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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 ,