BPOL2016-018178-495 CALLE TAMPICO VOICE, (760) 777-7125 0 U
D)D/7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT 10 (7 (7153
BUILDING PERMIT pr
DEC1529��
016
Application Number: BPOL2016-0181 OwProperty Address: 56720 JACK NICKLAUS MArr''��y'y
APN: 762070042 56720 JACK NICKYAIJs0F LA QUINTA
Application Description: MACRIS / POOL, SPA, AND FIRE PIT LA IMELOPMENT DEPARTMENT
Property Zoning:
Application Valuation: $26,750.00
Applicant:
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT
COACHELLA, CA 92236
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.: 999928,`
Date: 6 Contractor/
� c
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
($500).:
(_) 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.).
(_) 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.).
(T) 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:
Contractor:
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT
COACHELLA, CA 92236
(760)702-9222
Llc. No.: 999928
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 COMPENSATION INSURANCE FUND Policy Number: 9125416
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 Lab r Cod7 I shall forth lith
comply with those provisions.
Date: G Applicant: el
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 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.
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
construction, and hereby authorize representatives of this city enter upo the
above-mentioned pr perty for inspection purposes.
Date: Signature (Applicant or Agent): Q% ,
Application Number: BPOL-2016-0181
Property Address: 56720 JACK NICKLAUS
APN: 762070042
Application Description: MACRIS /POOL, SPA, AND FIRE PIT
Property Zoning:
Application Valuation: $26,750.00
Owner:
MACRIS
56720 JACK NICKLAUS
LA QUINTA, CA 92253
Date: 12/14/2616
Applicant: Contractor:
DESERT MIRAGE POOLS & SPAS DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT . 84267 MIRAMAR COURT
COACHELLA, CA 92236 COACHELLA, CA 92236
(760)702-9222
Llc. No.: 999928
Detail: DEMO EXISTING SPA, BUILD NEW POOL, SPA, AND FIRE PIT. DOES NOT INCLUDE 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.PER 2013 CRC CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$25.33
Total Paid for PLUMBING FEES: $38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$190.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
Total Paid for POOL / SPA: $293:36
Bin, #
Permit #
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Project Address:
City of La Quinta
Building 81- Safety Division
- 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet M��2tS
_ 7 Z 1 Owner's Name: y 15 Y'P S i
A. P. Number:
Address:�6rw
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Legal Description:
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Contractor:
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Project Description: f S �`
City, ST, Zip:
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Telephone:
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State Lic. #:
City Lic. #;
Arch., Engr., Designer:
Address:�—
City, ST, Zip:
Telephone:
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Co tructi ecu
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O Y:
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S te Lic. # •
PaProJeetty(cir Ie one) : New Add'n Alter Repair De mo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Tele hone # of Contact Person:
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Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
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 corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dced
Plans picked up
S.M.I.
II.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,
I
Total Permit Fees