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BPOL2017-021778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: HECTRO MARQUEZ 30905 SIERRA DEL SOL LA QUINTA, CA 92253 T . i4 4 4Q" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT POOL/PRIVATE . BPOL2017-0217 43390 CROISETTE CT 609052002 GU / POOL AND SPA AT REAR YARD $19,300.00 u JAN 04 2018 C'f OMMUNITYp OF(A QUINTA OPMENTpE TMENT 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.: _ Date: 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 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).: 'fes' , 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.). (m, 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.). ("am exempt under Sec. B.&P.C. fo this reason Date: L Owner: + CONSTRUCTION LENDING.AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of tiie work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: VOICE (760) 777-7125 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/4/2018 Owner: RUOYING GU 43390 CROISETTE LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: 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. 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: CarPolicy Number: rier: _ 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. _J i Date: 1& 4 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 Ctuinta, 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: - y Signature (Applicant or Age Date: 1/4/2018 Application Number: BPOL2017-0217 Owner: Property Address: 43390 CROISETTE CT RUOYING GU APN: 609052002. 43390 CROISETTE Application Description: GU / POOL AND SPA AT REAR YARD LA QUINTA, CA 92253. Property Zoning: Application Valuation: $19,300.00 Applicant: Contractor: HECTRO MARQUEZ OWNER BUILDER 30905 SIERRA DEL SOL LA QUINTA, CA 92253 Llc. No.: Detail: POOL, SPA, AND POND AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOLS NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE-PLASTER.INSPECTION. 2016 CALIFORNIA BUILDING CODE. FINANCIAL INFORMATION 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 $195.05 DESCRIPTION ACCOUNT QTY AMOUNT. SWIMMING POOL/SPA 101-0000-42404 0 $195.05 DESCRIPTION ACCOUNT QTY AMOUNT SWIMMING POOL/SPA PC 101-0000-42600 0 $106.11 Total Paid for POOL / SPA: $496.21 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 J 1 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: $512.2 Contractor am.e: PERM.I ,# Q 7 .......... _- GEM �ffbv r ESE.K'.r.• .—--------- --- ---- Conditioned- Space SF City; St; Zip -PLAN LOCATION: Project �--Elect�► Project Des`cription.PoolI2emodelAd'd't;=, Pl.um.b.,.Mech` APN #: ' �G O � ' `._S"tate _ Cityr c1 y Applicant -Name: Addr re s: Q � i I �.I - �ci�T Z;�� �• o � 5 GPS q 2 2 � � . � • Telephone:• <J � " _ � � , - Emai]? he cl- • ►•�,o � � �.z o c��'�11 a low Val uation,.of.P_rojec $ , _ Contractor am.e: New SFD Construction: - v At 'a-� Conditioned- Space SF City; St; Zip Garage SF Teleppho e: Patio/Porch SF . EMai? Fire Sprinklers' . SF `._S"tate _ Cityr c1 y Arch/Eng Name: Construction Type:, -Occupancy:. Address: Grading: City, St, Zip Construction Type; Occupancy: Telephone: Bedrooms: - ,Stories: #Units: Email: t j - State Lic: ' -City Bus Lic: I'FRF erty.Owneer's-Name:'� V •I V na New Commercial /Tenant Improvements: Address yLA I3 O Total Building SF, Cih�- ST Z P L (:)\U',-i� rA Construction Type; Occupancy: Tefie� pho- e�1' . Ems 78495 CALLE TAMPICO LA QUINTA; CA 92253 ' - 760-777-7000 r OFFICE USE ONLY # Submittal Req'd -Rec'd Plan Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report y ' Grading Plan (PM 10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License J P:'O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495.CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT • (760)777-7012 FAX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner -Builders. Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in our name listing y self as the builder of the property improvements specified at _ _ _ r - r�..:. _ _ _ : _ .� r�� ---- � �� s We are providing you with Owne Builder Ac w edgrnent sand Informs 'on Verification Fo to make yoala;; r of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit. until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute- this notice unless you, the property owner, obtain the prior approval of the permitting authority: DIRECTIONS: Read and initial each statement below to signer you understand or verify this information. �( I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" buil g permit that erroneously implies that the property owner -is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. L --_72:J I understand building permits are not required to be signed .by property owners unless they are res onsible for construction and are not hiring a licensed Contractor to assume this responsibility. P the 1y I understand as an "Owner-Btiilder" I am the responsible party of record on the permit I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead'of my own. M_.�'41. I understand Contractors are required by law to be licensed and bonded in California and to list their• license numbers on permits and contracts. , I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value Of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an ".employer" under state and federal law. 1g66 1 understand if I am considered an "employer". under state and federal law, I must register withthe state and federal mment, withhold payroll taxes, provide workers' compensation disabili � ty.hnsurance; and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to.serious financial risk. �7. I.understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with 'the intent to offer them for sale, unless all work is performed by licensed . subcontractors -and the number of structures does not exceed four within any calendar year, or all of the work is performed. under contract with a licensed general building Contractor. I I understand. as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries'sustained by any subsequent.owner(s) that result from any latent construction defects' in'the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue l S)rvice, the United States Small.Business Administration, the California Department of Benefit Pa ents and the CaliforniaYn? Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at I- 800-321-CSLB (2752) or www.cslb.ca.gov.for more information about licensed contractors. am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party .legally: and financially responsible for proposed construction activity at the" following address: 11 Iagree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as.well as employers. r ` T. I agree to notify the issuer of this formimmediately of any additions, deletions, or changes to any of the information I have provided on this form Licensed contractors .are regulated by laws designed to protect 4he public. If you contract with someone who does not have a license, the Contractors . State License Board may be unable to assist you with any financial loss YOU may sustain as a .result of a complaint. Your only -remedy against unlicensed Contractors may be in civil court. -it is also -important for you to understand that if an unlicensed Contractor or employee 'of that individual or firm is injured while working . on your property, you may be held liable fbi damages. If you obtain a permit as Owner -Builder and. wish to hire Contractors, you will be responsible forveri Y esP for.verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to. the agency responsible, for. issuing the permit. Note: A copy of the property owner'sdriver's license, form notarization, or other verification acceptable, to the agency is- required . to be resented when the permit is issued to verify the properly._ owner's signature. —Signature.offproperty-owner Date:' Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACTON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize ` the following person(s) to act as my agent(s) to apply for, sign; and file. the documents necessary to obtain an Owner -Builder 1Z.P.ermif for my project. . Scopejof Construction Project_(.or.D6scnption_of_Work): P-roject.Location oror Address: Name-of.Authorized.Agent:) Tel Ad f?Autho ze+" d�Ag n 7/t%�3 /%/79�f cr &,Ia,,'l #2 I declare under penalty of perjury that I am the property owner for the address listed above and I .personally filled out the above ` 'information and certify its accuracy. Note: A copy of the.owner's driver's license, form notarization, or other verification acceptable to the 'agency ms required to be presented when the permit is issued to verify the property owners signature. PropertyOwnerws�Signature: Da / �„ t SPECIFICATIONS (Attachment to PROPOSAUCONTRACT) POOL/SPA DESIGN PROPOSAL The following specifications describe the project in depth: GENERAL SCOPE OF WORK: 1. Engineering plans and specifications. 2. City construction permits. 3. Use existing pond and build within perimeters 4. Steel reinforcing throughout shell structures to exceed city code, surcharge as necessary. 5. Non -corrosive schedule 40 PVC plumbing, 2" suction and return lines. 6. Hayward dual -port skimmer. 7. MP Products automatic fill unit. 8. 2- Light niches with conduit. 9. Pneumatically applied gunite shell structures. 10. Electrical main runs from main panel to equipment location. 11. Gas run from meter to equipment location. DEMIENSIONS: FINISHES: Decking: POOL SPA Length: 2710" 650" Width: 1050" 6'0" Surface Area: 270 SF 36 SF Perimeter: 74' FT 24 FT Depth: 3' to 4 1/2/' 42" MAX FINISHES: Decking: n/a Tile: Group 1 and 2 tiles @ waterline pool and spa Dam Wall: TILE SPILLWAY +12"" Plaster: WHITE finish plaster - Raised Bond Beam SPA AT +12" Spa Specification: 7' WITH 4 JETS AND SPA LIGHT Spa Exterior: stucco finish Boulders: NONE Coping: Cantilever concrete - continued PAGE 1 of 2 INTTIAL Nod d330/1 3" PAVER DECKING 21 '0 5'2 m 10'0 POOL QfTY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE (12, IP 1T, BYE ,,E � qVM 0 c e, o I s u-1 E- I