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BPOL2014-105178-491 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: BPOL2014-1051 78441 W DEACON DR C�� 0 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/17/2014 ISI II II Owner: I�JI II II THOMAS HAACKER 770210017 NEW POOL, SPA, FIRE PIT AND WATER $30,000.00 Applicant: UNDLY'S POOLS OF CALIFORNIA 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 I '' 17 2014 CITY OF LA QUINTA TYDEYEWPMENTDEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.: :LIC -0100809 Date: — ( Contractor: i OWNER-BUILDLECLARA4� TION 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).: (_) 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.). (_J 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 Lender's Address: 78441 DEACON DRIVE WEST LA QUINTA, CA 92253 Contractor: LINDLY'S POOLS OF CALIFORNIA 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (760)343-0600' Llc. No.: :LIC -0100809 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 to the workers' compensation laws of California, and agree that, if 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: s Applicant: WARNING: FAILURE TO SECURE WORKERS' C MPENSATION 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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Date: �r) �) Signature( Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $2.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $11.92 $11.92 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $23.83 $23.83 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH Total Paid for PLUMBING FEES: $35.75 $35.75 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DETACHED SPA/WATER FEATURE/OTHER 101-0000-42404 0 $178.75 $178.75. 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404 0 $178.75 $178.75 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA PC 101-0000-42600 0 $97.24 $97.24 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER FEATURE ONLY 101-0000-42404 0 $178.75 $178.75 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER FEATURE ONLY PC 101-0000-42600 0 $97.24 $97.24 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LINDLY'S POOLS OF CALIFORNIA CHECK R1241 8561 SKH Total Paid for POOL/ SPA: $730.73 $730.73 TOTALS:4. Description: NEW POOL, SPA, FIRE PIT AND WATER FEATURE Type: POOL Subtype: Status: APPROVED Applied: 9/9/2014 MFA Approved: 9/9/2014 MFA Parcel No: 770210017 Site Address: 78441 W DEACON DR LA QUINTA,CA 92253 Subdivision: TR 28611 Block: Lot: 3 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $30,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL, SPA, WATER FEATURE AND FIRE PIT, [2 INCH GAS PIPING/#8 AWG IN 1 INCH CONDUIT ELECTRICAL] EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE - PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. ..___.I Applied to Approved. Printed: Wednesday, September 17, 2014 12:16:23 PM 1 of 3 IAF AC77.0_,•__ M CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK #. METHOD PAID BY BY LINDLY'S POOLS OF BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 9/17/14 R1241 8561 CHECK SKH CALIFORNIA Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $2.00 BSA: GAS SYSTEM, 1-4 101-0000-42401 0 $11.92 $11.92 9/17/14 R1241 8561 CHECK LIN POOLS OF SKH CALIFORNIAOUTLETS CALI GAS SYSTEM, 1-4 101-0000-42600 0 $23.83 $23.83 9/17/14 R1241 8561 CHECK LINDLY'S POOLS OF SKH OUTLETS PC CALIFORNIA Total Paid for PLUMBING FEES: $35.75 $35.75 DETACHED SPA/WATER LINDLY'S POOLS OF 101-0000-42404 0 $178.75 $178.75 9/17/14 R1241 8561 CHECK SKH FEATURE/OTHER CALIFORNIA LINDLY'S POOLS OF SWIMMING POOL/SPA 101-0000-42404 0 $178.75 $178.75 9/17/14 R1241 8561 CHECK SKH CALIFORNIA SWIMMING POOL/SPA 101-0000-42600 0 $97.24 $97.24 9/17/14 R1241 8561 CHECK LINDLY'S POOLS OF SKH PC CALIFORNIA WATER FEATURE ONLY 101-0000-42404 0 $178.75 $178.75 9/17/14 R1241 8561 CHECK LINDLY'S POOLS OF SKH CALIFORNIA WATER FEATURE ONLY 101-0000-42600 0 $97.24 I $97.24 9/17/14 R1241 8561 CHECK LINDLY'S POOLS OF SKH PC I I I I I CALIFORNIA Total Paid for POOL/ SPA: $730.73 $730.73 TOTALS: Printed: Wednesday, September 17, 2014 12:16:23 PM 2 of 3 Ar -lo ........ Bkz #City of- La Quihta BWkgng 8f Safety DW6n P.O Box 1504,-7849S Caste Tampfco 1.a.Quhita, CA 92253 -:(760) 777-7012 100 Building Permit Application and Tracking Sheet Perratt # P �. pl Project Addm�s: — l(04 M vi t. t Owner's Name:. 11-1,04AS %t�v) A P. Number �'1 �" 2,10— (9 Address: 7 U " co.) M.. Legal Description: City, ST, Zap: Conuutor. �1 N ��/ %Ms of CA T4.r-, `Telephone: Address:3Q�5� J� ProojectcD•escripttion: nP /��uE City, ST, Zip: 5 iA � Ali (A q ZT iv n^ 1 �L L P Foo L C �A POOL a)^ .' Telephone 30-0 l,i i� 4 oZ u if slate Lia # : 33 Lic: l ��aA PIT Address: City., ST. Zip: Telephone: State Lia #: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft : #Stories: #Units Name of Contact Person oSe ►V (!( i2 Telephone # of Contact Person: - (/� � Estimated Value of Project:, IJV APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACING PERMPP FEES Plan Sets Pian Cheek submitted Dam Amount 3trgetural Caler Reviewed, ready for con=does Plan Check Deposit. . 'Nass Cater. Called Contact Person Plan check Balance title 24 Caleo. Plans picked up Canstracdon Flood plaiu plan Plans resubmltted ' Medmfilcal Gmdlug plan Z" Review, ready for correctiomfusue Electrical Subeoatattor last Called contactPcrson Plumbing Grant Deed Pians picked up H.O.A. Approval Plans resubmitted Grading IN HOUSE • ''• Review; ready for oorree6 26.21 Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees