BPOL2014-100778-495 CALLE TAMPICO
4
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
1
BPOL2014-1007
81833 SUN CACTUS LN
764330025
POOL SPA FIREPIT EQUIP WALL
$32,000.00
Applicant:
DESERT OUTDOORS INC
78-065 MAIN STREET STE 205
LA QUINTA, CA 92253
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: C27. C53 License No.: 964474
Daf�
f te� y 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 no-, 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 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
Lender's
VOICE (760) 777-712 i
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/18/2014
Owner:
WEIBE BEN
81833 SUN CACTUS
LA QUINTA, CA 92253
Contractor:
DESERT OUTDOORS INC
78-065 MAIN STREET STE 205
LA QUINTA, CA 92253
(760)399-9600
Llc. No.: 964474
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
lSection 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.
Date 171 t�6 6i Applicant - 1/ 5 I
`J
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE_
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject tc
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to buildin;
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
Daae c4 Ly Signature (Applicant orAgent),:��
DCRIPTION''',° "`.
ES
••
4$A00OUNT "`"
•
wQTY , 'N7 .AMOUNT_T,,
- , :PAID U.PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
PAID BYMETHOD
. -
RECEIPT #
:`" ,CHECK # c`= CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $0.00
DESCRIPTION'`_ ~�".
; ACCOUNT;
;:QTY,=AMOUNT
`, 3
PAID r '+�;
'PAID. DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.19
$0.00
z PAID:BY�, =
METHOD r.. -
RECEIPT:# �.
CHECK # _
CLTD BY _.
DESCRIPTION' - _
'ACCOUNT s -
QTY
..
N.
AMOUNTS
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.06
$0.00
PAID,BY , ' ; '' S
f
x r + METHOD, ' "_
.RECEIPT # ,"`CHECK
#SCLTD
BY'
Total Paid forFENCE OR FREESTANDING WALL $107.25 $0.00
r
DESCRIFTION•'4
W
; - ACCOONT
QTY
; AMOUNT,
"� -
PAID '
_
;PAID'DATE'
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$11.92
$0.00
• ` PAID'BY
.,,METHOD ,;`.
`:r RECEIPT # �. may-
y CHECK# ,
CLTD BY
DESCRIP,.TION_
-ACCOUNT" , r�
:;QTY
{ PAID '"
' PAID DATE'
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$23.83
$0.00' '
PAID BY �.' }_::: Y
',z ;, METHOD , �; '
L RECEIPT #'
�' •_ ;CHECK #`.CLTD
BY�Ao
Total Paid for PLUMBING FEES: $35.75 $0.00
DESCRIPTIONyc ` -
ACCOUNTS _ z
QTY
�Y,
AMOUNT g
;
- PAIDT
PAID DATE:.
SWIMMING POOL%SPA
101-0000-42404
0
$178.75
$0.00
a a�'
PAI ,; .
> ; METHOD
sRECEIP.T #
.CHECK # of
CLTD BY" -
'"DESCRIPTION" ` �x
-t+.A00OUNT;€
'QTY
� AMOUNT-`
SWIMMING POOL/SPA PC
101-0000-42600
0
$97.24
$0.00
PAID BYE „$ ak+".'
y "- METHOD f #
, :-'RECEIP-T # a
n +CHECK #w+'
CLTD BY
Total Paid for POOL / SPA: $275.99 $0.00
TOTALS:0.00
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t.
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?a F- '3 .i a Tr? g'"z yr' �.r..1 z'c+;t• tw .'-' Fz .� .. Y;3 S
PermItTRAK e • _d �,, �, $420199
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`- BUILDING STANDARDS`ADMINISTRATION BSA o .^ ' h `" "` 2.00
$
h
BSAS 581473 FEE 101-0000-20306 0 $2.00
`"FENCE OR FREESTANDING WALL;:,. $1 5 .a
.07.2
add .�' y .,
l� s ,r� � "'
\.�Y:•E:I.AI •
r � t t:a�'� •
^V ® ' ,r!.y."C7� � .'t.� .s 4 • �
,ter = 5+� Ay
GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $23.83
GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $11.92
rr ;"x �r =:' s ` + *3 :.+, a fa z. aT x ,. '$275:99 -
u
SWIMMING POOL/SPA-PC 101-0000-42600 0 $97.24
SWIMMING POOL/SPA 101-0000-42404 0 $178.75
Q � • . , •y. I �T •' "'i .�'6'l
�! �.�Y L4 S���4'i'yi l !f �'^i $'`f1J i $ F i}�a�.i�'.' j'.• I .'.._
fid•
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-
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+
5i
t.
?a F- '3 .i a Tr? g'"z yr' �.r..1 z'c+;t• tw .'-' Fz .� .. Y;3 S
PermItTRAK e • _d �,, �, $420199
f` d j,
F
- , BPOL2014=1007- tApn 025iV ^ "T 420:99 .=�
rr=n. 4._-".3
.,76
.A. LLud: �dt.,. a �_. -. z :.:' .. ,�..a .. _ .�.. • _ r .. .: ..3:-.0
`- BUILDING STANDARDS`ADMINISTRATION BSA o .^ ' h `" "` 2.00
$
h
BSAS 581473 FEE 101-0000-20306 0 $2.00
`"FENCE OR FREESTANDING WALL;:,. $1 5 .a
.07.2
WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.19
WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.06
-.
' PLUMBING FE
r PLUMB
GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $23.83
GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $11.92
rr ;"x �r =:' s ` + *3 :.+, a fa z. aT x ,. '$275:99 -
SWIMMING POOL/SPA-PC 101-0000-42600 0 $97.24
SWIMMING POOL/SPA 101-0000-42404 0 $178.75
Q � • . , •y. I �T •' "'i .�'6'l
�! �.�Y L4 S���4'i'yi l !f �'^i $'`f1J i $ F i}�a�.i�'.' j'.• I .'.._
fid•
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d
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r
Date Paid: Sunday, July 20, 2014;
r !',
Paid By: DESERT OUTDOORS INC:
Cashier: SKH
Pay Method: CHECK 1559
Printed: Friday, July 18, 2014 2:09 PM 1 of 1
i
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504,-78-495 Calle Tampico
La.Qi inta, CA 92253 : (760) 777-7012
Budding Permit Application and Tracking Sheet
Permit #Y
0VA i I
Project Address: 8 �(�
Owner's Name: vi t E
A. P. Number.
Address: V I •2>7,)T)Sv S
Legal Description:
City, ST, Zip:l
UI Y
Telephone: C& ,.
Project Description:
Contractor: �� 'T �
Address: 7iOS 4�>r
City, ST, Zip: LA U CP,
Ek Ot7�—
Telephone• ,-3 40j
City Lie. 9.
State Lic. #:
Arch, Engr., Designer. L
Address:
City, ST, Zip:
Telephone:
3� Co :..
State Lie. #: ;� •, ...:<���'. �
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
# Stories: # Units:
Telephone # of Contact Person: 7
Estimated Value of Project 157-1 0
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted �'
,y
! 1 %
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Chcck Deposit
Truss Cafes.
U Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction _
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
rd Review, ready for eorrec ' sRssue
Electrical
Subcostactor 1st
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A, Approval
Plans resubmitted
Grading
1N ROUSE.-
'"° Review, ready for correctionsAnue
Developer Impact Fee
Planning Approval
Called Contact Person
A,LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
.( 3' INT.
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