14-0152 (RPL)TAt!� 4
P.O. BOX 1504 ^� % VOICE (760) 777-7012
78-495 CALLS TAMPICOFAX 760 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/13/14
Application Number: 14-00000152 Owner:
Property Address: 53699 VIA MALLORCA PISCO WALTER J
APN: 777-390-016-1 -33654 - 6000 SE 20TH ST
Application description: POOL - RESIDENTIAL MERCER ISLAND, WA 40
Property Zoning: LOW DENSITY RESIDENTIAL 2 ^ ZdA1F
Application valuation:. 50000 rtB
Contractor: CITY OF LAQUINT41 /
Applicant: / Architect or ineer: " MCINTYRE POOLS & S AS NAHCEDEPI
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic.-No.: 614611
LICENSED_ CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION.
1 hereby affirm under penalty of perjury that I am licensedunder provisions of Chapter 9 (commencing with . I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.- _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided '
` License Class: C43 License No.: 614611 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
�•t issued.
Date: Contractor:/� - _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier WESCO INS CO Policy Number WWC3053611
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the _ .person in any manner so as to become subject to the workers' compensation laws of California, -
_ permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State r and agree that, if I.should become subject to the workers' compensation provisions of Section' -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions.
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)•: Date: �/fApplicant:-
1 _ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, : SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
I and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES:
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.). APPLICANT ACKNOWLEDGEMENT -
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT 'Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State license Law does not apply to an owner of conditions and restrictions set forth on this application. '
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. . , B.&P.C. for this reason 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.
Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced
. i within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject '
CONSTRUCTION LENDING AGENCY permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this coun y to mer upon the above-mentioned property for inspection r § ues.
Lender's Name: - /7�_
Dater Signature (Applicant or Agent):
Lender's Address: - /.
LQPERMIT
LQPERA1IT
Application Number 14-00000152
Permit POOL 2013
Additional desc
.
Permit Fee . . . 357.50 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 8/12/14
Qty Unit Charge Per
Extension
2.00 178.7500 EA MISC POOL/SPA
357.50
--------------------------------------------------
Special Notes and Comments
POOL, SPA AND FIRE PIT AT REAR YARD
W/WATER FEATURE AT FRONT YARD (DENISE -
POELTLER ENGINEERING] THIS PERMIT DOES
.a
NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS
AND BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2013 CALIFORNIA
'
BUILDING CODE.
February 13, 2014 9:32:12.AM AORTEGA
------------------------------------------------ ----- ---- -----------------
Other Fees . . . . _ . . BLDG STDS ADMIN (SB1473). ,"
2.00
PLAN CHECK, POOL
97.24
Fee summary -Charged r. Paid Credited
Due
--------------------------------------------
Permit.Fee Total 357.50 .00 00
-----
357.50
Plan Check Total .00 _ 00 00
00
Other Fee Total 99.24 .00 .-00
'99..24
- ro Grand Total 456-.74 .00. 0-0
-456.74
r
LQPERA1IT
An #
•CI�Of La C(IClta
. ..
Building $t;' Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: —
, Owner's Name:Tse-o
A. P. Number
Address: - O l Nu f D
Legal Description:(W
City, ST, Zip:
Contractor: C
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t C
Telephone: k x
Project Description: f
Address: - 6q
....
City,'ST,.Zip: ' C~ -120
(AIC(
Telephone: (]
State Lie. # yG �,
City tic. # S
Arch., Engr., Designer:
264b
Address:
COM LA NTA
City.; ST, Zip:
t VELOPMENT
Telephoner
Construction Type: Occupancy:
State Lie. #:ject
tYPa circle one): New Add'n Alter Reair Demo
Name of Coxuact Person:
Sq. Ft:
#Stories:
Fu nits:
Telephone # of Contact Person:
Estimated Value of Project: ISSQ O00 �-
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.,
Reviewed, ready. for corrections
Plan Check Deposit.
Truss Calcs. '
..Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan2od
Review; ready 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:-
"d Reyiew, ready.for correcd Issne
Developer Impact Fee
AX P.
Planning Approval
Called Contact Person Iy
Pub. Wks. Appr
Z. ;
Date of permit issue
School Fees
Total Permit Fees
1