14-0261 (RPL)ri P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000261
Property Address: 52500 AVENIDA VELASCO
APN: 773-295-001- -
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 40000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING .PERMIT
--------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a 'licensed under rovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and rofe s Cod my License is in full force and effect.
License Class: C53 ansa 8149
Date: �� 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 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, 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 ownerof
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/11/14 R
Owner:
STOCKDALE, RONALD S
50885 WASHINGTON ST 2C
LA QUINTA, CA 92253 r
luContractor: I�ls�i� �� �!1i}
LAGUNA FALLS CUSTOM POOL/SPAS
P.O. BOX 2322 CITI�FO
INDIO, CA 92202 " UINRA
(760)347-8977
Lic. No.: 818149
WORKER'S COMPENSATIOWDECLARATION
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 NORGUARD INS Policy Number LAWCO10355'
_ 1 certify that, in the performance. the work for which this permit is issued, I shall not employ any
person in any manner so as tob come subject to the workers' compensation laws of California,
and agree that, if I should beco su Iecrt rs' compensation provisions of Section
Q 700 of the Labor Code, I shal orth itfSc . those provisions.
CDate: ✓ `f� 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 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 permi 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 inf mation is corre I agree to comply with all
city and county ordinances and state laws relating to building const r tion e u rize representatives
of this c unty to enter upon the above-mentioned property for ins cti ur as.
Date' /� / y Signature (Applicant or Agent):
Application Number . . . 14-00000261
PermitPOOL 2013
Additional des c*.
-Permit-Fee 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 9/07/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee . . . 194.48 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 40000
Expiration Date 9/07/14
Qty Unit .Charge Per
Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
4.00 14.3000 EA MISC WALL, ADDL 50 LF
57.20
1.00 47.1900 LS MI RET WALL <=12', IST 100'
47.19
3.00 14.3000 EA MI RET WALL <=121, ADDL 50'
42.90
-----,------------------------------------.----------------------
Special Notes and Comments
POOL AND SPA AT SIDE YARD WITH 140LF OF
51 -GARDEN W/3' RETAINING AT NORTH AND
WEST PROPERTY LINES, 10OLF OF 4' GARDEN
.W/2' RETAINING WALL AT SOUTH LINE AND
25LF.OF 4' GARDEN WALL FOR EQUIPMENT
ENCLOSURE [DENISE POELTLER ENGINEERING
AND ANGELUS BLOCK STANDARDS] THIS PERMIT
DOES NOT INCLUDE ALTERATION TO APPROVED
GRADING. ALARMS AND BARRIERS REQUIRED TO
BE INSTALLED'AT PRE -PLASTER INSPECTION.
2013 CALIFORNIA BUILDING CODE.
March 11, 2014 3:40:31 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
PLAN CHECK, POOL
97.24
PLAN CHECK, WALLS
120.12
Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fe"e Total 373.23 .00 .00
373.23
Plan Check Total .00 .00 .00
.00
Other Fee Total 219.36 .00 .00
219.36
Grand Total 592.59 .00 .00
592.59
LQPERMIT
Bin #
City of La Quinta
Building &r 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: S2 -se )e V t� '1.AAC0
Owner's Name: lea p C
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: /l/n�%�L1�1 -odLS
Telephone
Address: �( '� 0q tProject
Description: Now to,` d 4—
City, ST, Zip: 0/
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Telephone: 7p ��
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Arch., Engr., Designer.
Address: ;
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Telephone:
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on tru tlon TyPe•
State Lie.#
(circle one • New Add'n Alter Repair r Dem
Name of Contact Person: J ,� A 14
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ;j _2- •-�7 /
Estimated Value of Project: Ale, oo d ew
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APPLICANT:MO-R9T WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'
TRACKING
PERMIT FEES
Plan Sets
✓�
,Plan Check submitted
Item
Amount
Structural Calcs.
•���'
_
Reviewed, ready for corrections Of
Plan Check Deposit
Truss Cafes.
t
..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
Pians picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctio ssur
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
'
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BUILDING & SAFETY DEPT. ,ry d. .. r
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