BPOL2017-006578-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN &DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/12/2017
Application Number: BPOL2017-0065 Owner:
Property Address: 81454 AMUNDSON AVE JODY JONES DEVELOPMENT CORPORATION
APN: 767690011 81454 AMUNDSON AVENUE
Application Description: JODY JONES DEV. / POOL ANS SPA IN REAR AND COURTYARD AREAS LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $97,800.00 i--�
D Ll
Applicant. Contractor:
DESERT MIRAGE POOLS & SPAS DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050 MAY 12 2017 D
P 0 BOX 10050
INDIO, CA 92202 P INDI0, CA 92202
CITY QP LA QUINTA (760)702-9222
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 999928
LICENSED CONTRACTOR'S DECLARA ION
I hereby affirm under penalty of perjury that I am licensed der pro s ns of Chapter 9
(commencing with Section 7000) of Division 3 of the Busin s and P f ssions Code, and
my License is in full force and effect.
License Class: C53 License No.: 999928
CoF ntractor:
f�.
OWNER-BUILDE DECLA ATION
I hereby affirm under penalty of perjury that am ex pt from the Contractor's State
License Law for the following reason (Sec. 7 1.5, BlIsiness and Professions Code: Any
city or county that requires a permit to cons uct, er, improve, demolish, or repair any
structure, prior to its issuance, also requires a plicant 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 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.).
( ) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
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 tile_ k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se . io 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policyynumbeCarrier: STATE COMPENSATION INSURANCE FUND Policy25416
I certify that in the performance of the work forwhicis issued, I
shall not employ any person in any manner so as to beco suborkers'
compensation laws of California, and agree that, if I sho beco the
workers' compensation provisions of Section 3700 oft abor forthwith
comply with those provisions.
—/ I f Applicant: i
WARNING: FAILURE TO SECURE WORKE S' C PE SATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO RIMINAL NALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($ 01000). N ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDE FOR I 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. A
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above 1nfor ion is
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws r ing to
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to e#P1,
mentioned property for inspection purposes.
Lender's Name: _ _
it Date: :> !Z / (Signa�cant or
Lender's Address: �-
Date: 5/12/2017
Application Number: BPOL2017-0065
Owner:
Property Address: 81454 AMUNDSON AVE
JODY JONES DEVELOPMENT CORPORATION
APN: 767690011
81454 AMUNDSON AVENUE
Application Description: JODY JONES DEV. / POOL ANS SPA IN REAR AND COURTYARD AREAS
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $97,800.00 "
Applicant:
Contractor:
DESERT MIRAGE POOLS & SPAS
DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050
P 0 BOX 10050
INDIO, CA 92202,
INDIO, CA 92202
(760)702-9222•
---------------------------------- ----------------------------------------------------------
Llc. No.: 999928
Detail: POOL AND ATTACHED SPA AT REAR YARD. [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS
AND BARRIERS REQUIRED TO BE -INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
DESCRIPTION
♦ INFORMATION
FINANCIAL
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$4.00
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 .
Total Paid for POOL / SPA:
$293.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
$302.36
Bin ##
Permit #f
Project Address: _
S
...City of La Quip to
Building 8£ Safety Division
78495 Caile Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking "Sheet
Owner's Name: -Ja i e-5 �ev.,
A. P. Number:
Address: _ ,5
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Legal Description: (2
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ity, ST, Zip: J ,
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Contractor:
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Project Description: Q �, . t/t/
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State Lic. # :
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City Lie. U.
Arch., Engr., Designer:
ajr T� o
Address:
CJCJ 0d f ) 'et"
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City, ST, Zip:
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Telephone-
Co struction Type: Occupancy: •n
a S t to Lac. #
Project ty Pe(circle one • New Add n AlterRepair. Demo 0
Name of Contact Person:
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Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: C
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Estimated Value of Project: v
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
TRACKING
PERMIT FEES
Plan Sets
JRcc'd
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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 corrcctions/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
I-I.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" 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,
t
Total Permit Fees
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SCALE: 1'rr = 101-0rr 3 ol 00
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7"R5k-A, L,.EcTiAMPICO
LA QUINTA, CALIFORNIA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype:
POOL/PRIVATE
Application Number:
BPOL2017-0065
Property Address:
81454 AMUNDSON AVE
APN:
767690011
Application Description:
JODY JONES DEV. / POOL ANS SPA IN REAR AND COURTYARD AREAS
Property Zoning:
Application Valuation:
$97,800.00
Applicant:
DESERT MIRAGE POOLS & SPAS
R 0 BOX 100SO
INDIO, CA 92202
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.: 977341
Date: �l� Contractor:
OWNER -BUILDER D LARATION
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).:
(__j 1, 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—) 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' Statelicense 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:
Date: 4/19/2018
Owner: CJ �pp
JODY JONES DEVTbOPM T CO' POO
81454 AMUNDS(3@ AVENUE
LA QUINTA, CA 9 jP3
C?
rn
Contractor: f-1 N
BLACK DIAMOND 66,0:�& DES6GN
88-351 AVENUE 58TH #6
THERMAL, CA 92274
(760)619-1362 rn 1
Llc. No.: 977341 .I
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.
have and will maintain workers' compensation insurance, as required by
Sectio o he Labor Code, for the performance of the work for which this permit
is iss d. My workers' compensation insurance carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9164633
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 1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Applicant:
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 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 t • upon the
above-mentionecj,propertyfor inspection purposes.
Date: Signature (Applicant or Agent):
Date: 4/19/2018
AFAliration Number ::-; x ,?SP012017FU0,65
Owner:
Property Address: 81,454 AMUNDSON AVE
JODY JONES DEVELOPMENT CORPORATION
APN: 767690011
81454 AMUNDSON AVENUE
Application Description: JODY JONES DEV. / POOL ANS SPA IN REAR AND COURTYARD AREAS,
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $97,800.00
Applicant:
Contractor:
DESERT MIRAGE POOLS & SPAS
BLACK DIAMOND POOLS & DESIGN ,
P 0 BOX 10050
88-351 AVENUE 58TH #6
INDIO, CA 92202
THERMAL, CA 92274
(760)619-1362
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Llc. No.: 977341
Detail: POOL AND ATTACHED SPA AT REAR YARD. [DENISE POELTLER ENGINEERING) THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS
AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
r
FINANCIAL•R•
r;.'DMESCRIPTION. ACCOUNT CITY AMOUNT
PLAN CHECK/PERMIT EXTENSION PROCESSING
'101-0000-42600 0 $104.55
Total Paid for ADMINISTRATIVE: $.104.55
DESCRIPTION
ACCOUNT
CITY,
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$190.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
Total Paid for POOL / SPA: $293.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:. $5.00
TOTALS:%0.