13-0774 (RPL)r _ 4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA ,.QUINTA, CALIFORNIA 92253
Application Number: x13-00000774
Property Address: 5304-5,HUMBOLDT BLVD
APN: 767-200-998-54 -330762-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 75000 N
r
T4&t 4 w
1
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
tea" XA__
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjt that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of th usi ss and Professio aIs Co4, and my License is in full force and effect.
License Class: C53 No.: 820132
Date: Co^�" ontra�ct~o,.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury t tat 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 ($500).:
1 _ 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
1 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
7 / 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
Owner:
JAMES FILLER
(
Contractor: D
STOKER POOLS
43653 PARKWAY ESPLANADE E T
LA QUINTA, CA 92253
(760)772-1111
Lic. No.: 820132
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153-
Date:
77-7153
Date: 6/26/13
U
7OF
6 2013
A QUINTA
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 BENCHMARK INS Policy Number CST5002749
_ 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, i hould become subject to the workers' compensation provisions of Section
3700 of the L y^ Fode, I shalt for�tcomply with those provisions.
Date: Applicant. �„ '
WARNING: FAILURE TO SECURE ORKERS' 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. 1
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 the above information is correct. I agree to comply with all
city and county ordinances and state laws relating buil 'ng construct- and he eby authorize representatives
o�cont er upon the above-mentioned ropert for inspect- n r po e
DSignaturelApplic�Agent):
IV
Application Number . . . . . 13-00000774
Permit . . . POOL 2013
Additional desc .
Permit Fee 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/23/13
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA, AND 220LF [2 INCH GAS PIPING]
THIS PERMIT DOES NOT INCLUDE ELECTRICAL
AT BBQ. EQUIPMENT SHALL -BE INSTALLED IN
ACCORDANCE WITH MANUFACTURER
SPECIFICATIONS. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2010 CALIFORNIA BUILDING
CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24'
Fee summary Charged Paid Credited
-------------=----------------
Due
---------------------------
Permit Fee Total 178.75 .00 .00
178.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 98.24 .00 .00
98.24
Grand Total 276.99 .00 .00
276.99
LQPERMIT
a
Bin #
City of LA Quin
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: r� ho ' I
Owner's Name: U,
A. P. Number:
Address:
•
Legal Description:
Contractor: �'D%�`
-VICES I ice. S
City, ST, Zip:
cz,>: r::;.::>:.>.<k.:,..::.. •`'.
Tele hone: • •• :§c
P ;.,.3:y;�:�>�r>"�`;<:°,.>:;
Address:P�VS
C�SA6t,Project
Description:
City, ST, Zip: At ►1. �l� - I/d�d .3
I v t 'T�RaVto jA • IV �DI�L
Telephone:�(� �
i�'r,.'•%o-:psti:fy��;;s:'::;y�.',:
�C`::... � % >
�r ::�
State Lie. # .13
City Lia #:
U ro i- , a' I VDL. CQ , C .
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:':s"fi;;::>:<:••,:;'>:�,;:<
State Lie. #:>;:
i;;' ;:r rb ; <'•
�: \......vh:vi'{:.}• .. %';'i SN'i Lyi'ti'�:5?
ConstructionType: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Tft<,,t Sin �
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person: D Z,SD ,
Value of Project: A, 75 pQp�
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
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 correctionsriissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' 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
bL111LUINU
F LA QUINTA
07
Total 416 ee
A P Pa FFI um C
FOR CONSTRUCTION
DATE6'�-138 _
013
JUN 2 A %i
COMMUNITY DEVELOPMENT
dl&
{ Y" "O lTL1tl. ew BY DRIB DATE �ij PILLI=R-LOT 54b * 12'
77725 Enfield Lane, #130 REVISED 55-045 Humboldt 51vd. PACE
Pala Desert, CA 92211 Lo QulntA, GA
(760) 772-4411 FAX (760) 772-4409 OF�`
STOKER POOLS
45655 Parkway Esplanade East
La Ouinta, GPS 82255
(760) 772-1111
WATERPROOF
SLIPSHEET
DECK
#3 BARS AT 12" 0. C.
HORIZ./ VERT. _
TYP.
I" GAP
2-1/2" DIAM.
SCHED. 40 PVC
DRAIN LINE
STEEL: FY = 40 KSI ASTM A615
CONCRETE: F'c = 4500 PSI AT 28 DAYS, TYPE V CEMENT
ZERO EDGE AT NEW POOL DECK JAI