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BPOL2017-0052LICENSED 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: License No.: 737763 Dat ;TQ 3, /% Contractor- OWNER-BUILDER ontractorOWNER-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 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, 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 Na Lender's Add L 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. ��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: SECURITY NATIONAL INSURANCE COMPANY Policy Number: SWC1134158 _ 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 shall forthwith comply with those provisions. ns- 03-/7 Applicant:�� QZS%c-S-t--r- 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 to enter upon the above- mentioned property for inspection purposes. Date:000" 7 Signature (Applicant or Agent•)l�� �•2Ty �� � I �S/ �i�.C., 78-495 CALLE TAMPICO D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/3/2017 Application Number: BPOL2017-0052 Owner: Property Address: 79140 COYOTE CREEK GABRIEL & LINDA FERNANDEZ APN: 776030035 78140 COYOTE CREE Application Description: FERNANDEZ / WATER FEATURE ADDITION TO EXISITNG POOL LA QUINTA, CA 9225 Property Zoning: Application Valuation: $7,500.00 Q 0 p rQ w N zo Applicant: Contractor: 5 z o S ® DESERT ISLES INC DESERT ISLES INCa how 41490 SPARKEY WAY 41490 SPARKEY W Q o BERMUDA DUNES, CA 92203 BERMUDA DUNES, CA 9 03- _� C5 it z (760)345-3585 ��� C Llc. No.: 737763 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: License No.: 737763 Dat ;TQ 3, /% Contractor- OWNER-BUILDER ontractorOWNER-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 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, 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 Na Lender's Add L 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. ��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: SECURITY NATIONAL INSURANCE COMPANY Policy Number: SWC1134158 _ 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 shall forthwith comply with those provisions. ns- 03-/7 Applicant:�� QZS%c-S-t--r- 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 to enter upon the above- mentioned property for inspection purposes. Date:000" 7 Signature (Applicant or Agent•)l�� �•2Ty �� � I �S/ �i�.C., f Date: 5/3/2017 Application Number: ` BPOL2017-0052 Owner: Property Address:' '79140 COYOTE CREEK GABRIEL & LINDA FERNANDEZ APN: 776030035 78140 COYOTE CREEK Application Description: FERNANDEZ / WATER FEATURE ADDITION TO EXISITNG POOL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $7,500.00 Applicant: Contractor: DESERT ISLES INC DESERT.ISLES INC '41490 SPARKEY WAY 41490 SPARKEY WAY BERMUDA DUNES, CA 92203 BERMUDA DUNES, CA 92203 (760)345-3585 Llc. No.: 737763 -------------------------------------------------------------------------------------------- Detail: WATER FEATURE ADDITION TO EXISINT POOL AND 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. 0 m FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT• BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ,ACCOUNT QTY AMOUNT DETACHED SPA/WATER FEATURE/OTHER 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 $S.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin #Qty Permit # Project Address: � ! � D Co of La, Quin td Building U Safety Division 78-495 Calfe Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet 7c, Ce—, n- g: Owner's Name: ::?C2 4 AJU X- A. P. Number: Address: Q CO O 1 G= t✓�' Ltt� Legal Description: City, ST, Zip: 41:7 0,yV'fi/1 ' 'S t / Contractor..TeleP hone:n 6 i e. Address: Project Description: City, ST, Zip: � /LIIS J,1 7bFjcd,j "L- - -- - - Telephone: 7 2-Z Z O Y ` State Lic. # : z� C, CityLic. #.'. Arch., Engr., Designer: JA1) Address: COMMUNITY DEVELOPMENT City, ST, Zip: hone: . ,...tYPa .... Con traTele ction Type: O c cu P ancY : Lic. #. r Demo Project circle one): New dn Alter Repair.ai Name of Contact Person: Sq. Ft.: its: Telephone # of Contact Person: %6 d ' Z Z Estimated Value of Project: 9 Submittal Req'd APPLICANT: DO NOT WRITE BELOW THIS LINE Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural CACS. Revicived, ready for corrections 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. A. Approval Plans resubmitted Grading IN 110[JSE:- 'rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. \Vks. Appr Dale of permit issue School Fees, Total Permit Fees M er feature to existing pool. I :3 Existing Pool Equipment Area T w pL PL x w Cyote Creek PL 1/811 = 11 f C 1 —1 Y OF- LA 0 U1 K' TA BUIL DING &. SAFETY DEE-PT. VE FOR GO'-,, iS T R U C T01, 4 , ''-, ""' i �' DAT -r ey 6 GENERAL CONSTRUCTION LANDSCAPE -POOLS LICENSE # 737763 M VQ < 1z z U U) 4^iro T-4 U) E Q) 0 Ln w�, V) U c: UJ I n U r,4 U) 1111"I 0 W al (_9 w 2: < UJI U , Ek0 0 U cc z CZ 0 4-J UJ < < 1104 _ 14C 0 cr .j ::) 0 M W 0) 0 LUw N a co 0) Concret-� MAI N DRAINS 2 112" SUCTION 14'-6 11/64" 2 "URN 'WATER fALL 2" RETURN. '+42"" 1 -HP PUMP ILD 00 00 Cyote Creek PL 1/811 = 11 f C 1 —1 Y OF- LA 0 U1 K' TA BUIL DING &. SAFETY DEE-PT. VE FOR GO'-,, iS T R U C T01, 4 , ''-, ""' i �' DAT -r ey 6 GENERAL CONSTRUCTION LANDSCAPE -POOLS LICENSE # 737763 M VQ < 1z z U U) 4^iro T-4 U) E Q) 0 Ln w�, V) U c: UJ I n U r,4 U) 1111"I 0 W al (_9 w 2: < UJI U , Ek0 0 U cc z CZ 0 4-J UJ < < 1104 _ 14C 0 cr .j ::) 0 M W 0) 0 LUw N a co 0) E 0 LU z 0 U) 4^iro T-4 U) E Q) 0 Ln w�, V) U c: UJ I n U r,4 fu 1111"I 0 Qj al (_9 -0 +-, < U , Ek0 0 U cc z cu 4-J UJ 1104 _ 14C cr .j E 0 LU z 0 U) LU T-4 U) E Q) V) Ln LU V) U c: UJ I n UJ (1) E 0 z z 0 Z U r1l < CL " ce LU :3 4-J ro (D VII 4-J fa E Q) U Ln V w U c: UJ I n UJ (1) fu 1111"I 0 E; M 0 (_9 -0 N 0 fto "77 z 0 Z U r1l < CL " ce LU :3 4-J ro (D VII 4-J fa 0 fto "77 1"0 0 fto "77