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14-0587 (RPL)i P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/07/14 Application Number: 14=00000587 Owner: Property Address: 77450 CALLE TECATE EDWIN & SU FEI BURGOS APN: 774-293-025-12 -000000- 77450 CALLE TECATE Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: COVE ,RESIDENTIAL Application valuation: 6800 D A Contractor: A 0 v} 2014 Appli �flt: Architect or Engineer: L & D CUSTOM WORK MAY 0 84419 ROSAL AVENUE COACHELLA, CA 92236 CITY OF LAQUI4 (760)578-860,6' pINANCE OEiK Lic. No.: 814095 ------------------------------------=------------------------------------------------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed and provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Busin s and Professionals ode, 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 X License Class: B Li ense No.: 814095 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is —issued. Date:;/7//C/ Contractor: I have and will maintain workers' compensation insurance, as required by Section 3700 of the labor 7--F--F—Code, for the performance of the work for which this permit is issued. My workers' compensation 4qUILDER 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 STATE FUND Policy Number 9000594-2013' following reason (Sec. 7031 .5, Business and Professions Code: Anycity or county that requires a permit to _ I certify that, in the performance of the 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 become subject to th 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 sho ecome subject to the wo kers' 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 C e, shall forth it ply ith those provisions. 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)•: Dater Applicant: . . (_ 1 1, as owner of the property, or my employegs 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' COMPENSA N 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 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 am exempt under Sec. B.&P.C. for this reason Date: Owner: - CONSTRUCTION LENDING AGENCY A 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 the above information is correct I agree to comply with all pity and county ordinances and state laws relatingto building c s uction, and hereby uthorize representatives of this county to enter upon the above-mentioned property fo i ection p ose . Date/� Signature (Applicant or Agentl: --- _. t j_i �,- ir'��` .� �: _ s ' • )4_ , ? �' '—*c -,i • � , " t'': �,. -�� � ;� r„ _ �� tt � �� .. ,y. '�; �.• � Application Number • . . . . .. 14-00000587 Permit_ . POOL 2013 Additional desc . Permit Fee . . . . 178.75 Plan Check Fee .00 Issue Date . . Valuation . . . . 0 Expiration Date 11/03/14 Qty Unit Charge Per Extension 1.00 178.7500 EA MISC POOL/SPA ---------------------- : 178.75 . . . WALL/FENCE PERMIT 2013 Additional desc . Permit Fee 47.19 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 680.0 Expiration Date 11/03/14 Qty Unit Charge Per Extension 1.00 47.1900 LS MISC WALL, FIRST 100 LF 47.19 Special Notes and Comments INSTALL (2).WATER FEATURES, 30LF OF 68IN GARDEN WALL ON TOP OF'2-3FT HIGH RETAINING WALL, 15LF OF 5FT HIGH GARDEN WALL, 5.OLF OF 2FT HIGH GARDEN WALL AND (2) 16IN X 16IN COLUMNS PER ATTACHED APPROVED PLANS AND ORCO BLOCK'WALL DETAILS. 2013 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- 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 t Bin # City of. La Quin to Building 8L 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: .7 s-© Owner's Name: A. P. Number: Address: -�7 ( O Legal Description: City, ST, Zip: L6 Contractor:TeleP C hone: Address: q ul- <;qLProject Description: City, ST, Zip: CC� C('.l C'� / 4i*`� - / TeleP ho 6 o6 a State Lie. # : IR -0 'City Lie. #:. Gn I �/ 0 Arch., Engr., Designer: Address: City, ST, Zip: cn_ oTelePhne: 'Construction • Type: Occupancy:cY State Lic. #: Project type (circle one): •NewAdd n Alter Repair Demo Name of Contact Person:'U _ _ �R _. Sq. Ft.: # Stories: _ # Units: Telephone # of Contact Person:26-6-5A-=, i16 Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS LINE t! Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. f Reviewed, ready for corrections Plan Check Deposit " Truss Cal cs. 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 Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading . IN HOUSE: '"' 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