BPOL2016-007878-495 CALLE.TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BPOL2016'0078
Propef-tyAddress:•
54339 SOUTHERN HILLS
APN:
775105051
Application Description:
CARMEN ERICSON / POOL
Property Zoning:
o
Application Valuation:
$44,000.00
Applicant:
DESERT OUTDOORS INC
IV
.'O
78065 MAIN STREET #205
p�
9
LA QUINTA, CA 92253
T4tw4XPQu;.rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice ed under provisions of Chapter
9 [commencing with Section 7000) of Division 3 of th Bnsdfessions Code,
and my License is in full force and effect.
License Class: C53 License No.: 964474
Date: I t Contracto . -
LDER DECI
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
CARMEN ERICSON
54339 SOUTHERN HIILS
LA QUINTA, CA 92253
Contractor:
DESERT OUTDOORS INC
78065 MAIN STREET#205
LA QUINTA, CA 92253
(760)399-9600
Lic. No.:.964474
� spate: .6/1/2016
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 or 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: Policy Number: _
I hereby affirm under penalty of perjury' that I am a empt 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 (S t . 7031.5, EPsiness 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 c • nstruct, ter, improve, demolish, or repair compensation laws of California, and agree that, if Is: du b e jest to the
any structure, prior to its issuance, also re fres a applicant for the permit to file a workers' compensation provisions of Section 3700 o the or o e, shall forthwith
signed statement that he or she is licensed pur uant to the provisions of the comply with thosr provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 1�p
3 of the Business and Professions Code) or that he or she is exempt therefrom and the Date: ` Applica
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 WORII
($500).:, AND SHALL SUBJECT AN EMPLOYER TC
(_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS I
compensation, will•do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVI
(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
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 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:
COMPE ATION COVERAGE IS UNLAWFUL,
J
NALTIES AND CIVIL FINES UP TO
ADDITION TO THE COST OF
CTION 3706 OF THE LABOR CODE,
APPLICANT ACKNOWLEDGEMENT {
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions'and restrictions set forth on this application. I
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 inf
I agree to comply with all city and county ordinances and state laws
construction, and hereby authorize representatives of this city to en
above-mentionedpropertyfor inspection purposes.
Date: I (� Signature (Applicant or Agent
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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 or 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: Policy Number: _
I hereby affirm under penalty of perjury' that I am a empt 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 (S t . 7031.5, EPsiness 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 c • nstruct, ter, improve, demolish, or repair compensation laws of California, and agree that, if Is: du b e jest to the
any structure, prior to its issuance, also re fres a applicant for the permit to file a workers' compensation provisions of Section 3700 o the or o e, shall forthwith
signed statement that he or she is licensed pur uant to the provisions of the comply with thosr provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 1�p
3 of the Business and Professions Code) or that he or she is exempt therefrom and the Date: ` Applica
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 WORII
($500).:, AND SHALL SUBJECT AN EMPLOYER TC
(_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS I
compensation, will•do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVI
(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
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 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:
COMPE ATION COVERAGE IS UNLAWFUL,
J
NALTIES AND CIVIL FINES UP TO
ADDITION TO THE COST OF
CTION 3706 OF THE LABOR CODE,
APPLICANT ACKNOWLEDGEMENT {
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions'and restrictions set forth on this application. I
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 inf
I agree to comply with all city and county ordinances and state laws
construction, and hereby authorize representatives of this city to en
above-mentionedpropertyfor inspection purposes.
Date: I (� Signature (Applicant or Agent
FINANCIAL, INFORMATION,
ACCOUNTr
QTY'
AMOUNT "zf„e,
PAIDF
PAID DATE
.Ir i'DE$CRIPTION
VIA
€.d x...
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
'BY r -x
r a .� ti �M
{' a ECEIPT # `$sad
CHECK #
CLTD BY A
-PAID
g pETHOD � ;,
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00
��rDESCRIPTIONY'��M'”
g "�;,yrACCOUNT,x,QTY
AMOUNT':Swp�
PAID "x
PAID DATE-'
q`x',
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
Y '� PAID:BY3`�
METH.OD�4RECEIPTs#
4$aCHECK#
"`'CLTpBY
E
J.
��;
"P;
i DESCRIPTION'S fe ,
`ACCOUNT +E
QTY
AMOUNT
_
PAID DATE
:;
.,
.PAID F
IN
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
METHODR��
RECEIPTS#'
CHECK #
�4 CLTD BY
;
Total Paid for PLUMBING FEES: $36.26 '$0.00
&DESCRIP.TION ,$ s%ACCOUNT,`
PAID.'
'OATE
SWIMMING POOL/SPA
101-0000-42404
0,
'$181.29
$0.00.
PAID! BY e
METHOD
� #ice
CHECK # E'
CLTD BYE
x
rRECEIPT
�rk�DESCRIP„„TION
�a
a ` UNT a
A D
PAID:;DATE
,°ACCOUNT :''QTY
a ..:.o.r ...
:AMO
r
SWIMMING POOL/SPA PC
101-0000-42600
0 •
$98.62
$0.00
METHOD
° RECEIRT,# {` 5
r `CHECK #
=CLTD BY
€ s
f
'”
Total Paid for POOL / SPA: $279.91 $0.00
TOTALS:••
Description: CARMEN ERICSON / POOL
Type: POOL . Subtype: Status: APPROVED -CONDITIONS
Applied: 5/25/2016 RSE
Approved: 5/26/2016 BHA
Parcel No: 775105651 Site Address: 54339 SOUTHERN HILLS LA QUINTA,CA 92253,
Subdivision: TR 22432-2 SEE ASSESSORS MB 769/43, Block: Lot: 6
Issued:
FOR CMS
5/26/2016
Lot Sq Ft: 0 _. Building Sq Ft: 0 . , Zoning:, . • _ _ _ '
Finaled: - _ -
valuation: $44,000.00 Occupancy Type: Construction Type:
Expired: ,
No. Buildings: 0• No. Stories: 0 No. Unites: 0'
Details: POOL (36'-9"X14'-6" W/ SPA (7X7) 400,000 BTU HEATER (1.5 INCH GAS PIPING. THIS PERMIT DOES NOT INCLUDE FIRE PIT OR EXIST.
BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. (ENGINEERING; DENISE POELTLER).
t
- Applied to'Approved'
Printed: Wednesday, June 01, 2016 9:34:52 AM 1 of 3 syszrMs
-
NOTIFIED JOHN THAT PERMIT IS APPROVED. ENGINEERING
TELEPHONE CALL BURT HANAOA
5/26/2016
5/26/2016
-
SHEET IS REQUIRED PRIOR TO PERMIT ISSUANCE.
• •
P ,: N..
..d,G. S d .5 ATE--r-1-DATE
CONDITION DATE
4 2i+'" 7",,
us
..-; s E
,_':;.,CONTACT e a, STATUS "`
•
REMARKS.: Y� s"NOTES£
TYPE ADDED :.. REQUIRED ;SATISFIED -.
,
READY TO ISSUE
- ENGINEERING SHEET BY DENISE POELTLER
BURT HANADA 5/26/2016 5/26/2016
6/1/2016 COMPLETE
CHECKLIST
-
REQUIRED PRIOR TO MPERMIT ISSUANCE.
NAME TYPE
i
NAME +; f .:CITY
S?ATE ZIP'S. :PHONES `* FAX,
;:�ADDRESSi
.i:, .�� ^a.:vx4A$'..3'u'y 5..i ..--i'+i+w y... :n
q..
t h.'.'iL-k^.%. i4Mti
APPLICANT.
DESERT OUTDOORS INC 78065 MAIN STREET LA QUINTA
CA 92253. (760)399-9600
#205
CONTRACTOR
DESERT OUTDOORS INC 78065 MAIN STREET LA QUINTA
CA 92253 (760)399-9600
#205.
Printed: Wednesday, June 01, 2016 9:34:52 AM 1 of 3 syszrMs
........... ............ ...........
... - . '. . - ..� I ... ...........
......... . ....... .. ...... .. ... . II II'
.......... ........... . ... ... .. .. ..
........ .. . TARENTPROJECTS
. . .... . ............. . ...... ............ . .... . .. ........ . ....... . ........... . .. .... .
I ,H. ...... .. . .. ..... INFORMATION
. ........ . Y ................ P�11!.."' 11. 161.1hY .. . ........... ....................... 'mq
. ....... . 11 ml t I � , "' '.. . ... ...; � IM1
1. . . . . . I 'N ........... ... U.; . . . .. I. ) A
Printed: Wednesday, June 01, 2016 9:34:52 AM 2 of 3
c§?w.1YSTrMS
.............
FINANCIAL INFORMATION
'7777777r-77-;=
'i:QTY-
PAID, PAIDPATE.
LTD.�
CEIPT'#7.', CHECK METHOD�
—_DESCRIPTION
BSAS SB1473 FEE
101-0000-20306
.0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00
-$0.00
BSA:
GAS SYSTEM, 1-4
.
101-0000-.42401
0
$12.09
.$0.00
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
01
$24.17
$0.00
OUTLETS PC
Total Paid for PLUMBING FEES:
$3616
$0.00
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00,
SWIMMING POOL/SPA
101-0000-4269*0
0
$98.62
$0.00,
PC
Total Paid for POOL SPA:
$279.91
$0.00
....... ...
TOTALS:
$318,17,
. .. .....
........... ............ ...........
... - . '. . - ..� I ... ...........
......... . ....... .. ...... .. ... . II II'
.......... ........... . ... ... .. .. ..
........ .. . TARENTPROJECTS
. . .... . ............. . ...... ............ . .... . .. ........ . ....... . ........... . .. .... .
I ,H. ...... .. . .. ..... INFORMATION
. ........ . Y ................ P�11!.."' 11. 161.1hY .. . ........... ....................... 'mq
. ....... . 11 ml t I � , "' '.. . ... ...; � IM1
1. . . . . . I 'N ........... ... U.; . . . .. I. ) A
Printed: Wednesday, June 01, 2016 9:34:52 AM 2 of 3
c§?w.1YSTrMS
PermitµDetails .k'-Y4,-PE-RMIT:NUMBER���
6Gty of La Quanta �" :� _� , :B.POL2U16-U�78 M
a' J4'� .*. ^�.� _ a._;f:. _:.,. < ..rte °n.+a'"k.....•F ` '::���'*� �._.x. '
v
,fi,.ATTAGHMENTS .,. �.,.•.,, .,� ..,
I
Bin #
City of La QuInta
Bulkilils &r Safety Division
P.O. Box 1504,78-495 Calle Tampico
L3,Qdnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
011111
Permit #
L OL-,�Lo I
L—
Project Addf=: -�LP3±1
TRACING
--
Owner's 11 Name: CA -61-21 C cp
Add 53UT+(o(44 -M I LL�
A. P. Number.
Legal Description:
City, ST, Zip: LAV I 11�2261T I
!!-P,*
Contractor. TF-Cjm--T
Item,
Telephone: - MIN=
Project Description: NCO -'2L- I SAA
Address: -Mc)( 45
�"-S-W 1:&�5
City, ST, Zip: L
Reviewed, ready for corrections
Telephone- -AQ-3M.
%z�
State Lfc. #: LOA
City Llc. #,
Called Contact Pawn
Arch, Engr-, Designer.
Plan Check Balance
Address:
Mde 24 Pales.
NALY, 0 9, "F,.
Telephone:
State Lic. M
Name of Comet Person:
Telephone # of Contact I
Construction Type. OCC*UPWIW:
Construction
Project We (circle one): , Now Add1n Alter Repair Demo
Sq. FL: -it Stories: # =Unit%
Estimated Value of Project I LA oc>:,—>
AEM lNAkrr. fto%
N
ESubmittal
'd
11 -ted
TRACING
PERMr FEES
plan sets
Plan Check submitted
Item,
Amount .
Structural CAlM
Reviewed, ready for corrections
Pin 6tck Deposit
Trus Cates.
Called Contact Pawn
Plan Check Balance
Mde 24 Pales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
mccoahicai
Grading pian
r! Review, ready for vorrectiousnow
Mectritai
Subcontattor Lin
Called ConractPergon
Plumbing
Grant Deed
H.O.A. Approval
11
Plans picked up
Plans resubmitted
&SLL
Grading
Review, ready for corrections&soc
Developer Impact Fee
Planning Approval
Called Contact person
AIP.P.
Pub. Wks- Appr
Date of permit issue
School Fees
FT—
I Total Permit Fees
I
FOR PERMIT0 01
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