13-0534 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'!t 4 J4 Q"
Application Number:
13-00.0AA&34
Property Address:
53351 VIA STRADA
APN:
772-520-052- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2000
Applicant: Architect jor Engineer:
ca
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 Professionals Code, and my License is in full force and effect.
License Class: C53 License No.: 802919
" Date: 5-2-/ 3 Contractor:
OWNER-BUILDERER DEC
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).:
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
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.).
(_ 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:
LQPERMIT
SCANNED VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
CVETAS RESIDENCE
53351 VIA STRADA
LA QUINTA, CA 92253
Contractor:
AZURE POOLS AND
P.O. BOX 10641
PALM DESERT, CA
(760)322-7665
Lic. No.: 802919
SPAS
Date: 5/01/13
92255
-----------------------------------------------
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
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:
Carrier SOUTHERN INS Policy Number PWC002199-12
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 s 1 orthwith comply with those provisions.
WOM
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 (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, 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, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any as 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 building const ction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for in tion purposes.
Date: a1 �3 Signature (Appl�cant_or Agent):
Application Number . . . . . 13-00000534
Permit
BLDG POOL PERMIT
Extension
Additional
desc . .
15.00
Permit PLUMBING
Permit Fee
. . . . 45.00
Plan Check Fee
29.25
Issue Date
. . . .
Valuation . . . .
2000
Expiration
Date 10/28/13
. 0
Expiration Date 10/28/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
15.00
----------------------------------------------------------------------------
2.0000 HND BLDG
501-2,000
30.00
Permit
. . . ELEC.POOL PERMIT -RES
Additional
desc .
PLANS & ST.
Permit Fee
. . . . 15.00
Plan Check Fee
3.75
Issue Date
. . . .
Valuation . . . .
0
Expiration Date 10/28/13
Qty Unit Charge Per
Extension
BASE FEE
------------------------------=---------------------------------------------
15.00
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 10/28/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE
1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
COURTYARD WATER FEATURE PER APPROVED
PLANS & ST.
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 78.00
.00 .00
78.00
Plan Check Total 37.50
.00 .00
37.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total 116.50
.00 .00
116.50
LQPERMIT
Bfn. #
Permit #
Project Address: '
Citjr of La Quihta
Building & Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Wnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
i Q Owner's Name:. C V-P—
A. P. Number.
Address:
Legal Description:
Contractor. (��
6 (S S'
City. ST, Zip:
Telephone:
Address: pt.ftK
lou 4 `
Project Description:
City, ST, Zip:
Telephone:
State Lic. # City Lic,
Arch., Engr., Designer:
Address:
.J r
City, ST, Zip:
Telephone:
State Lie. #:
Construction Type:. Oaarpancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq, FL ;
#Stories: #Units
Telephone # of Contact Person:
.. 2 . `Q �� g Value of Proje': Zito
APPLICANT: DO NOT WRITE BELOW THIS UNE
k
Submittal
Req'd
Rev'd
TRACKING PERhIITFEES
Plan Sets
Plan Check submitted Item Amount
Structural Calm
Reviewed, ready for corrections r Plan Check Deposit.
Truss Calcs.
Called Contact Person Plan Check Balance
Tithe 24 Calm
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
Z`! Review, ready for correctionsrmue Electrical
Subcontactor List
Called Contact Person Plumblag
Grant Deed
Plana picked up SALL
fi.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''• Review; ready for correctionvIssue Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
stotal Permit Fees
BUILUINU ZSk AHI -r=1 i ucr- l .
APPROVED
FOR CONSTRUCTION
DATE_�BY