type:
Expired: li,O/?016:cm
. Z
No: Buildings: 0 No: Stbries:.0 No. Unites: 0
Details. 'POOL,SPA, & FIRE Pit. EQUIPMENT'SHALL.,BE INSTALLED L.,,IN,��CC-.ORDANCE-,WITH MANUFACTURER R SPE ALARMS -AND
BAR'RIERSREQUIRED-Ti) BE INSTALLED � AT*PRE-PLASTER INSPECTION` *iOi3,C-A'LI'VORNIA.,BUILDING.CODE. .. -
-7
, FIRE PIT/ OUTLET NOT INCLUDEWN, ORIGINAL PLAN. OBTAIN SEPARATE PERMIT OR SUBMIT. REVISION.
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APPLI �ANT MCRAE�.�,OOLSSPA
MCRAE POOLS,&-SPA.S
•
DRIVE
'BENjAmIN VANSKIKE 44640 CALLE SA:NTA LA QU iN�TA ®®i
BARBARA
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5, 1-'FINANCIA 11IFFINFORMATIONSM, "'.g— .0 121 �,,,?W q,
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DESCRIPTIO
ACCOUNT-::�!:i!:
AMOUN T
RECEIPT
BY
BSAS'SB1473 FEE
101-0000-20306
0
$1.00
$1.00
6/4/15
R6781
6358
1 CHECK
IMCRAEPOOLS&SPAS1
SKH
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
Total Paid forPLUMBING FEES:
$36.26
$0.00
SWIMMING POOL/SPA
101-0000-42404
0
$181.29.
$181.29
6/4/1S
R6781
63S8
CHECK
MCRAE POOLS& SPASI
SKH
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$98.62
-6/4/15
R6781
6358
CHECK
MCRAE POOLS & SPAS
SKH
PC
Total Paid for POOL SPA-
$279.91
$279.91
ECTION TYPE
SEQID, INSP —IIYSPECTOJR-
COMPLETED
RESULT.
REMARKS
[SCKDOILED.
DATE
DATE
FINAL"
BLD
FIRE PIT/ BBQ OUTLET NOT INCLUDED IN
UNDERGROUND GAS
JFU
6/22/2015
6/22/2015
APPROVED
ORIGINAL PLAN. OBTAIN SEPARATE PERMIT
OR SUBMIT REVISION.
UNDERGROUND PLBG
JFU
6/22/2015
6/22/2015
APPROVED'
PRE-GUNITE
JFU
6/22/201S
6/22/2015
APPROVED
DECK BOND
KKI
7/24/2015
7/24/2015
AP PROVED
Printed: Tuesday, August z1,2D1S4:25:42PIA 2of3
Bin #
City of La Quinta
Building &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:1/0
t
Owner's Name:Ll 444s'
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:Project
Description: , t
City, ST, Zip:
Telephone:
.......................................................
State Lic. # : Z . ('
City Lie. #•:
Arch., Engr., Designer:
Address:
YPZ 1 7�
/
City., ST, Zip:
Telephone:
hone:
Con tr uction Type: anc
O ccu Y:
P
State L ic. #:
Pd'n
Alter Repair Demo Ject type (circle one): New Ad
Name of Contact Person: —_
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 6 •� .� Y- 6 J J
; Estimated Value of Project: '^ wv
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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 Cales.
Plans picked up
Construction
Flood plain plan
7PIans 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 HOUSE:-
"d Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
3'
3
71
3
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE /� � gy