BPOL2016-0143l
78-495 CALLE',TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BPOL2016-0143
[N)
Property Address:
81316 VICTORIAAPN:
764440029 '[
Application Description:
SMITH RESIDENGIE �jlp
L""-
Property Zoning:
Application Valuation:
$26,800.00
Applicant: a-£
DESERT MIRAGE POOLS & SPAS-
84267 MIRAMAR COURT
COACHELLA, CA 92236
44 Qu w
DESIGN & DEVELOPMENT DEPARTMENT
`f7B'j DING PERMIT
L ° I I �,11
OCT 0 4 zul
OUudTA
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
SMITH
81316 VICTORIA LN
LA QUINTA, CA 92253
Contractor:
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT
COACHELLA, CA 92236
Date: 10/4/2016
(760)702-9222
Llc. No.: 999928
---------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARAT N WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed der prow ons of Chapter I hereby affirm under penalty of perjury one of the following declarations:.
9 (commencing with Section 7000) of Division 3 of the Bus ess and ofessions Code, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C53 License No.: 999928 of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
-Contactor: 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:
OWNER -BUILD R DECLA TION Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 912;L416
I hereby affirm under penalty of perjury th t I am a mpt from the Contractor's State
License Law for the following reason (Sec. 31.5, siness and Professions Code: Any
city or county that requires a permit to cons uct, Iter, 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.Ae 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 ) 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: ~
I certify that in the performance of the work for w ch this pe Ft is issued, I
shall not employ any person in any manner so as to become bject to workers'
compensation laws of California, and agree that, if I should comes ct to the
workers' compensation provisions of Section 3700 of the La or Co , I hall forthwith
comply with those provisions. Y
Date:+ Applicant: `
WARNING: FAILURE TO SECURE WORKERS' CMPENS ION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PE LTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,0 0). IN DDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FO IN CTION 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. A
I certify that I have read this application and state that the above info atio i correct.
I agree to comply with all city and county ordinances and state laws lati t building
construction, and hereby authorize representatives of this city to a er u n he
above-mentioned property for inspection purposes.
Date: G- `f `� Signature (Applicant or Agent
RF
Date: 10/4/2016
Application Number: BPOL2016-0143
Owner:
Property Address: 81316 VICTORIA LN
SMITH
APN: 764440029
81316 VICTORIA LN
Application Description: SMITH RESIDENCE / POOL & SPA
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $26,800.00
Applicant:
Contractor:
DESERT MIRAGE POOLS & SPAS
DESERT MIRAGE POOLS & SPAS
84267 MIRAMAR COURT
84267 MIRAMAR COURT
COACHELLA, CA 92236
COACHELLA, CA 92236
(760)702-9222
Llc. No.: 999928
Detail: POO & SPA WITH 9'6 LF AT 4 FT HIGH EQUIPMENT WALL. THIS PERMIT DOES NOT INCLUDE ELECTRICAL. 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
PATIO
DESCRIPTION
MATION
ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $2.00,
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
'$190.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
a •
'
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY --�>C
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Bin #
City Of La Quin t'a
Building & Safety Division
Permit # 78-495 Calle Tampico
n� La Quinta, CA 92253 - (760) 777-701.2
Building- Permit Application and Tracking Sheet
Project Address:
316"v l \ Of ;. Z Owner's Name: �5i Y 5
A. P. Number:
Address .8 ,_ 3
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Legal Description:
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Contractor. '
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Telephone:
Project Description:Pool oo'
Address: _ o',
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State Lic. # :
City Lie. #..
Arch., Engr., Designer-
esignerAddress:
Address:
City, ST, Zip: '
Telephone:
State Lic.
Name of Contact Person:
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Construction Type: cy
(circle Project efcircle one • New Add'n Alter Repair Demo
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Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
_
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACFQNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calls.
Called Contact Person
Plan Check Balance
Title 24 Calcs_
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2”! Review, ready for corrcctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SMI.
A.0 A. Approval
Plans resubmitted
Grading
IN HOUSE:
Jnd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Aper
Date orpermit issue .
Sclwol Fees,
1
-
Total Permit Fees