BPLB2015-004278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
wyl D � � VOICE (760) 777-7125
v FAX (760) 777-7011
IMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/11/2015
Application Number:
BPLB2015-0042
Owner:
Property Address:
81413 COLUMBUS WY
T STAR III LLC
APN:
767690007
2030 E FLAMINGO RD STE 290
Application Description:
T -STAR 80 LNFT 1" POLY GAS LINE
LAS VEGAS, NV 89119
Property Zoning:
Application Valuation:
$300.00
Q
D
Applicant:
; j�R 1 1 2015
Contractor:
SCOTT POOLS
SCOTT POOLS
74 532 GARY AVENUE
QF LAQUWTA
74 532 GARY AVENUE
PALM DESERT, CA 92260
cm
COMMUNITY DEVELOPMENT OEPARTMEN
PALM DESERT, CA 92260
(760)275-7626
Llc. No.: 644723
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: D35, C53 License No.: 644723
Contractor:
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
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 I 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:
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.
Pite:�q (/,c �Sr2 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. ,
It /// d�sgnature (Applicant or Agent);
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY
AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $36.26 $0.00
TOTALS:00
Description: T -STAR 80 LNFT 1" POLY GAS LINE
CONDITIONS
Type: PLUMBING
Subtype: Status: UNDER REVIEW
Applied: 3/11/2015 PJU
Approved:
Parcel No: 767690007 Site Address: 81413 COLUMBUS WY LA QUINTA,CA 92253
Subdivision: TR 33076-2
Block: Lot: 15
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $300.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
PHONE
Details: 80 LN FT X 1 " PILYPIPE GAS LINE FROM POOL EUIPM ENT TO FIRE PIT LOCATED POOLSIDE PER APPROVED PLAN. 2013CBC
CHRONOLOGY
CONDITIONS
CONTACTS
.NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
SCOTT POOLS
74 532 GARY AVENUE
PALM DESERT
CA
92260
CONTRACTOR
SCOTT POOLS
74 532 GARY AVENUE
PALM DESERT
CA
92260
OWNER
T STAR III LLC
2030 E FLAMINGO RD
STE 290
LAS VEGAS
NV
89119
Printed: Wednesday, March 11, 2015 12:08:27 PM 1 of 2
N?�SYSTEMS
INSPECTIONS
--
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS
NOTES
PLUMBING FINAL*"
CLTD
DESCRIPTIONJ
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
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 for PLUMBING FEES: $36.26 $0.00
TOTALS:• •0
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS
NOTES
PLUMBING FINAL*"
Printed: Wednesday, March 11, 2015 12:08:27 PM 2 of 2
RWSYSTEMS
Bin #
Permit #
Project Address:,o� L�/
City of La Qurnta.
��� Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
�� 6 Owner's Name: �s
A. P. Number:
Address: 0- S j
Legal Description:
City, ST, Zip: eA3
Contractor: se
G s
telephone-
.240- 3 -Q (O
Address: , �S3
�� 6
Project Description:g2 C
City, ST, Zip:7 b22
SAZY,
eWQ
f
Telephone:
-225
.?> "E
r
State Lic. #: 09
Arch., Engr., Designer:
Address:
1 l _ %
City., ST, Zip:
Telephone:
State Lie.
"'A ^ % "'"':'-":::;'`'"`';`:"':`:::':
Construction Type: Occupancy:
oject type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project: - � el
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss C21eS.
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 Decd
Plans picked up
S•M•I•
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3'" Reyiew, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub: Wks. Appr
Date of permit issue
School Fees
Total Permit Fees