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BPOL2016-010678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 14P Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPOL2016-0106 Property Address: 78350 VIA DIJON APN: 604600022 Application Description: NETTIMI RESIDENCE / POOL & SPA Property Zoning: Application Valuation: $44,133.00 Applicant: BRILLIANT POOLS DBA PREMIER POOLS & SPAS P 0 BOX 429 ICCA %,71'.EY, CA 9278E ; VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 L1—U U Owner: U 1AISURYA NETTIMI 78350 VIA DIJON JUL 2 6 2016 11�LA QUINTA, CA 92253 CITY OF LA QUINTA COMMUNITY DEVELOPPIENT DEPARTtIENT 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.: 878257 Date: W4—/t Contractor: OWNER -BUILDER ECLARATION 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.). (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 Law.). I I 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 Date: 7/26/2016 . Contractor: BRILLIANT POOLS DBA PREMIER POOLS & SPAS P O BOX 429 YUCCA VALLEY, CA 92286 (760)333-0187 Llc. No.: 878257 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 Pork for which this permit is issued. ave and will maintain workers' compensation insurance, as required by Sect' 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and polity 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. 3 Date: ` 026- / ("_Applicant: WARNING: FAILURE TO SECURE 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 PROVICED 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 r lating to building construction, and hereby authorize representatives of this city to e r upon the above-mentioned property for inspection purposes. // Date: 7-2 C /S- Signature (Applicant or Agent) DESCRIPTION FINANCIAL ACCOUNT r QTY AMOUNT PAID. PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 7/26/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY BRILLIANT POOLS DBA PREMIER PO DEBIT R17362 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $2.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 7/26/16 PAID BY METHOD RECEIPT # CHECK # CLTD-BY BRILLIANT POOLS DBA PREMIER PO DEBIT R17362 RSE DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ; WIMMING POOL/SPA PC 1J1-0000=41600 Oy $99.6i'- $98.62 7/26/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY BRILLIANT POOLS DBA PREMIER PO DEBIT R17362 RSE Total Paid for POOL / SPA: TOTALS: $279.91 $279.91 Description: NETTIMI RESIDENCE / POOL & SPA Type: POOL Subtype: Status: ISSUED Applied: 7/19/2016 MFA Approved: 7/19/2016 bCL Parcel No: 604600022 Site Address: 78350 VIA DIJON LA QUINTA,CA 92253 Subdivision: TR 30521-2 Block: Lot: 22 Issued: 7/26/2016 RSE Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $44,133.00 Occupancy Type: Construction Type: Expired: 1/22/2017 RSE No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL & SPA ONLY. CHRISTOPHER J BIEDENBACH ENGINEERING. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. PER 2013 CALIFORNIA BUILDING CODE. '� o __j Applied to Approved Approved to Issued CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE ry• NOTES TELEPHONE CALL DUANE CLAYTON 7/19/2016 7/19/2016 SPOKE TO CONTACT AND INFORMED THEM THAT THE PLANS ARE READY Tp PICK UP AND REVISIONS ARE REQUESTED (SEE t REVIEW NOTES). CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT BRILLIANT POOLS DBA PREMIER POOLS & SPAS P 0 BOX 429 YUCCA VALLEY CA 92286 CONTRACTOR BRILLIANT POOLS DBA PREMIER POOLS & SPAS P 0 BOX 429 YUCCA VALLEY CA 92286 OWNERJAISURYA NETTIMI 78350 VIA DIJON LA QUINTA CA 92253 FINANCIAL INFORMATION Printed: Tuesday, July 26, 2016 8:27:16 AM l.of 2 cp SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECn # METHOD PAID BY CLTD DATE ;� BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 7/26/16 R17362 7/19/2016 DEBIT BRILLIANT POOLS DBA RSE DAY) BUCKET PREMIER PO Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $2.00 BSA: SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 7/26/16 R17362 DEBIT BRILLIANT POOLS DBA RSE PREMIER PO SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $98.62 7/26/16 R17362 DEBIT BRILLIANT POOLS DBA RSE PC PREMIER PO Total Paid for POOL / SPA: $279.91 $279.91 TOTALS: PARENT PROJECTS REV E IEW TYP REVIEWER SENT DATE DUE DATE RETURNED REVIEWS STATUS - REMARKS NOTES DATE ;� ZA S' SET BACK BETWEEN PROPERTY LINE AND 1ST BLDG NS (1 BUILDING 7/19/2016 7/20/2016 7/19/2016 REVISIONS REQUIRED I.ftW POOL EQUIPMENT IN SIDE YARD REQUIRED DAY) BUCKET PER LQMC 9.60.070.2.8. BOND INFORMATION Printed: Tuesday, July 26, 2016 8:27:16 AM 2 of 2 r srsTEMS Bin ## 0ty of La Quinta l A Building &r Safety Division Permit #. r �`� 78-495 Calle Tampico l La Quinta, CA 92253 = (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:�3.�� j v ; +� !�t -� Owner's Name: /iC , A. P. Number: Address: % S LAli 0,J 61d Legal Description: i1% h>ST ZiP: J4u ei r- s Contractor:r: M 7 Telephone: CS J MM Address: �� 3 O C( e� Project Description: V G( 0& L City., ST, Zip: Tele hone: 1 P C I6 State Lie. # : J City Lie. #: Arch.,. Engr., Designer: Address: City., ST, Zip: Telephone: Construction Type-. � kOccupancy: P Y: Gv. L#. a e ie. S tt P type circle one) ew Add'n AItor. Repair r Dem oJ Name of Contact Person: J �� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project.4e APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"' Review, readv for correctionsfissue Electrical Subcontactor 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 corrcctionsCssue Developer Impact FCC Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit FC2s