13-1030 (RPL)P.O. BOX 1504 '
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
V
13-00001030
78331 DEACON DR W
770-210-028- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
133000
Td4t 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED NTR OR'S DECLARATION
I hereby affirm under penalty of perjury that am Ii ens d d provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine nd rofes io al Code, and my License is in full force and effect.
License Class: C53 icense No.: 856835
//
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of p ' ry that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, B siness 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.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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. , 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
JONES DEVELOPMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/13
78331 DEACON DRIE\W �� II I��
LA QUINTA, CA 92 E��J
AUG 11_ ,� 2013
Contractor:
VACATION POOLS I C CITY BF l.i>t QUINTA
P.O. BOX 10940 FINANCE DEPT.
INDIO, CA 92202
(760)775-0468
Lic. No.: 856835
-----------------------------------------------
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
OA?for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
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
C/ insurance carrier and policy number are:
Carrier STATE FUND P0 umber 1948584-2013
I certify that, in the performance of w • rk for which this permit is issued, 1 shall not employ any
person in any manner to ecom subject to the workers' compensation laws of California,
and agree that, if I ould ome s ject to the workers' compensation provisions of Section
3700 of the Lab Code, shall fo hwith comply with those provisions.
Date: APP i n
WARNING: FAILURE T RE 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 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 ngk
rk is not commenced
within 180 days from date of issuance of such permit, or k for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov InformI agree to comply with all
city and county ordinances and state laws relating to building nstruc 'uthorize representatives
of thi ounty to enter upon the above-mentioned propert f inspec o
Date.P Signature (Applicant or AgentL
Application Number . . . . . 13-00001030
Permit . . . POOL 2013
Additional desc . .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 2/11/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00 Plan Check Fee
4.50
Issue Date . . . . Valuation
0
Expiration Date 2/11/14
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA, AND FIRE PIT WITH 80LF GAS
LINE [1 1/2 INCH GAS PIPING] EQUIPMENT
SHALL BE INSTALLED IN ACCORDANCE WITH
MANUFACTURER SPECIFICATIONS. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 196.75 .00 .00
196.75
Plan Check Total 4.50 .00 .00
4.50
Other Fee Total 98.24 :00 .00
98.24
Grand Total 299.49 .00 .00
299.49
LQPERMIT
Bin #
Qty of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
r03�,/ Building Permit Application and Tracking Sheet
Permit #
(0)0
Proj6ctAddress: 1)eCJa)v d,- 1h 0
Owner's Name 1 1
: - I
A. P. Number:
Address: 33 ep, 01'e
Legal Description:
City, ST, Zip:
Contractor: VQC4T)-QN Pbq�S
Telephone:
Address: 216MI&
Project Description: Pccz— abid
City, ST, Zip:1Q/0 CA 9,;Ix-
fo 11 S 494-5. 1 A('e'
Telephone:
StateLic.#:
cityLic.#.:.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project typ e(circleone): New Add'n Alter 'Repair Demo
Name of Contact Person: COA)kl -b
Sq. Ft.;
# Stories:
# Units:
Telephone. #,of Contact Person: ?
Estimated Value of Project: L
-33
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Reqld
RecId
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctz,/iss.-ze
Electrical
Subcontgctor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
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
LTotal Permit Fees
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