BPOL2016-0080I - r
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: g53 if License No.: 614611 /moi
D�� a �G 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
($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.).
(_) 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 Ad
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 th wor for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti.A 00 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 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 3700 of the Labor Code, I shall forthwith
comply with th a pr isions.
. P
Date: /G 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 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 lawsrelating o building
construction, and hereby authorize representatives of this city to enter u n the
above -men ' n property for inspectionpurposes.
Da4//
4 6 Signature (Applicant or Ageloo
78-495 CALLE TAMPICO
4aw
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX Q760) 777-7011COMMUNITY
DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Da 6/1/2016
Application Number: BPOL2016-0080
Owner:
Property Address: 80750 VIA MONTECITO
CATHY & SCOTT SPEHAR
APN: 777400020
Property Zoning:
Application Valuation: $50,000.00
_ a
Applicant:
Contractor: <'� z n
MC INTYRE POOLS & SPAS INC
MC INTYREYOOLS & SPAS INC v i_
83-695 AVENUE 45
83-695 AV E 45
INDIO, CA 92201
INDIO, CA 92201 : o
U
(760)342-3612
Llc. No.: 614611
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: g53 if License No.: 614611 /moi
D�� a �G 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
($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.).
(_) 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 Ad
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 th wor for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti.A 00 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 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 3700 of the Labor Code, I shall forthwith
comply with th a pr isions.
. P
Date: /G 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 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 lawsrelating o building
construction, and hereby authorize representatives of this city to enter u n the
above -men ' n property for inspectionpurposes.
Da4//
4 6 Signature (Applicant or Ageloo
T
DESCRIPTION
FINANCIAL INFORMATION
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
ACCOUNTQTY
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
CITYAMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
PAID BY
METHOD
RECEIPT q
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
DESCRIPTION
ACCOUNT
CITY
AMOUNT
" PAID
PAID DATE
•WATER FEATURE
101-0000-42404
0
$362.S8
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
-. • ,AMOUNT
PAID
PAID DATE
WATER FEATURE PC
101-0000-42600
0
$197.24
$0.00.
PAID. BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for POOL / SPA: $839.73 $0.00
` Permit Details PERMIT NUMBER
City of La Quinta BP00016.'oo 0
e
Description: SPEHAR / POOL, SPA, FIRE PIT, BBQ AND (2) WATER FEATURES
Type: POOL Subtype: Status: APPROVED
Applied: 5/19/2016 SKH
Approved: 6/1/2016 JJO
Parcel No: 777400020 Site Address: 80750 VIA MONTECITO LA QUINTA,CA 92253
Subdivision: TR 29894-4 Block: Lot: 74
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $50,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ADDRESSI
Details: POOL, SPA, FIRE PIT, BBQ, AND TWO WATER FEARURES. GAS LINES SHALL BE SLEEVED WHERE REQUIRED, DECK SHALL DRAIN PER
APPROVED GRADING PLANS. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS
AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45
INDIO
CA
92201
(925)324-5387
CONTRACTOR
MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45
INDIO
CA
92201
(925)324-5387
OWNER
CATHY & SCOTT SPEHAR
118 DEER RIDGE PLACE
DANVILLE
94506
(925)324-5387
OWNER 1
CATHY & SCOTT SPEHAR
118 DEER RIDGE PLACE
DANVILLE
94506
(925)324-5387
FINANCIAL INFORMATION
Printed: Wednesday, lune 01, 2016 1:57:54 PM 1 of 3
CI?W.IYSTEMS
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD -
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
PC
101-0000-42600
0
$98.62
$0.00
WATER FEATURE
101-0000-42404
0
$362.58
$0.00
WATER FEATURE PC
101-0000-42600
0
$197.24 j
$0.00
Total Paid for POOL / SPA: $839.73 $0.00
TOTALS:00
Printed: Wednesday, June 01, 2016 1:57:54 PM 2 of 3
CRWlYSTEMS
BOND INFORMATION
Printed: Wednesday, June 01, 2016 1:57:54 PM 3 of 3 J
SYST[MS
IR
Bin # , ,
City of .La Quinta.
Building 8t Safety Division
iPelmh�# P.O. Box 1504, 78-495 Calle Tampico .
�✓✓�� dd La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: a V — 5 V.r' � ( Wo Uh per's Name: e Or
A. P. Number: Address:12
SU . Ul
Legal Description: City, ST, Zip:
Contractor:C Telephone:
r
�� f� 5 S eP
Address: —.05ninf Project Description:PA
City—ST-1—ZipST-1-Zip ta QJ 0 09W 020 .
Telephone: 70 — ILI 2-3G X..4
State Lie. # : C 53 - I. [ City Lic_ #; qS
Arch., Fngr., Designer . .
Address:
City; ST, Zip:
Telephone: Const action Type: Occupancy:
State Lie. #:„ Project type (circle one): New Add'n' Alter Repair Demo
Name of Contact Person: e Sq. Ft : #Stories: #.Units:
Telephone # of Contact Person: Estimates Value of Project -
API il
rojectADPI ICA IUr. nf% nlr►T 1AMr 1 --'bo ^ur r1 —'2 wr
4
Submittal
Req'd
Rec'd
TRACENG.
PBRwrFm
Plan Sets
Plan Check submitted
Item Amount
Structural Cales., .
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
2nd Review, ready for correctionslissye
Electrical
Subcontactor List
Called Contact Person
Plumbing.
Grant Deed
Plans.picked up
S.M L
I•LO.A. Approval
Plans resubmitted
Grading
INHOUSF,:=
'”' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval '
Called Contact Person
A.LP.P.
Pub. Wks. Appi
Date of permit issue
School Fees
Total Perini
MAy 2 g 2016
L CITY OF �'�EL pMENT
r►rMMUtJjV D