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13-1687 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001687 Property Address: 80220 VIA PESSARO APN: 772-550-015- - - Application description:- POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Applioation valuatigni 22949 Applicant: T&f"r' % VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 Architect or Engineer: Ty BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: C53 Lice a No.: 856835 Date: I ,y Contractor: Q 61? 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).: (_ 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.). (_ 1 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 Caw.). (_ 1 I am exempt under Sec. , BAP.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: LQPERMIT Date: 1/03/14 Owner: DORWARD, DAVID C 10328-81 AVENUE 300 EDMONTON, AB T6E 1-X2 0 Contractor: E VACATION POOL I C JAN 0 3 2014 P.O. BOX 1094 INDIO, CA 922 2 CITY OFLAQUINT A (760)77S-0468 FINANCE DEPT. Lic. No.: 856835 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 Yissued. l 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 STATE FUND Policy Number 1948584-2013 _ 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 bec;m�subject to t workers' compensation provisions of Section 3700 of the Labor d I shith co ply w'th those provisions. �101 Date: `� Applicant: QQ—v WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESANDCIVIL 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 Ouima, 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 nul n void if work is not commenced within 180 days from date of issuance of such permit, or ess ion of work for 180 days will subject permit to cancellation. I certify that I have read this application and statethat [h above i orma 'on is correct. I agree to comply with all city and county ordinances and state laws relating [o b Iding c struct n, and hereby authorize representatives of this ounzty to enter upon the above-mentioned pro erty f inspe on purposes. Date: ' 7 Signature (Applicant or Ag Application Number . . . . . 13-00001687 Permit . . . . . . POOL 2013 Additional desc . . Permit Fee . . . . 178.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/02/14 Qty Unit Charge Per Extension 1.00 178.7500 EA MISC POOL/SPA ---------------------------------------------------------------------------- 178.75 Permit . . . . . PLUMBING 2013 Additional desc . . FIRE PIT Permit Fee . . . . 11.92 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/02/14 Qty Unit Charge Per Extension 1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS 11.92 ---------------------------------------------------------------------------- Special Notes and Comments POOL, SPA AND FIRE PIT AT REAR YARD [POOL ENGINEERING INC] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. January 3, 2014 8:21:09 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 Bin # City of La Quinta Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 104 • Project Address: j �� SS� C Owner's Name: A. P. Number: �,'t� Y k Legal Description: Address: toll City, ST, Zip: Contractor: Q3 Telephone: /1 Address: % 9107 Cp G t F CCuTel- /t Project Description: Qo ( -pd City, ST, Zip: Aol oC C4- 99a o Qfv Telephone: i G 7 l %`<'•. + State Lic. # City Lic. #•: :/(�V % 4f (� ti Arch., Engr., Designer: Address: 2.6 201 City., ST, Zip: CO OF L4 Telephone: State Lic. #. ' Name of Contact Person: �? :::;zs:>:<:>;.>;::z:::>:::<•>;>;;'•>.'?>.':.:s::»«<::>:: :.................. .:; ;r v`-<> <#r%�s�`;<.>;;:.:;;.>.:..;;:�;>::.;�<>:.�>:.;;:;::•;;::. <: >:««•»; >•> «•: «:<:; � O/v........ CttiT e: c E�/ Type: O cupancy: Construction ELO , Project type (circle one): New Add'n Alter Repair Demo S Ft.: #Stories: #Units: q. Telephone # of Contact Person: 7 %s -Q Estimated Value of Project: Oc 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 Pians 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 HOUSE: '"' Reyiew, ready for correction issu Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 313.E 14 J i�-yk?l TA l t la' AK�►N�%r �K11�ti2- ia�C` ID A �ENr ....... . . . . ....... 5' x 12' Tanning Shelf I in with Umbrella Sleeve +18", 8'-0" sq. Spa with 1 (5) Architectural 5p1ll5. 31'-8" 1 Pool Bench 1I Vmm Pool cV (5) Spout Style 5pl115 Centered on Face of 5pa PA 28' All concrete decking by Others LOT 201 a PA t 20'-I I" 1 I 1 1 Fire Pit 1 i PA Pool/5pa Egylpment Location P Existing Gas and Electric Meter this side O I H VACATION POOLS, INC. a P.O. soot 10010 kK1W CA 11111� .900 Ph. (700) 7700100„ FOO" 410 U0 o 00 8866880 � __ fft CITY OF -L-A QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE. it— RYA S 4040 14W Irsoc NOTE: Landscape elements (Trees, Shrubs, Vines and Lawn) and Patio Furniture shown for illustration only. Unless by separate bid. WNTRAGTOR cannot assume responsibility for damage to curbs, sidewalks, driveways, cement slabs, sewers, lawns, trees, fences, retaining walls, sprinklers, wires, valves, telephone or shrubs. When access is made through a neighbor's property it is understood that you, the owner, have that neighbor's permission and assume full responsibility. DATE SIGNATURE D .!ONES DEVELOPMENT A& LOT 201, THE HIDEAWAY 1" VIA PE55ARO LA QUINTA, GA Q2255 DATE: 12.11.13 7EVI5ED: 4t