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BPOL2015-011978-495 CALLE'TAMPICO LA QUINTA, CALIFORNIA 92253 V TdT 4 .1� Qumrcu COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPOL2015-0119 Property Address: 79465 TOM FAZIO LN APN: 766032013 Application Description: DANIELS RESIDENCE / POOL & SPA Property Zoning: I certify that in the performance of the work for which this permit is issued, I Application Valuation: $60,000.00 Applicant: compensation laws of California, and agree that, if I should become subject to the VINTAGE POOL CONSTRUCTION workers' compensation provisions of Section 3700 the bor Code I shall forthwith 78755 DARBY RD comply with Tose provisions. BERMUDA DUNES, CA 92211 VOICE (767-7125 1 P�(1§6 7-7011 TIONS (76 07 7-7153 CITY OF LA QUINTA COMMUNITYDEVELOPMEP D Owner: JOHN DANIELS 79465 TOM FAZIO LN LA QUINTA, CA 92253 Contractor: VINTAGE POOL CONSTRUCTION 78755 DARBY RD BERMUDA DUNES, CA 92211 (760)722-3673 Llc. No.: 1002467 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of th iness and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. \ compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: C53 License No.: 1 467 \J of the work for which this permit is issued. �. t� I have and will maintain workers' compensation insurance, as required by 11 Date: Contractor: 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: OWNER -BUILDER DECLARA N Carrier: Policy Number:_ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 the bor Code I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with Tose provisions. Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 l of the Business and Professions Code) or that he or she is exempt therefrom and the Date: Applican 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (1 1, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or -improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (� I am exempt under Sec. . B.&P.C. for this reason 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. 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 Na Lender's Address: 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 ating to building construction, and hereby authorize representatives of this city to nter up the bove- mention ed p operty for inspection purposes. Date: Signature (Applicant or Agent). FINANCIAL INFORMATION DESCRIPTION '�?g ACCOUNT QTY AMOUNTd .. s� PAID �, PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $3.00 $3.00 6/11/15 .. PAID BY a � ` '� K � s .,� ._x .. "� METHOD `` rs .RECEIPT $I ' - r�z- CHECK # CLTD BY ^' VINTAGE POOL CONSTRUCTION CHECK R6974 1017 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA' $3.00 $3.00 %DESCRIPTION = i• ACCOUNT_. Nom.' :`QTY AMOUNT ' t `y , "PAID`g t` PAID DATE. SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 6/11/15 =PAID BY T µ . H METHOD' ;RECEIPT # CHECK # CLTD BY, _ VINTAGE POOL CONSTRUCTION CHECK R6974 1017 MFA DESCRIPTION � � COUNT �` QTY ',--',AMOUNT' . =. " P, "' AID PAID DATE' _.-.....-.- k pyAC . _ , - SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $98.62 6/11/15 PAID BY.; x- «�k METHOD j RECEIP.T # HECK ,;• C # " CLTD BY ,..= a VINTAGE POOL CONSTRUCTION CHECK R6974 1017 MFA' Total Paid for POOL / SPA. $279.91 $279.91 TOTALS: $282.91 $282.91 Description: DANIELS RESIDENCE / POOL & SPA Type: POOL Subtype: Status: ISSUED Applied: 6/9/2015 MFA Approved: 6/9/2015 KKI Parcel No: 766032013 Site Address: 79465 TOM FAZIO LN LA QUINTA,CA 92253 Subdivision: TR 27728 Block: Lot: 48 Issued: 6/11/2015 MFA Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $60,000.00 Occupancy Type: Construction Type: Expired: 12/8/2015 MFA No. Buildings: 0 No. Stories: 0 No. Unites: U Details: POOL & SPA ONLY. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. 2 �0 -Applied to Approved.. In Approved to Issued,.. _ _ . FINANCIAL INWRIVIA`I"ION .r Printed: Thursday, June 11, 2015 9:35:20 AM 1 of 2 SYSTEMS DESCRIPTION ACCOUNT, QTY AMOUNT PAIDm PAID DATE RECEIPT #, ...' CHECK - METHOD, - PAID BY. - CLTD _ BY BSAS SB1473 FEE .101-0000-20306 0 $3.00 $3.00 6/11/15 R6974 1017. CHECK VINTAGE POOL MFA CONSTRUCTION Total Paid for BUILDING STANDARDS ADMINISTRATION $3.00 $3.00 - BSA: SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29. 6/11/15 R6974 1017 CHECK VINTAGE POOL MFA CONSTRUCTION SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $98.62 6/11/15 R6974 1017 CHECK VINTAGE POOL MFA PC CONSTRUCTION Total Paid for POOL / SPA: $279.91 $279.91 TOTALS: ...... ....... ". ... T PARENT PROJECTS ATTACHMENTS Printed: Thursday, lune 11, 2015 9:35:20 AM 2 of 2 y , srST[Ms INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE I RESULT I REMARKS- NOTES FINAL" BLD ...... ....... ". ... T PARENT PROJECTS ATTACHMENTS Printed: Thursday, lune 11, 2015 9:35:20 AM 2 of 2 y , srST[Ms Bin # 0ty of La Quinta Building 8I' Safety Division bill P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # (r (yv Project Address: b Owner's Name: TELs A. P. Number: '2 (- Address: Legal Description: ' City, ST; Zip: 1 Contractor:Tele fit L P hone: ................. Address: Project Description: City, ST, Zip: m P /� Tele h ne o . W Z` State Lie. # : OblLiQ City Lie. #: Arch., Engr., Designer: Address:, City,, ST, Zip: Telephone: one: XX Construction Type: e• ccu Occupancy: Y P P Y: State Lie. # Prect Pa cir cleone: New Add'noJ Alter Repairair Demo Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: 0 U V V APPLICANT: DO NOT WRITE BELOW THIS LINE 4 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 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan2". 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 ROUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees . : I I . . I - 1- . __ , ,. ..._;,�,Ii:-H. -il p, ..., . , �:. ". " - , � ... ..:. ", � � �,.::li� ­.:. ­ .:., �4 1 . , , . . - .. � ,, ,�4.- , �'gj�_'.,_". ; " �. . � ;. .., , ; ... , �- .. : . ;�,V:m '� ... �,�,:r4vj�r -�., Mil 7.*.�l - - - : z - I .. � ." -, A . � - , I , I - . I -10- 11 I I -�,! - . . - ..,. -1 . . ., ... - , ,,'�� �".:� �-,.. �t % , * 1,�,,'�,�'j I � . . 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