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14-916 (RPL)78495 CALLE TAMPICO LA QVINTA, CALIFORNIA 92253 Application Number: RPL44-916 Property Address: 78451 DEACON DR W APN: 770210016 Tj+r 4 1w 40& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Description: POOL/SPA/FIRE PIT/BBQ AT REAR, YAW Property Zoning: Application Valuation: $37,000.00 JUL 2 5 2014 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 License No.: 408796 �te: Z Contractor: OWNER -BUILDER DEC LA TION I hereby affirm under penalty of perjurythat I am exempt from the Contractor's State License Law for the,followng reason (Sec.. 70315, Business and Professions Code: Any city or county that requires a permitto 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 pursuantto 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 70315 by any applicant fow permit subjects the applicant to a civil penaltyof not more than five hundred dollars ($500).: U 1, as owner of the property, or my employees with wages:as their sole compensation, will do the work, and the structure isnot 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=builderwill have the,burden of provingthat 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),Iicensed pursuant to• the Contractors' State License Law.). ( ) I am exempt under Sec. ..B.&P.C. for this reason Date: 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (160) 777-7153 Date: 7/25/2014 Owner: SAMUEL KAPUKCHYAN Contractor: CUSTOM BUILT POOL & SPA 9480 SAN BERNARDINO RD RANCHO CUCAMONGA, CA 91730 (909)981-7767 Llc. No.: 408796 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty.of perjury one of the following declarations: I have and Will maintain a,certificateof 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 I should become.subject.to the workers' compensation provisions of Section 3700 of.the Labor Code, I shall forthwith comply with those provisions. ate: % �i / pplicant: WARNING: FAILURE TO SECURE WORKERS' "SATIONAGEIS.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 INSECTION 3706 OF THE LABOR CODE, INTEREST, -AND ATTORNEYS FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for permit subject to the condltions;and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose requestand 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 Qulnta, its officers, agents, and employees for any act oromission related to the work being performed under or 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 appiicationand 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'herebyauthorize representatives of this city.to enter upon the above- mentioned property for inspection purposes. Date: % ignature (Applicant or Agent): J4 MW2 Permit Number: RPL -14916 Applied: 6/23/2014 Issued: 7/25/2014 Status: ISSUED Parent Permit: Parent Project: Approved: 7/14/2014 Finaled: Description: POOL/SPA/FIRE PIT/BBQ AT REAR YARD Site Address: 78451 DEACON DR W City, State Zip Code:,LA QUINTA, CA 92253 Applicant: <NONE> Owner: SAMUEL KAPUKCHYAN Contractor: CUSTOM BUILT POOL & SPA Details: POOL; SPA, BBQ AND FIRE PIT ATAEAR YARD [POOL ENGINEERING INC] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. Printed: Friday, 25 July, 2014 1 of 1 sysrEMS •• • � D SCItIPTI � `. a• , � _� AN7 Y' � 'I' .' D' �,+"'"� �A D' OA'[E .BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 7/25/14 gi :.Oi BY .£_ N,METJ{OD ��- RECEfIaTu �j r �: . - BY CUSTOM BUILT'POOL & SPA CHECK RS11 3903 KHE Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $2.00 >, ACCOUNT. Q pAr M NT � }PAID P.IVDATE DEVICES, FIRST 20 101-0000-42403 0 $23.83 $23.83 7/25/14 F CHECKS CLTD BY° . CUSTOM BUILT POOL & SPA CHECK R511 3903 KHE R ' A��UNTID_.,. PAID D'A�TE, DEVICES, FIRST 20 PC 101-0000-42600 0 $23.83 $23.83 7/25/14 SAID B METFIOD !7HOD �RECEI #� CHECK # TDBY ` CUSTOM BUILT POOL & SPA CHECK R511 3903 KHE Total Paid for ELECTRICAL: $47.66 $47.66 ACCOUNT` NT PAID'R PAID D14TE GAS SYSTEM,.1-4 OUTLETS 101-0000.42401 0 $11.92 $11.92 7/25/14 } a . � r �� , � e t° as • -a -• kk:��i � I .. LTD BYE CUSTOM BUILT POOL & SPA CHECK R511 3903 KHE R,PTION' Q�.. NT PAID 3PAID DATE GAS SYSTEM, 1-4 OUTLETS. PC 101-0000-42600 0 $23.83 $23.83 7/25/14 PAID BY g ?zf YMETHOD RECEI �f gy ��CHECK CLTD BY, ,= CUSTOM BUILT POOL & SPA CHECK R511 3903 KHE Total Paid for PLUMBING FEES: $35.75 $35.75 r DESCRIPTIO,lilrc Y�ACCOUNT 07 Ctl ,AMONT. ! ,s " =PAID PAID SATE SWIMMING POOLISPA 101-000042404 0 $178.75 $178:75 7/25/14 CLTD BY CUSTOM BUILT POOL &.SPA CHECK R511 3903 KHE ._r ~ ESCRIPTIO „ r .IME ,_ 3i&°"-.:. @4Y.4�' _.e CCOU s 'i.F AM_t�PAIDy� PAID DATE SWIMMING POOL/SPA PC 101-0000-42600 0 $97.24 $97.24 7/25/14 ti� __PAID:BY 1f1ETH0 RECEI "CHECK # GLTDBY CUSTOM BUILT POOL & SPA CHECK R511 3903 KHE Total Paid for POOL/ SPA: $275.99 $275.99 TOTALS.�� 40 Date Paid: Friday, July 25, 2014 Paid By: CUSTOM BUILT POOL & SPA Cashier: KHE Pay Method: CHECK 3903 Printed: Friday, July 25, 2014 8:18 AM 10f 1 CYtTCMC ON103 VI �Nlll ......... ti 700d ONIMPY1 LS .......... .......... ..... S .. . . Id 3811 ............ 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La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking -Sheet Permlt # Project Address: %�" Sal ��' p Owner's Name: JQ C S� A. P. Numbel Address: Legal Description: _ City, SZ, Zip: Contractor: 45, r 6N eU I C (/ODl Telephone: Address: S-,4 IV 6£'/2%1/ IN rojectDescription: O0 SU" City, ST, Zips RANC Ha C ttC#M.O'/✓ f's Telephone: 6f; / fr/'7 7 C7 State Lic. # <.S_ O9'7 J'C City Lie- c Arch., Engr., Designer Address: City,, ST, tip: Telephone- _•ww: Construction 1)rpc:l Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic: #: Name of Contact Person: �d ��l/ S y Sq. Ft :# Stories: #Units Telephone #;of Contact Person: Estimated Value of Project: '� 7 000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Iite'd TRACIMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Cbeek Deposit Truss Calcs. called Contact Person an Check glance • V Title 24 Calm Plans picked up Construction • f mo Flood plain plan Plans resubmitted } Mechanical Grading.plan 2•' Review, ready for corrections/issue Electrical Subcontactor List Called Contact;Person Plumbing Grant Decd Plans picked up S36LI, H.O.A. Approval Plans resubmitted Grading IN,HOUSE;- '"/ Review, ready for correetionsliissue Developer Impact Fee Planning. Approval Called.Contact.Person A.I.P.P. Pub. Wks. Appr Date of perm It Sch . Total Permit Fees JUN,2 3 Z0147, 'j'OIq —0�• CITY OF 1A QUiNTA f COMMUNITY DEVELOPMgNT