13-1431 (ELEC)tti
4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153.
BUILDING PERMIT
Date:1
Application Number: 13-00001431 Owner:
Property Address: 78808 VIA CARMEL RICHARD PESCHKE D
APN: 646-430-015'- - - 78-808 VIA CARMEL O OQ 013
Application description: ELECTRICAL LA QUINTA, CA 92253 (J
Property Zoning: LOW-DENSITY RESIDENTIAL (760) 771-4625 0•
Application valuation: 500
Architect or Engineer:
------------------------ -------------------------
LICENSED CO ACTOR'S DECLARATION
hereby affirm under penalty of perjury t I am licens der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus' a t and Profes io Is Code, and my License is in full force and effect.
License CI ss: C53 License No.: 838188
Date S� Contractor: V
WNER-BUI DER DECLARATION
I hereby affirm under penalty of perjury that I a exempt fr the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and P fessions 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 applicat 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 (5500).:
1—) 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.).
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.).
( ) 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:
LQPERMIT
Contractor:
C & M POOLS INC
41530 BALACLAVA DRIVE
BERMUDA DUNES, CA 92203-1100
(760)360-6254
Lic. No.: 838188
-----------------------------------------------
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 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 STATE FUND Policy Numb 9010408
_ I certify that, in the Performa a of the work f ' hich this permit is issued, I shall not employ any
person in any manners to become subj c to the workers' compensation laws of California,
and agree that; if I sh d,gecome subject o e workers' compensation provisions of Section
7<t 3700 of the Labor C,21 de, s all forthwith o ply with those provisions.
Date: V Applicant: ,
WARNING: FAILURE TO SECURE WORKERS' C MPENSATION OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL INES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COM NSATION, 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 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 pe mit, or cessatio f work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ov information i i rrect. I agree to comply with all
city and county ordinances and state laws relating to build' g c nstruction a d• ereby authorize representatives
of this county to enter upon the above-mentioned propert fo nspection ur o as.
Date: (" �� Signature (Applicant or Agent):
Application Number . . . . . 13-00001431
Permit . . . ELECTRICAL 2013
Additional desc .
Permit Fee . . . . 23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date 5/07/14
Qty Unit Charge Per
Extension
1.00 23.8300 EA ELEC POWER
----------------------------------------------------------------------------
APPARATUS
23.83
Permit . . . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11-92
Plan Check Fee
.00
Issue Date . . . .
Valuation . .
. 0
Expiration Date 5/07/14
Qty Unit Charge -Per
Extension
1.00 11.9200 EA PLBG WATER
INST/ALT/REP
11.92
----------------------------------- ----------------------------------------
Special Notes and Comments
RELOCATE POOL/SPA CIRCULATION PUMP AS,
PER PLAN. 2010 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PLAN CHECK,
ELECTRICAL
23.83
PERMIT
ISSUANCE .M/P/E
90.57
PLAN CHECK,
PLUMBING
11.92
Fee summary Charged Paid
--------------------
Credited
--------------------
Due
-----------------
Permit Fee Total 35.75
.00 .00
35.75
Plan Check Total .00
.00 .00
.00
Other Fee Total 126.32
.00 .00
126.32
Grand Total -162.07
.00 .00
162.07
LQPERMiT
Bin #
City of La QUlnta
Building &r SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: C L
Owner's Name: 1 C14AR Akt
A. P. Number:
Address: 'l f —go g V, -,A CAp.m1_-_I_
Legal Description:
City, ST, Zip:tA Qu (0-r A ,C A 9tiL53
Contractor: £I� 100 LS .
Telephone:
PIN?
Address: .5 UAL Lcj A'V A 1)
Project Description:
City, ST, Zip:' (--R bA _6kAA6CA "1 W7
czI0CA4 Mori o,(-- S .A
Te phone:"'%—�(vo—(oZj
^<#
f'CLi(,A4li/(,1vKP Q
State Lie. # :&53 7j, g) g g
City Lie. #t
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
<?;»;j.< :: ;::::>:<;;;;<:>:<::<
.;;:c..;�:>r�•>•::<X%:>�r:::i>s;
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n ter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Projec • ` QQ
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
U Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" 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 HOUSE:-
7nd 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