BPOL2016-012278-495 CALLE TAMPICO
TwIt 4 4 QuIAS
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Nur ber: - BPOL2016-0122
Property Address: 80105 VIA CAPRI
APN: 777100063
Application Description: WEIR / (2) WATER FEATURES AT SIDE AND REAR YARDS
Property Zoning:
Application Valuation: $7,500.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
MICHAEL AND SUELLEN WEIR
817 ANDERSON LANE
SEWICKLEY, PA 15143
Date: 9/2/2016
Applicant: Contractor:
AZURE POOLS & SPAS INC D AZURE POOLS & SPAS INC
P 0 BOX 10641 P 0 BOX 10641
^,L^'1 ^rSFRT;.CA?2255:1
SE? L' 2016 PALM DESERT, CA 92255
CITY OF LA QUINTA (760)322-7665
COfaIAUtvJTYDDJELOP?JEN`TDEPkKkiENT Llc. No.: 802919
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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: C53 License No.: 8029
Date;.O C6—ntractor-
OWNER-BUILDER DECLARATION
I hereb affirm under enalt of er'u that I am exem t from the Contracto ' St t
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 r 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number:
Y p 7 p 1 rY p r s a e
VyY
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any I certify that in the performance of the work for which this permit is issued, 1,
city or county that requires a permit to construct, alter, improve, demolish, or repair shall not employ any person in any manner so as to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for the permit to file a compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division comply with those provisions.
3 of the Business and Professions Code)"or, that he or she is exempt therefrom and the e
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a c Date: ' I A"pplicanY:• VVV��f--^--"'
permit subjects the applicant to,a civil penalty of not more than five hundred dollars
($500).: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
(� I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES.
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:
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.
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.
CONSTRUCTION LENDING AGENCY I I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of thndtyto enter upon the
above-mentioned property for inspection purposes.
Lender's Name:
�: Signature (Applicant orAgent
Lender's Address:, _=---
Date: 9/2/2016
Application Number: 8POL2016-0122
Owner:
Property Address: 80105 VIA-CAPRI
MICHAEL AND SUELLEN WEIR
APN: 777100063
817 ANDERSON LANE
Application'Description: WEIR / (2) WATER FEATURES AT SIDE AND REAR YARDS
SEWICKLEY, PA 15143
Property Zoning:
Application Valuation: $7,500:00
Applicant:
Contractor:
AZURE POOLS & SPAS INC
AZURE POOLS & SPAS INC
P 0 BOX 10641
P 0 BOX 10641
PALM DESERT, CA 92255
PALM DESERT, CA 92255
(760)322-7665
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Llc. No.: 802919
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M' v
iktail:-i- WEIR /'(1)'LERO EDGE WATER FEATURE AT REAR YARD NEAR "NOOK" ROOM OF HOUSE AI D (fl WATER I EATURE WITH ATTACHED 6' CMU WALL AT
WEST SIDE YARD NEAR MASTER BEDROOM. PER SITE-SPECIFIC ENGINEERING. 2013 BUILDING CODES.
FINANCIALINFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION _
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000=42404
0
$181.29
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
WATER FEATURE
101-0000-42404
0
$181.29
DESCRIPTION
ACCOUNT
qTY
AMOUNT
'WATER FEATURE PC
i01'0000 4'2(i0t7"
0
$98.62 "
r
Total Paid for POOL / SPA: $559.82
TOTALS:.0
0