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13-1388 (RPL)P.O. BOX 1504' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Ta�/ 4u�lGv VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Application Number: 13-00001388 Property Address: 52975 LATROBE LN APN: 770-340-014- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 38000 Applicant: Architect or Engineer: ------------------ 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 Busi�andssionals Code, and my License is in full force and effect. Licp.nse Class: C53 License No.: 833313 � ati ! J(-1 Contractor OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of jury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, - 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).: (_ 1 1, 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 (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.). (_ 1 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 Name: _ Lender's Address: c LQPERMIT ----------------------------------------------- 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 sued. _ 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 workerscompensation insurance carrier and policy number are: Carrier RMU SOLUTIONS Policy Number 428122 _ 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 Ishould ecome subject to the workers' compensation provisions of Section 3700 of the Labor Code hall forthwith comply with those provisions. Date: �Q`.r1 �� Applicant:-� Ii �� WARNING: FAILURE TO SECURE -W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDI N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR ODE, 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, indemnity 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 buildi g construction, and hereby authorize representatives of this county to enter upon the above-mentioned propert f inspection rposes. Date: -_10_31'9 SignatVra Applicam or Agent)!' Date: 10/31/13 Owner: BRENDA JEAN WEST TRUSTEE RILEY TRUST 136 2ND LANE BURLINGTON, ON L7L2H-7 Contractor: b('I 22013 LINDLY'S POOLS OF CALIFORNI 30755 DESERT PALM DRIVE ca{iU THOUSAND PALMS, CA 92276 �a�uio_ FINANCE DEPT (760)343-0600 Lic. No.: 833313 ----------------------------------------------- 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 sued. _ 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 workerscompensation insurance carrier and policy number are: Carrier RMU SOLUTIONS Policy Number 428122 _ 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 Ishould ecome subject to the workers' compensation provisions of Section 3700 of the Labor Code hall forthwith comply with those provisions. Date: �Q`.r1 �� Applicant:-� Ii �� WARNING: FAILURE TO SECURE -W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDI N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR ODE, 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, indemnity 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 buildi g construction, and hereby authorize representatives of this county to enter upon the above-mentioned propert f inspection rposes. Date: -_10_31'9 SignatVra Applicam or Agent)!' i Application Number . . . . . 13-00001388 Permit . . . POOL 2013 Additional desc . Permit Fee . . . . 178.75 Plan Check Fee .00 Issue Date . . . . Valuation_ . . . . 0 Expiration Date .. 4/29/14 Qty Unit Charge Per Extension 1.00 178.7500 EA MISC POOL/SPA ---------------------------------------- ----------------------------------- 178.75 Permit . . . PLUMBING 2013 Additional desc . Permit Fee . . . . 11.92 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 4/29/14 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. 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 190.67 .00 .00 190.67 Plan Check Total .00 .00 .00 .00 Other Fee Total 98.24 .00 .00 98.24 Grand Total 288.91 .00 .00 288.91 LQPERMIT BIR # City Of La Quints ButWtng s[ Safety Division P.O. Box 1504,79-495 Otte Tamptco La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # ProjedAdd=. J Z 5 C Owner's Name: A P. Number. Lege[ Description: L.0 r (� i:DCf l 110 $ Contractor. Q 4 0 0 S Pi�;v B 0 F Coi- I aCl Address: � 2 � � S � �j,� � � E , , Cita+STZip: C1 0,1 �J Telephone: Project Description: Address: �% {� �5 en (j' �rn U� MAI/ r City, sT,Zip: ' 4d5NJD -1'�S S V1 C'JJ'j0. Telephone: 1\00 lj4) -0b 0? ►VeV.., VVI ISfid n 6 -AS LNt l (l�ti i CrDrS V► 1� State Lic #: City Lic. fk. OD $ Arch, Bngr., Designer � .p�. . Address: �.r1 F1 �1/D �'.� X • V.i �( O; (� 2 �� GAS lh L City., ST, Zip: qvw oeslaa f (r C-) 1,7L -i r, M YID rets ' Q QJIPM�►'r Telephone: Construction Type:. Occupancy: Slate Lia #:' Project type (circle one) New Add'n Alper Repair Demo. Name of Contact Person: . • Sq. Ft.: # Stories: #Univ Telephone # of Contact Person: ��c7 + , 7� Estimated Value of Pmject 3 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec,d TBACICIING • P$RMITFEiS- Plan sets Pian Cheek submitted item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Caked Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain pian Plans resubmitted.'. Mechanical Ginding plan 2'! Review, ready for correcti u ke Electrical Snbeoatactor ListCalled Contact Person Plumbing Grant Deed Plans picked up ML H.O.A. Approval Plans resubmitted Grading I IN HOUSE% 1ie Review; ready for eorrectlonslissue Developer Impset Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees CITY OF U U I BUILDING & t �otalPermit tea Ar r F v v L_ L-✓ FOR CONSTRUCTION DA 0 BY� 1sf ]U)SS DEYPi caln 00.1'rt.mousa:�Y natNS Cn s�)le.ucanll)1 )-()6]I>•'Yw,00-v:N�:.uNR lSG.COn-u::q��ynR�nafLtOn • , O ............ \ . T % / I — FMM.24 In \I LTJ ��' DXCC DY07D)ot8 Dacxevor�a PA DPC¢ 9Y O'1�B8 PA PA DG �— cvvWJ=T MAIs DIA DXIE']2NC DIgCH WAM DIA XXDnuc w.aca WAIL CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DA /-gt BY S'f ouamW R.:e:wm Retlmre mem Sees i.oveeL,m m � asd ue,me: m wmn: v DCDW: 3 � 5 PRMc UI U R Spee ]RLQ � a. 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