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13-1619 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001619 Property Address: 79960 TANGELO APN: 772-230-022- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 68000 a9ml Tilyx VOICI (760) 777-7012 44 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 Applicant: Architect or Engineer: BUILDING PERMIT -------------------------------------------------- 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. Licens lass* C8 C10 P33 License No.: 891048 Date: / 7 7 l� 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).: (_ 1 1, 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. , BAP.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 Date: 12/19/13 Owner: ODENBAUGH, KEVIN 79960 TANGELO LA QUINTA, CA 92253 A D Contractor: DEC 1 2013 UNITED STATES POOLS. CORP TION 4190.5 BOARDWALK STE P CITY OF 5ROUINTA PALM DESERT, CA 92211 FINANCE DEPT. (760)674-9700 Lic. No.: 891048 -—————————————————————————————————————————————— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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. 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 ACE AMERICAN Policy Number WCLC47116219 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 �L/ iof th� or'Code, I shall. forthwith comp) ith those Provisions. ate: A Dpplicant: 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 persue uyun whose behalf this application is mode, tach 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 andstate 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 count to ter upon thea e -mentioned property for inspection purposes. Date:/� Signature (Applicant or Agent): Application Number . . . . . 13-00001619 Permit . .". POOL 2013 , Additional desc . Permit Fee . . . . 178.75 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 6/17/14 ' Qty Unit Charge" Per Extension 1.00 178.7500 EA MISC POOL/SPA --------------------------------------------------------------------- 178.75 -- Permit . . PLUMBING -2013 Additional= desc FIRE PIT Permit Fee . . . . 11.92 Plan Check Fee'. .00 Issue Date . . . . Valuation'.. 0 Expiration Date 6/17/14 Qty. Unit Charge Per Extension 1.00 11.9200 LS PLBG GAS SYS,.174 OUTLETS - 11.92 ---------------------------------------------------------------------------- Special Notes and Comments POOL, SPA, AND FIRE PIT AT REAR YARD [JOHN HACKER ENGINEERS] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. December 16, 2013 12:56:26 PM AORTEGA ---------------------------------------------------- ---------------------- Other Fees . . . BLDG STDS ADMIN (SB1473) 3.00 PLAN CHECK, POOL 97.24 PLAN CHECK, PLUMBING 23.83 Fee summary Charged Paid Credited Due -------------- Permit Fee Total 190.67 .00_ .00 1.90.67 Plan Check Total .00 .00 .00 .00 • Other Fee Total 124.07 .00 .00 124.07 Grand Total 314.74 .00 .00 314.74 LQPERMIT p DIA# y s Tifit_ City of La Quin to RECEAJ Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico DEC 0 9 2013 La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking SheMy IF L4Me Permit # Project Address: Q�V Qh (� Owner's Name: <ev j n A. P. Number: Address: 7f /C) %4 l C7 Legal Description: City, ST, Zip: //--//'' �p Contractor: 00CA .S7' 4S r QO/3 Telephone: % V 27A 87 TCO Address: 011 5 004rZ► &4%11c 1-11) Project Description: A Cw A01 r q City, ST, Zip: 441 Pejtr4- C,4-9 C�Cr` w� MG A - Telephone: ;?&o Y72Y G $ T s State Lic. # : 91/4D41e City Lic. #: Arch., Engr., Designer. U A— Address: 77k1Z) Zdrs AT /f 4.s Ita. City.; ST, Zip: Telephone: (pi% 3Yr 3 ::;s.# :<s: <x>::>;>r<:< .<.::: >> : r:>;:<<,:::<:r.::s::>>>::: == :<::##<:r:;:->::>;•::;:::;>;>;�•:>:;< Construction Type: Occupancy State Lic. #: yG 7 . Project type (circle one): New Add'n Alter Repair Demo Sq. Ft :# Stories: # Units: Name of Contact Person: Y&% �.� ttr Telephone #,of Contact Person: 7&67 Estimated Value of Project: S' ®'© APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES a Sets '� Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calls. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: ''J Review, ready for correctio s sue 111%J0117 Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees ►Z'lo�let'j -- P -FC. C�A6tllleut R•��11�%a) 3 IQ.s�oy � Iss�c w� u VQ