14-0320 (RPL)•
P.O. BOX 1504 4 VOICE (760) 777-7012
78-495'CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/07/14
Application Number: 14-00000320 Owner:
Property Address: 60918 DESERT ROSE DR BARNES, ROBERT & JO
APN: 764-390-012- - - 60918 DESERT ROSE DR
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 31000
Contractor: D i
Applicant: Architect or Engineer: OJEDA POOL & SPA FQ, f !"
52815 AVENIDA MARTr E APR tii ` 20 Vi I�
LA QUINTA, CA 9225
(760) 564-6274 CITY P-1.,q�yIN7�
Lic. No.: 859702 —gym �Ih�!�: C,' t.-sP
J
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
LICENSED CONTRACTOR'S DECLARATION
1 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: CS License No:: 859702
Date: ] ontractor:
OWNER -BUILD DECLARATION
I hereby affirm under penalty of perjury that 1 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 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.).
(_ 1 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.1.
Lender's Name:
Lender's Address: t
LQPERN11T
WORKER'S COMPENSATION DECLARATION
1 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
-AX,�n,r is� ued.
I5ve 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 NORGUARD INS Policy Number EDWC424858
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
37 O oof/the Labor Code, I shall forthwith comply with those provisions.
Dater / �� • Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSA ON 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 coun ord' ances and state laws relating to building construction, and hereby authorize represe tatives
of this cOc toe er on the above-mentioned property for in n purposes.
Date: - "nature (Applicant or Agent):
Application Number . . . . . 14-00000320
Permit . . . POOL 2013
Additional desc . .
Permit Fee 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 10/04/14
'
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . PLUMBING 2013
Additional desc . . FUTURE BBQ/FIREPLACE
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date . . 10/04/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92
--------'--------------------------------------------------------------------
Special Notes and Comments
POOL AND SPA AT REAR YARD WITH GAS
PIPING FOR FUTURE BBQ AND FIRE PLACE
[DENISE POELTLER ENGINEERING] THIS
PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE OR CONSTRUCTION OF FIRE PLACE
OR BBQ. ALARMS AND BARRIERS REQUIRED TO
BE INSTALLED AT PRE -PLASTER INSPECTION.
2013 CALIFORNIA BUILDING CODE.
April 7, 2014 9:03:21 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
PLAN CHECK, POOL
97.24
PLAN CHECK, PLUMBING
23.83
Fee summary Charged Paid Credited
-------------------------------------
Due
--------------------
Permit Fee Total 190.67 .00 .00
190.67
Plan Check Total .00 .00 .00
.00
Other Fee Total 123.07 .00 .00
123.07
Grand Total 313.74 .00 .00
313.74
LQPERMIT
Permit #
City of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
1. /"A 0OOt_7 /7L/11 777.7/1f9
PERMIT FEES
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Building Permit Application and Tracking Sheet
Project Address:ljcj8 frsy �.�
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Owner's Name:
A. P. Number: `/��r
Construction
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telehone:
S.M.I.
Address:
Project Description:
City, ST, Zip: /
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Telephone: 7a 10 q 3?D:
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State Lic. # : ?OZ
City Lic.
OF LA QUI
Arch., Engr., Designer:
/A/6-R
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Address:
e44 -
City, ST, Zip:
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Telephone:
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Construction Type: Occupancy:
State Lic. #:hP
) Project a circle one): Now Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
/tel
Estimated Value of Project: Axy
PERMIT FEES
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Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer ImpVU:
.I.P.P.
AR 2 5 Z014
MT
OF LA QUI
COMMU
Total Permit Fees
Nf /�•
44C .
S
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