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BPOL2015-0206LICENSED 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 a Business and Professions Code, and my License is in full force and effect. License Class: C3 D3 License No.: 72 96 �12V11 " Date:" Cnntradnr•� � 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 contractors) licensed pursuant to the Contractors' State License Law.). I I 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 Lender's 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' c p nsation, as provided for by Section 3700 of the Labor Code, for the performance t ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by on 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: _ Policy Number: _ I certify that in the performanceof t or for which this ermit is issued, I shall not employ any person in any manners s to b come subject the it compensation laws of California, and agree at, if I yhould beco subject the workers' compensation provisions of Secti n3700 the Labor ode, I s I orthwith comply with thos provisions. Date: 2� Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 law elating to b " ding construction, and hereby authorize representatives of this city a ter. upon th above-mentioned property for inspection purposes. Date: �" Signature (Applicant or Agent): 78-495 CALLE TAMPICO DV ",ILII/ VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/23/2015 Application Number: BPOL2015-0206 Owner: Property Address: 59655 SEVILLE T D DESERT DEV APN: 764710009 81570 CARBONERAS , Application Description: ANDALUSIA LOT N183 / POOL SPA FIREPIT BBQ LA QUINTA, CA 0 Property Zoning: Application Valuation: $50,000.00 is > o z o C=3 N Applicant: Contractor: JOHN L CAREY INC DBA BUBBLE SPRINGS JOHN L CAREY INC DBA BUBB E SPR NG_ Q P O BOX 1046 P O BOX 1046W ie s_ RANCHO MIRAGE, CA 92270 RANCHO MIRAGE, CA 92270 cn (760)341-2336 Llc. No.: 728796 --" 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 a Business and Professions Code, and my License is in full force and effect. License Class: C3 D3 License No.: 72 96 �12V11 " Date:" Cnntradnr•� � 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 contractors) licensed pursuant to the Contractors' State License Law.). I I 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 Lender's 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' c p nsation, as provided for by Section 3700 of the Labor Code, for the performance t ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by on 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: _ Policy Number: _ I certify that in the performanceof t or for which this ermit is issued, I shall not employ any person in any manners s to b come subject the it compensation laws of California, and agree at, if I yhould beco subject the workers' compensation provisions of Secti n3700 the Labor ode, I s I orthwith comply with thos provisions. Date: 2� Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 law elating to b " ding construction, and hereby authorize representatives of this city a ter. upon th above-mentioned property for inspection purposes. Date: �" Signature (Applicant or Agent): FINANCIAL •• 1• DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for POOL / SPA: $279.91 $0.00 TOTALS:• 00 Perl'1'11t �etaUS PERMIT NUMBER City of La Quinta BPOL2015-0206 Description: ANDALUSIA LOT N183 / POOL SPA FIREPIT BBQ Type: POOL Subtype: Status: APPROVED Applied: 9/22/2015 MFA Approved: 9/23/2015 KKI Parcel No: 764710009 Site Address: 59655 SEVILLE LA QUINTA,CA 92253 Subdivision: TR 31681-3 Block: Lot: 183 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Fina!ed: Valuation: $50,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 STEPHANIE KHATAMI Details: POOL, SPA, FIRE PIT, AND BBQ [2 INCH GAS PIPING/#8 AWG IN 1 INCH CONDUIT ELECTRICAL] 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. 2013 CALIFORNIA BUILDING CODE. FINAIVCIAL,INFORMATION Printed: Wednesday, September 23, 2015 5:58:09 PM 1 of 2 " CR6.I LI SY57EMS • • • • CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE STEPHANIE KHATAMI 9/23/2015 sent back 9-23-15 .-CONDITIONS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT JOHN L CAREY INC DBA BUBBLE P O BOX 1046 RANCHO CA 92270 SPRINGS MIRAGE CONTRACTOR JOHN L CAREY INC DBA BUBBLE P O BOX 1046 RANCHO CA 92270 SPRINGS MIRAGE OWNER T D DESERT DEV 81570 CARBONERAS LA QUINTA I CA 0 FINAIVCIAL,INFORMATION Printed: Wednesday, September 23, 2015 5:58:09 PM 1 of 2 " CR6.I LI SY57EMS INSPECTIONS PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, September 23, 2015 5:58:09 PM 2 of 2 CI?WSrsTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $0.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34 $0.00 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $0:00 OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $0.00 OUTLETS PC Total Paid for PLUMBING FEES: $36.26 $0.00 SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $0.00 SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $0.00 PC Total Paid for POOL / SPA: $279.91 $0.00 TOTALS: $366.51 00 INSPECTIONS PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, September 23, 2015 5:58:09 PM 2 of 2 CI?WSrsTEMS Bin. # W _ City of La Qtr%rz�a Btri(dhtg 8t Safety Division P.O. Box 1504,78-495 Case Tampico La.Qub4 CA 92253 •:{760} 777-7012 Building PenWt'Application' and Tracking Sheet Permit #-Q� Project Address:`i S V Owner's Name:. T p2 E r� ev M?Jti} A. P. Number. Address: Legal Description: Contractor: City. ST, Zip: Ca VI v>.I-o► Telephone: kju) 771 -Iq'q Project Description:c- 0 / Address:. 0 -be& tp City, ST; Zip: ► a 2 Z 7 fl Telephone: bp, q State Lia # : 1'l, City Lic, & .P Arch, Engr., Designer. Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construcdon Type: R.i QW Oc6pancy: Project type (cdrde one N Add'a Alter Repair Demo Sq, Ft: # Stories: # Utrits Telephone # of Contact Person: p j Estimated Value of Project p APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal RWd 'Reed TIRAG4LYaVG PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Cides. Reviewed, readp for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance. Title 24 Cates. Plana pielced up Construction Flood plain plan Plans resubmitted Mecharitca Grading plan T" Review, ready for correctioasrusue Electrical Subeontactor List Called CoatattPerson P14ing Grant Deed Plans picked up r S SEP 2 H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Revtew, ready for correcdonvIssue ,irn+ Develo p VUIN'TA Planning Approval Called Contact Person A,yP,P, Pub. Wks. Appr ' Date of permit issue School Fees Total Permit Fees \ POOLSPECS m O � v SIZE: 46'x 24' Ln r a 0 MI Cy J DEPTH: 35- s.D' Date: 5/18j2j 015 By: Scale: SQFT: 1014 sO.R =1' 8y: Date: PERIMETER: 140' Date: TILE: atwaterMe INTERIOR MATERIAL, pebble plaster NOTES: SPA SPECS SIZE: 9x 8' DEPTH: 3.5' RAISED HEIGHT: +ILT SQFr: n su.tt. PERIMETER: 34' TILE, at watertne BENCH SEAT: 18' WATER DEPTH WITH ONE UMBRELLA INTERIOR MATERIAL: pebble plaster SLEEVES SPILLWAY: toe DECK SPECS DECK TYPE 1: add wash concrete TOTAL DECK SQFr: 2256 s4.TL DECK TYPE 2: POOL: -0- ELEVATION WITH TILE TOTAL DECK SQFr 2: AT WATERLINE AND PEBBLE NOTES: PLASTER FINISHES FIRE FEATURE: +12" WITH THREE PLASTER BUBBLE BLUE MINI PEBBLE V CUSTOM CASCADE SHEER PIA DECKTYPE 1: Add Wash DESCENTS; STAINLESS STEEL FIRE PIA DECK COLOR 1: Mesoufte BAR, FIRE GLASS VALVE AND KE`; ACID WASH FINISH CONCRETECAP RAISED TILE: Cepac REF -124 Sumrrdt WITH TILE SIDES WATERLINE TILE: Cepac REF124 Summit BBQ: QUa1tZRa 65:6" with stucco sides to ma ouse • FIREPIT: Concrete cap with Cepac REF124 es n 4 a i 5.D' WD 3.5° WD a T g' WD \ 24� P/A —� o*^ O 3 0' r ' r r r O V , o , F1F] ' N BBQ: +36" WITH TILE F ❑ Zi Q COUNTERTOP AND D '"' MATCH ALFRESCO E --� _INTEGRATED STEEL BBQ WITH : o – --, �... • wA a _,.+ INFRABROIL, ROTISSERIE AND Q HOUSE INCLUDES 00 O INTEGRATED LIGHTING AND C OSTAINLESS STEEL ACCESS ® Ul J O DOORS & DRAWER COMBO a ®off • A 0 0 r - Z m O � v Q49Lw Ln r a 0 MI Cy J Z .a Date: 5/18j2j 015 By: Scale: 1/16" =1' W. CK Date. 315/2015 8y. do Date: 3/23/2015 BY: do Date: 3/26/2015 Sr. CK Date: 5/1.3/2D15 By: CK Date: 5/18j2j 015 By: Date: Sr. Date: 8y: Date: By: Date: CITY OF LA UINTA BUILDING & SAFE TY DEPT. APPROVED FOR CONSTRIJ,CTION U PIA RESIDENCE FINAL 5/18/2015 BENCH SEAT: 18" WATER DEPTH WITH ONE UMBRELLA SLEEVES TANNING SHELF: 9" WATER DEPTH WITH THREE UMBRELLA SLEEVES SPA: +18" WITH TILE SPILLWAY; TILE AT WATERLINE; PEBBLE PLASTER; 6 FLUSH MOUNTED HYDRO -THERAPY JETS; ACID WASH FINISH CONCRETE CAP WITH TILE SIDES P/A FIREPIT: +18" WITH STAINLESS STEEL FIRE BAR, FIRE GLASS VALVE AND KEY; ACID WASH FINISH —CONCRETE CAP WITH TILE SIDES DECIQNG: ACID WASH FINISH CONCRETE PADS WITH SYNTHETIC TURF INLAYS (TURF PROVIDED BY LANDSCAPE CONTRACTOR) DECKING: ACID WASH FINISH CONCRETE LOCATION