RPL-14-770i r
o
!J
.78-495 CALLE TAMPICO D ��
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT '
BUILDING PERMIT
Application Number:
RPL -14-770
Property Address:
53364 VIA PALACIO
APN:
777220023
Application Description:
POOL AND SPA AT REAR YARD
Property Zoning:
#nT_
Application Valuation:
$38,500.00
Applicant:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:, 7/1/2014
Owner:
JACOB TAUBER
12007 CREST CT
BEVERLY HILLS, CA 92253
Contractor:
SUNLITE DEVELOPMENT INC
P O BOX 10668
PALM DESERT, CA 92255
(760)340-9800
LIc. No.:
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: .
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, - I have and will maintain a certificate of consent to self -insure for workers'
and my Lice se i in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance.
License Gj�s : LI N CLASSIFICATION Lic6se N of the work for which this permit is issued.
to /I r/ _ I have and will maintain workers' compensation insurance, as required by
mate: ` Contractor. 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:
OWNER -BUILDER DECLARATION Carrier: Policy Number:
1 hereby affirm under penalty of perjury that I am exempt from the ontractor's State <1 1 certify that in the performance of the work for which this permit is issued, I
License Law for the following. reason (Sec.•7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a workers' comp 'ns tion provisions of Section 370 of the Labor Code,.l shall forthwith•
signed statement that he or she is licensed pursuant to the provisions of the comply with s pr islons.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3LOU /I# 41n_- M)
of the Business and Professions Code) or that he or she is exempt therefrom and the Date'. -'V l (Applicant
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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($50C).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES.
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 APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT:Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application,
he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose
(_J I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or
the Contractors' State License Law.). following issuance of this permit.
l_J I am exempt under Sec.. B.&P.C. for this reason 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.
Date: Owner.
I certify that I have read this application and state that the above information is correct.
CONSTRUCTION LENDING AGENCY I agree to comply with all city and county ordinances and state laws relating to building,
I hereby affirm under penalty of perjury that there is a construction lending agency for construction, a d ereby authorize representatives of thi city t9 enter u on the above -
the performance of the work for which this permit is issued.(Sec. 3097, Civ. Q. mentioned [VrSpection purposes.Lender's Name: Date ignat (Applicant or Agent
Lender's Address:
i
FIN ANCIALI INFORMATION
` DESCRIPT 0" i yA000.UNT` � CtT/ Y AMOUNTS � °t',PAI ' PAIDsDATEx
•-.a-w..n+.ad` u.r . +, . , i ,a..3ls!-� ---T w -.:•a -
BSAS SB1473 FEE
1 101-0000-20306
0
$2.00- $0.00
��«�'�a PAID'sBYf
, . y •
METHOD
°,h *' ` z <*� ` ate' ;:.
RECEIPT# .;CHECK #: CLTD+BYE
l,.��-.,_
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA;.' ' $2.00 { $0.00
{ e 4 ,r DESCRIPTION"
��l+ ACCO.UNT°
Y
QTO
r AIVIOUNT�
fA
IDg
PAID DATE
SWIMMING POOL/SPA
*NONE*
0
$178.75(
$0.00,
'PAIY� A
i„. MD "r*ECEIPkT;
` a
G N'y E.a'
CLTR!'BY
;1r.+w `iY tt.j"A �•
ml al
i ..
^.rte f. k? :'4i• µ 1
,t
�
r
QTI(yi+t
�
i •I'
:. AMOUNT; -�w
.�!�.a?" SA 5e•.
PAIDPAID
" DATE
SWIMMING.POOL/SPA PC .
101-0000-42404
0.
$97.24
$0.00
n x PAID; BY v r
s=��� t .�.a..
DOM- wM THOD�
; ��,:'
'sRECE T
:lis x
"CHECK`#r�a�C
t
LTD.BY'
Total Paid for POOL / SPA: $275.99• $0.00 "
TOTALS:00
n'
Total Pcrmil Fces "
Bin #
Pe t
Project Address: 36
Qtyof La Quinta
Building &r SaretyDivision
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and. Tracking -Sheet
VIA G ` Owner's Name:
A. P. Number:
Address: 53 3 VIVA 19�.i9C1
Legal Description: T 2—
z
City, ST, Zip: Lp. Q V I VJrA C K- J2"Z S3.
Contractor:
( ,
Wt
Telephone:2
Q' 9,60
->::s;:� s;�� •::.;:�>.»:
Address: - O 10,669,
Project Description:
City, ST, Zip:
�[ �' 22S's
Telephone: 34t)- rb Q
State Lic. # :
City Lia #,
Arch., Engr., Designer:
�KJC- ` KJ .! e `� r
L1�
Address: 1 Q
D
t G�
C'�
City, ST, Zip:.
�� ss
Telephone:
SO3' O O I s
c C
State Lic.22 #: 0
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•'i�4�ryr .SYS �n%i � � {i Fii'�:iiii i{.;:j
Construction Type: Occupancy:
_____
^•i <2'l'r(V'il?'f i}: :?.?:i?ii:ti:iCCii
Project type (circle one): New, Add'n Alter Repair Demo
Name of Contact Person:
LSq.
fjW
FL:
# Stories:
# Units:
Telephone #,of Contact Person:
6 YGd lEstimated
Value of Project:
t/ Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Che Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subconfactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
''" Reylew, ready for corrections/issue
Developer Impact Fee
-Nanning-A--pprovai
- Called-Conta-crPerson
Pub. Wks. Appr
Date of permit issue
School Fees
Total Pcrmil Fces "
4
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