BPOL2016-0020LICENSED 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.: 8 83
r
Date: �— _ SILP Contracto . tr
OWNER -BUIL 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 Address:
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,wor or 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: _ 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 agre at, if I should become subject to the
workers' compensation provisions of S tion 310 of the Labor Code, I sh I forthwith
comply with those provisions.
� r
Date: -7
r Ivl ADDlica hl\/ L'., L,
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 ($100,000). 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 l 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 of4
_'i[y to enter upon the
above-mentioned property for inspection purposes. I c , A /`
Date: / "` Signature (Applicant or Agent
E
Q�i29
C< 4 Qu&cu
- VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/1/2016
Application Number:
BPOL2016-0020
Owner:
Property Address:
78570 ESTELO CT CT
LINDA RUE
APN:
604174020
78570 ESTELO CT?=7
Application Description:
Property Zoning:
RUE / POOL
LA QUINTA, CA 92253
c cs
Application Valuation:
$20,000.00
Applicant:
Contractor:
C>
Rti 2
LINDA RUE
MC CALLUM POOLS
a a
78570 ESTELO CT
46-576 VIA CELESTE
' c"
LA QUINTA, CA 92253
INDIO, CA 92201
---��
(760)275-6403
—_-
Llc. No.: 818835
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.: 8 83
r
Date: �— _ SILP Contracto . tr
OWNER -BUIL 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 Address:
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,wor or 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: _ 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 agre at, if I should become subject to the
workers' compensation provisions of S tion 310 of the Labor Code, I sh I forthwith
comply with those provisions.
� r
Date: -7
r Ivl ADDlica hl\/ L'., L,
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 ($100,000). 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 l 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 of4
_'i[y to enter upon the
above-mentioned property for inspection purposes. I c , A /`
Date: / "` Signature (Applicant or Agent
E
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 #
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 for POOL / SPA:
TOTALS::•
$279.91
$0.00
0.00
Description: RUE / POOL
CONDITIONS
Type: POOL
Subtype: Status: APPROVED
Applied: 2/25/2016 SKH
Approved: 2/29/2016 JFU
Parcel No: 604174020 Site Address: 78570 ESTELO CT CT LA QUINTA,CA 92253
Subdivision: TR 23269
Block: Lot: 185
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $20,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
APPLICANT
Details: POOL ONLY EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
LA QUINTA
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
LINDA RUE -
78570 ESTELO CT
LA QUINTA
CA
92253
(760)567-9053
CONTRACTOR
MC CALLUM POOLS
46-576 VIA CELESTE
INDIO
CA
.92201
(760)567-9053
OWNER
LINDA RUE
78570 ESTELO CT
LA QUINTA
CA
92253
(760)567-9053
Printed: Tuesday, March 01, 2016 10:10:00 AM 1 of 2
SYSTEMS
Pef 11111 IDfff lI5 PERMIT NUMBER
Y�
City of La Qunta BPO:L2016-0020
Printed: Tuesday, March 01, 201610:10:00 AM 2 of 2
L./ {3 LJ LJ SYS iEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
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
Printed: Tuesday, March 01, 201610:10:00 AM 2 of 2
L./ {3 LJ LJ SYS iEMS
Bin #
City of ra Quinta
6uifding a Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application -and Tracking Sheet
Permit #
LVA
Project Address: .. - �S �� C T'n
Owner's Name:
A. P. Number:
Address: -76-5-20 L S } U C_�
Legal Description:
City, ST, Zip: A .
Contractor: M'CTelephone:
C coo S
C7 - S— Qj
(� b-7
Address: Ll "7(,:, v Q p_ 1 e to
Project Description:
City, ST, Zip: t U
Telephone: a 1+
State Lic. # : g 8 3
City Lie. #•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
on tructi n Type: —Occupancy:
aLic.
State L c.#
Project type (circle one): New Add'n Alter Repairair Demo
Name of Contact Person:C (u ✓s'L
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 7 (,,3 —7 �^ 1, 4
Estimated Value of Project: OnC) CD
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for co n., ax
Z
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 plan
2'.' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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
P�
.O. CHOICE
C
CIV OF LA QUIP PA
BUILDING SAFETY®
App
FOR CONSTRUCTION
DATE
P/I
ESTGLU
PA
P/I .
:0. CHOICE'
� {Aw-too ftp f�+*f
1
-
L..
4 me F8-
�2 TANNING SHELF
POOL, EQUIPMENT W/UMBRELL•A. SLEEVE
r
G
1�LCONSTRUCTION C Ul]NA f
[DATE
FEN F-
/ E
exsisting potio
P/I
1.
N EXISTING HOME
Linda Rue78-570 este Ila 'court
-'Gybi31 �
44
v
34�
exsisting potio
P/I
1.
N EXISTING HOME
Linda Rue78-570 este Ila 'court
-'Gybi31 �
44