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13-1576 (RPL)'P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001576 Property Address: 53485 HUMBOLDT BLVD APN: 767-700-017-3 -330762- Application description: POOL - RESIDENTIAL . Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 80000 T -Ulf " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: 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 Professionals Code, and my License is in full force and effect. License Class 3 License No.: 614611 Date: 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 not more than five hundred dollars 1$5001.: 11 (_ 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cbde: 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. , BAP.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 ! VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 D 12/05/13 Owner: BERNT BODAL LIVING TRUST 53485 HUMBOLDT BLVD LA QUINTA, CA 92253 D Contractor: (�4C' OJ��(• MCINTYRE POOLS & SPAS, 83695 AVENUE 45 INDIO, CA 92201 (760)342-3612 LiC. No.: 614611 ----------------------------------------------- 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 WESCO INS CO Policy Number QWCA1843029 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 3 0 of the Labor Code, I shall forthwith comply with those provisions. ate: r0 Applicant: 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 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 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 building construc ' O , and hereby authorize representatives of this count /(to nt%e�r upon the above-mentioned property for 'nsp n poses. Pate: " �_.6ignature (Applicant or Agent): Application Number . . . . . 13-00001576 Permit . . . POOL 2013 Additional desc . Permit Fee . . . . 536.25 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/03/14 Qty Unit Charge Per Extension 3.00 178.7500 EA MISC POOL/SPA --------------------------------------=------------------------------------- 536.25 Permit . . . PLUMBING 2013 Additional desc FIRE PIT Permit Fee '. . 11.92 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/03/14 Qty Unit Charge Per Extension 1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS 11.92 ---------------------------------------------------------------------------- Special Notes and Comments POOL, TWO (2) SPAS AND FIRE PIT AT REAR YARD WITH ENTRY COURT FOUNTAIN (DENISE POELTLER] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE, BBQ AND OTHER ITEMS AS NOTED ON PLAN. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. December 5, 2013 4:07:20 PM AORTEGA -------------------------7-------------------------------------------------- Other Fees . . . . . BLDG STDS ADMIN (SB1473) 4.00 PLAN CHECK, POOL 97.24 PLAN CHECK, PLUMBING 23.83 STRONG MOTION (SMI) - RES 8.00 Fee summary Charged Paid Credited Due Permit Fee Total 548.17 .00 .00 548..17 Plan Check Total .00 .00 .00 .00 Other Fee Total 133.07 .00 .00 133.07 Grand Total 681.24 .00 .00 681.24 y LQPERMIT Bin # Permit # 7 Project Address:3 — g" :City of La Quinia Building 8c Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253: (760) 777-7012 B-u►Id►ng Permit Application and Tracking Sheet Owner's Name: 7077� A. P. Number Address:- S 3 — tc Humhw Legal Description: City, ST, Zip: Contractor: Telephone: Address: - 6 Project Description: PboT City,'ST,.Zip: c Telephone: 3—.. State Lic. # : yG City Lie. #; S Arch., Engr., Designer . Address: City.; ST, Zip: Telephoner State I ic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # ' Submittal Plan Sets Req'd Recd TRAC NG Plan Check submitted ; PERMTI FEES Item Amount Structural Cala... 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 plan 2" Review; ready for correctionsfissue Electrical Subconmctor List Called Contact Person Plumbing . . Grant Deed Plans picked up S.M.I. HOA. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctio ue DeveloperImpact Fee Planning Approval Called Contact Person A.I:P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees k. EREERISR naslER 5 . sTCR uL n•. i cAR cE DOIXV 'YID" rwWWD,llc$="sp�P.W//5. 1 i I'. 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