BPOL2015-017878-495 CALLE TAMPICO -
LA QUINTA, CALIFORNIA 92253
Application Number:
BPOL2015-0178
Property Address:
53605 FREMONT WY
APN:
767710008
Application Description:
DUDUM RESIDENCE I
Property Zoning:
Application Valuation:
$85,000.00
Applicant:
BRILLIANT POOLS
P 0 BOX 429
YUCCA VALLEY, CA 92286 f
Ct 0 D VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/17/2015
Owner:
JACK DUDUM
j� 53605 FREMONT WAY
(I I I LA QUINTA, CA 92253
AUG 242015
LAQUINTA
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.
)"C"ate:
jLicense Cllass: C53 License No.: 8782577
V �N. (i Contractor: j'\,-�'F"`� iLl
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
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
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:
Contractor:
BRILLIANT POOLS
P 0 BOX 429
YUCCA VALLEY, CA 92286
(760)333-0187
Llc. No.: 878257
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:
Carrier: _,?C 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 Labor Code, I shall forthwith
comply with those provisions.
,Zate: _ �' / S Applicant:
. - /7
WARNING: FAILURE TO SECURE WORKERS' MPENSATION 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 cit to enter upon the above-
mentioned property for inspection purposes.
bate: —J /_ �S Signature (Applicant or Agen
a " c DESCRIPTION �.' •`
FINANCIAL .• /.
"7 "ACCOUNT " •,y QTY :r AMOUNT_ "'„
RAID PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $4.00
$0.00
PAID BY -`
ti " ,,METHOD,,
RECEIPT #
" CHECK # , CLTD BY `
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $4.00 $0.00
` DESORIPTION' '
, .ACCOUNT F-': `. _::
QTY
AMOUNT
' PAID,PAID
DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
" PAID BY
METHOD
RECEIPT #- ' . -
CHECK #
CLTD BY_
...DESCRIPTION ` :
ACCOUNT
QTY"
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID:BY,,,.,
?� ; METHOD
- RECEIPT,#
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $36.26 $0.00
+ "'- •'.: DESCRIPTION "`. = z ; '
-'ACCOUNT
ACCOUNT-
QTY
---AMOUNT,','
:PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
• 0
$181.29
$0.00
PAID,BY•
METHOD
"` RECEIPT # =; ,.
CHECK#
CLTD BY
'r= `DESCRIPTION
- ACCOUNTQTY
AMOUNT
'^ . r PAID' "
`PAID�DATE
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$0.00
PAID BY"
METHOD _ ;
'' RECEIPT # ''
CHECK.#,
CLTD By
DESCRIPTION
ACCOUNT. ,
QTY
AMOUNT
PAID
PAID DATE
WATER FEATURE ONLY ti
101-0000-42404
0
$362.58
$0.00
.' PAID BY.
METHOD
" • ; , RECEIPT #, - `
CHECK #
`CLTD BY,
"DESCRIPTION
ACCOUNT." " . `'QTY
AMOUNT -
PAID °w
PAID DATE
WATER FEATURE ONLY PC
101-0000-42600
0
$197.24
$0.00
° PAID BY
METHOD';'' : ,
., RECEIPT #
CHECK#'' r
CLTD�BY '
Total Paid forPOOL / SPA: $839.73 $0.00
• 1 00
Description: DUDUM RESIDENCE POOL
Type: POOL Subtype: Status: APPROVED
Applied: 8/14/2015 EVA
Approved: 8/14/2015 KKI
Parcel No: 767710008 Site Address: 53605 FREMONT WY LA QUINTA,CA 92253
Subdivision: TR 33076-2 Block: Lot: 95
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $85,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: NEW NEGATIVE EDGE POOL,BLOCK FIREPIT WITH TWO WATER FEATURES PER APPROVED PLANS & KK.EQUIPMENT SHALL BE
INSTALLED IN ACCORDANCE
ACTION DATE, '
WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION2013
CALIFORNIA BUILDING CODE.
KIRK KIRKLAND
Printed: Monday, August 17, 2015 10:56:06 AM 1 of 3 C
SYSTEMS
ADDITIONAL
CHRONOLOGY
-.CHRONOLOGY TYPE ,
, _ TSTAFF NAME
ACTION DATE, '
COMPLETION DATE ,. , _•
NOTES
NOTE
KIRK KIRKLAND
8/14/2015
SENT BACK TO PHILIP 8/14/15
CONDITIONS
CONTACTS
NAME'TYPE ' "� NAMES f _ =
ADDRESSI `
CITY ' -?
STATE
`` • ZIP
•
PHONE >: ,, FAX. `� ' E MAIL
APPLICANT
BRILLIANT POOLS
P O BOX 429
YUCCA VALLEY
CA
92286
(925)768-9393
CONTRACTOR
BRILLIANT POOLS
P O BOX 429
YUCCA VALLEY
CA
92286
(925)768-9393
OWNER
JACK DUDUM
53605 FREMONT WAY
LA QUINTA
CA
92253
(925)768-9393
Printed: Monday, August 17, 2015 10:56:06 AM 1 of 3 C
SYSTEMS
DESCRIPTION
ACCOUNT
',QTY .
AMOUNT y
PAID = -
'PAID DATE
:RECEIPT#
CHECK#
METHOD
PAID BY
,
FINAL"
BLD
�;
BSAS SB1473 FEE
101-0000-20306
0
1 $4.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$4.00 $0.00
BSA:
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
'
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
Total Paid for PLUMBING FEES: $36.26 $0.00
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$0.00
PC
WATER FEATURE ONLY
101-0000-42404
0
$362.58
$0.00
WATER FEATURE ONLY
101-0000-426000
$197.24
$0.00
PC
Total Paid for POOL / SPA: $839.73 $0.00
TOTALS:0i
Printed: Monday, August 17, 2015 10:56:06 AM 2 of 3 C SYSTEMS
INSPECTIONS
,SEQID INSPECTION.TYPE,,
« INSPECTOR SCHEDULED COMPLETED
�. *RESULT; : f
T REMARKS } NOTES t -
�`
.. r
PATE"DATE
,
FINAL"
BLD
Printed: Monday, August 17, 2015 10:56:06 AM 2 of 3 C SYSTEMS
Permit. Details* NU
�PERnn�T
Cit ;oft Quinta?
y ,.
.r ... ,+., ♦ . N, s�•�Sd`..s'.�° ?.:ti .i"'. _.sr L
T�
BOND INFORMATION
ATTACHMENTS
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Cil?g Building Permit. Application and Tracking'Sheet
Permit #
_ •
«7
Project Address: ,cj O S rce /r\ of C, q
Owner's Name: 1-4 C U
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
r J� /
Telephone:
Address: P 0 I 41.2
Project Description: AAW. PCIIA0( e& Otl L
City, ST, Zip: 04.Cq 04.0Vq / P
Telephone- 3—
6Cc� D
� 7
L7ct - r
tr e
_
State Lic. # : $ 5
City Lie. #c
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Cn tructi
•a
on Type: �N Occupancy:ancY
Cl✓O
State Lie. #:
Pro 'ect e Add'n Alter Re pair Demo
J tYPa (e (circle one • w
Name of Contact Person: J Q S �/� �(j
Sq. Ft.:
# Stories:
# Units:
Telephone.# of Contact Person: 7(.o 3 - C>
Estimated Value of Project:. S/ o oO
" APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, 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"a 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 ROUSE:-
'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