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BELC2015-002978-495 CALLE TAMPICO . -1 LA QUINTA, CALIFbRNIA 9225 TyYY i 4Q"&fk AMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0029 Property Address: 53255 AVENIDA DIAZ APN: 774071013 Application Description: MICHEAL DEANDRA (2) ELECTRICAL LIGHTS ON COLUMNS Property Zoning: Application Valuation: $125.00 Applicant: Q CRYSTAL BLUE POOLS AND PATIOS 31166 ORANGE AVENUE NUEVO, CA 92567 QR 1 2p15 A G\� OF,Uk,►,tiFP EM 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. B. C-8 License , o.: 8468 r pate: Contractor: r ` 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 Divisio of the Business and Professions Code) or that he or she is exempt therefrom and the 7F 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 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: ' j . VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/17/2015 Owner:. MICHAEL DEANDREA 53255 AVENIDA DIAZ LA QUINTA, CA 92253 Contractor: CRYSTAL BLUE POOLS AND PATIOS 31166 ORANGE AVENUE NUEVO, CA 92567 (951)906-2761 Llc. No.: 846843 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: _ 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 t ' to a workers' comp ensatio laws of California, and agree thaI sho Id become s ct to the workers' co pens tion provisions of Section 00 of t Labor Cod , I shall forthwith comply wit4thos4 provisions. Date: 01 W, 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 inf rm tion iVgorrect. I agree to comply with all city and county ordinances and state la r ting t wilding construction and hereby authorize representatives of this city to upon a above• mentioned rope y for inspection purposes. Date: ISignature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $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 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 Description: MICHEAL DEANDRA (2) ELECTRICAL LIGHTS ON COLUMNS Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 4/17/2015 PJU Approved: Parcel No: 774071013 Site Address: 53255 AVENIDA DIAZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 183 Lot: 1 Issued: UNIT 18 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $125.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: (2) ELECTRICAL LIGHTS ON OUTSIDE BLOCK WALL COLUMNS PER APPROVED PLANS & BY JJ. 2013 CALIFORNIA ELECTRICAL CODES. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE - ZIP PHONE FAX „ EMAIL APPLICANT CRYSTAL BLUE POOLS AND PATIOS 31166 ORANGE AVENUE NUEVO CA 92567 ( Printed: Friday, April 17, 2015 10:11:54 AM 1 of 2 Cfl?mr SYS7EM5 .0% DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $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 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERM1T ISSUANCE: $91.85 $0.00 TOTALS:0• INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED - DATE DATE RESULT REMARKS NOTES ELECTRICAL FINAL" BLD BOND INFORMATION Printed: Friday, April 17, 2015 10:11:54 AM 2 of 2 cff?"WSYSTEMS Bin # City of La Quin to 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 Perinit # Project Address: 153 2S�__ Owner's Name: 11 r A. P. Number: Address: G'3 2 . Legal Description: City, ST, Zip: C4- t Contrac o r• . i ?� Telephone: hone: Address:(ZZ �� Project Description: 2) c� City, ST, Zip: Nlil a r�Li 223±ao 0( Q Telephone: — — ele h o O `'1 -756'3- P 565 �t ru 5 State State Lic. # City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ne p 0 u Construction Type: Occupancy: y: State Lic. #:s Project type circle one): : New Add'n Alter Repair Demo Name of Contact Pers n, Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: : ]Estimated Value of Project: \2S psi APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HO.USE:- '"' 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 " Total Permit Fees