BPOL2015-019478-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
I;j
`&ttf 44Qu;«rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPOL2015-0194
Property Address: 81929 VIA LA SERENA
APN: 767660037
Application Description: BENZINGER / ADD SPA TO EXISTING POOL
Property Zoning:
Application Valuation: $16,000.00
Applicant:
PALOMAR POOL'S
31-225 SIERRA DEL SOL
THOUSAND PALMS, CA 92276
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: CC53 License No.: 912619 `V/
Dater 1 .f — I / Contractor: �4 1 Q e— " ,l ed
OWNER -BUILDER DECLARATION
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.).
( ) 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury one of -he 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:
Carrie 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 3.00 of the Labor Code, I shall forthwith
comply with those provisions. %
I/ f
Date:01—,-t 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 ($100,00C_). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR11N 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 appliotion 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 owne4 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 tlh 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 i::suance of such permit, or cessation of
work for 180 days will subject permit to cancellbtion.
I certify that I have read this application and stele that the above information is correct.
I agree to comply with all city and county ordirances and state laws relating to building
construction, and hereby authorize representaives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent)
Date: 9/4/2015
Owner:
CARMELA COMMUNITY ASSN
P 0 BOX 799
RANCHO MIRAGE,.CA 92253
F
0 o
CXCX
Q
Zo
w
Contractor:
g o
PALOMAR POOLS
C
o
31-225 SIERRA DE=_ SOL
W
o
THOUSAND PALM i, CA 92
6 c�
U
z
(760)774-7624
C)
Llc. No.: 912619
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury one of -he 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:
Carrie 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 3.00 of the Labor Code, I shall forthwith
comply with those provisions. %
I/ f
Date:01—,-t 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 ($100,00C_). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR11N 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 appliotion 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 owne4 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 tlh 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 i::suance of such permit, or cessation of
work for 180 days will subject permit to cancellbtion.
I certify that I have read this application and stele that the above information is correct.
I agree to comply with all city and county ordirances and state laws relating to building
construction, and hereby authorize representaives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent)
DESCRIPTION
FINANCIAL INFORMATION
:. ACCOUNT CITY AMOUNT
PAID PAID DATE.
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA'. $1:00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
PAID BY
METHOD
RECEIPT #-
- CHECK #
'CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
= PAID
PAID DATE
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$0.00
PAID BY,
METHOD
RECEIPT #
CHECK # ..
CLTD BY
Total Paid forP00L /SPA. $279.91 $0.00
TOTALS::• 0•0
Description: BENZINGER / ADD SPA TO EXISTING POOL
Type: POOL Subtype: Status: UNDER REVIEW
Applied: 9/4/2015 SKH
Approved:
Parcel No: 767660037 Site Address: 81929 VIA LA SERENA LA QUINTA,CA 92253
Subdivision: TR 31874-1 Block: Lot: 37
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $16,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME
Details: POOL REMODEL -ADD NEW RAISED SPA, REAR WALL OF POOL RAISED 18" FOR WATERFALL. EQUIPMENT SHALL BE INSTALLED IN
ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2013 CALIFORNIA BUILDING CODE.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
PALOMAR POOLS
31-225 SIERRA DEL SOL THOUSAND
PALMS
CA
.92276
CONTRACTOR
PALOMAR POOLS
31-225 SIERRA DEL SOL THOUSAND
PALMS
CA
92276
OWNER
CARMELA COMMUNITY ASSN
P 0 BOX 799 RANCHO
MIRAGE
CA
92253
Printed: Friday, September 04, 2015 9:23:28 AM 1 of 2 ..
sysrcnns
BOND INFORMATION
Printed: Friday, September 04, 2015 9:23:28 AM 2 of 2 CB?WSYSTEMS
L
CLTD
DESCRIPTION
ACCOUNT-
QTY
AMOUNT
PAID.
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$0.00
PC -
Total Paid for POOL/ SPA: $279.91 $0.00
$280.91 $0.00
BOND INFORMATION
Printed: Friday, September 04, 2015 9:23:28 AM 2 of 2 CB?WSYSTEMS
Bin #
City of La Quinta
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet
Permit #
Project Address:2)1 -ILA
U , A li e (
Owner's Name:
A. P. Number:
Address: ,$ �- U 1 .
C.
Legal Description:
City, ST, Zip:
Contractor:
d '" L
Telephone:
Address:3 S
Project Description:
City, ST, Zip:
Telephone:
State Lic. #:
City Lie. #.: �. J
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
le one:
P
'.
Con tructi
s on Type: O ccu :3rtc Y:
P
State to Lic. #:
r Ject type (circle one): New Add n Alter Repair Demo
Name of Contact Person: I: f . C' VkU
If,
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: (p r%— a. - vz
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
1i.0.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,
Total Permit Fees
C.TY. OF L'14-aUINTA.SU -CONTRACTORS-LIST
(&_wf'�RMIT.
JOB ADDRESS l I ' NUMBERT3PL-k- t5' -O gTOWNER _ _ BUILDER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance.
ot.building permit. I -or each applicable trade, an information requested below must be co.rnpletea by applicant. "un rile is not an accepfaoie response.
:.
r
::;�::•:Tr�rin.L (`lacc�fira'tinn�.`�i:.........nntrartnnic:l<irPneP':'.:i .. ..... ....... ... .........c.tnril�nct1►a�n'CP.....�....... ..........
/V dao[ /a
POOL (C:53)... "\ CS /'"�/ ilr�• ) �I 1. L '! �'1 6 Z 3 ads r 1 L
Company Name
Classification
(e.g. A B C-8)
License Number
xxxxxx)
Exp. Date
O.x/xxlxx
Carrier Name
e. .State Fund CalComP
1
Policy Number.
(Format Varies)
Exp Date
xx xx/xx)
License Number
(x xxx)
Exp.. Date
xx xx x x )
.:EARTH. 13 ;H:. .'(C'<T;2') ?> «>
.........................................................
TE M,
�Y�� ,. .�
""
0�
0 0 - (
�( en %
�1 - Cid/ �6 Z
10'�-
:.::::::::::
t::..:::.::AJ
.
;STRUCT.:STEEL:;(C;51;!;>::;>
�(
J"�'" V/N"r� UAtil
.�
l
0'J
Q `J01
�a6o,�j-
g6�1
�� )`
(6 �-
r /
�3�`dotb
/5' —3j
MA 9. NRY'{C;-29j.>:::
...LUMBING _(C 36:).' ...........
`C� /�.�'� / ' flclJ S
C
Ot O C I q
p
rZ 3r) -K
^� /y
/ U /-
/V dao[ /a
POOL (C:53)... "\ CS /'"�/ ilr�• ) �I 1. L '! �'1 6 Z 3 ads r 1 L
PAi nMARI
760-774-7624
LIC# 912619
31-225 SIHRRA DEL SOL, THOUSAND PALMS CA, 92276
POOL SPECS
,