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BPOL2015-023378-495 CALLE TAMPICO s LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: c&t!t 4 4Qumrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPOL2015-0233 011M■ 43450 CROISETTE CT 53 609052002 DACHENHAUSEN/GOODMAN RESIDENCE/POOL $25,000.00 Applicant: COMPETITIVE WEST POOL CONSTRUCTION 77980 WILDCAT DR PALM DESERT, CA 92248 OCT 2 9 2015 CITY OF lA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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: C53 License No.: 916827 Date: W -Z9- It� Contractor: 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 violationbf 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 contractors) 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 Nam Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/28/2015 Owner: DACHENHAUSEN / GOODMAN 43450 CROISETTE CT LA QUINTA, CA 92253 Contractor: COMPETITIVE WEST POOL CONSTRUCTION 77980 WILDCAT DR PALM DESERT, CA 92248 (760)625-5705 Llc. No.: 916827 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 tX700 rk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sectof 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: 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 3700 of the or Code, I shall forthwith comply with those provisions. Dater 10. 2-9 -I S Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). 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 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. 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 construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Date: 10 '?Q ' IJ 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 for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION,: : ACCOUNT 'QTY AMOUNT PAID : PAID DATE. SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $0.00 PAID BY METHOD RECEIPT #::: :: CHECK .# DESCRIPTION ACCOUNT QTY:; AMOUNT PAID PAID DATE SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $0.00 PAID BYMETHOD > .. RECEIPT # CHECK # CLTD BY Total Paid for POOL / SPA: $279.91 $280.91 $0.00 , $0.00 Description: DACHENHAUSEN/GOODMAN RESIDENCE/POOL Type: POOL Subtype: Status: APPROVED Applied: 10/27/2015 MFA Approved: 10/27/2015 KKI Parcel No: 609052002 Site Address: 43450 CROISETTE CT LA QUINTA,CA 92253 Subdivision: Block: Lot:5 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $25,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL & SPA. EQUIPMENT WALL NOT INCLUDED ON THIS PERMIT. 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. Applied to Approved CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES . NOTE MARY FASANO 10/27/2015 sent back 10/27/15 CONDITIONS NAME TYPE NAME., ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT COMPETITIVE WEST POOL CONSTRUCTION 77980 WILDCAT DR PALM DESERT CA 92248 CONTRACTOR COMPETITIVE WEST POOL CONSTRUCTION 77980 WILDCAT DR PALM DESERT CA 92248 OWNER DACHENHAUSEN / GOODMAN 43450 CROISETTE CT j LA QUINTA j CA j 92253 FINANCIAL INFORMATION Printed: Wednesday, October 28, 2015 10:51:23 AM 1 of 2 SYSTEMS INSPECTIONS ATTACHMENTS Printed: Wednesday, October 28, 2015 10:51:23 AM 2 of 2 SYSTEMS CLTD DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY - BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING 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 TOTALS::0 0• INSPECTIONS ATTACHMENTS Printed: Wednesday, October 28, 2015 10:51:23 AM 2 of 2 SYSTEMS Building 8i• Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #i pp b Project Address: Cec tt�0TR<— Owner's Name: '�ACRN-M1+P(0sE)11' appM A. P. Number: Address: 43 4-5o cvo i Legal Description: City, ST, Zip: LA Ji Contractor: F voc�S Telephone: .�:::'l'<��'•><:;.;;:.:;.;:::•;,:: Add-ress: '�� G�� -- Project Descr iption: ter ae, City, ST, Zip: 'Z' ,1 S vi Telephone: State Lic. # : City Lic. #.: ,) -A Pte' Arch., Engr., Designer: . - Address: �PLh Di;>✓1�(' City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): ew Add'n Alter Repair Demo Nanie of Contact Person: 4-E N t' LAc1. Sq. Ft.: # Stories: If Units: Telephone # of Contact Person: /OZ -5-5-70,s- Estimated Value of Project: 2 Cj APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance. Title 24 Cates. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2"Review, ready for correclionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. Ii.O.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