BPOL2017-0159t 1,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPART . ENT
BUI AG PEIT
Permit Type/Subtype: POOL/PRIVATE
Application Number: BPOL2017-0159 OCT U 2 2017
Property Address: 78170 MASTERS CIRCLE
APN: 770360001 r)TA
Application Description: SMOKOWSKI RESIDENCE / P OL, SPA, V% TgFCFr'EA��iU�R•�
Property Zoning:
Application Valuation: $100,000.00 DESIGN AND DEVELOPMENT DEPARTMEN
Applicant:
MC INTYRE POOLS & SPAS.INC
83-695 AVENUE 4S. .
INDIO, CA 92201
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am Ircensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C53 License No.: 6146111��/
Date: �V 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).:
(_) 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: .
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/27/2017
Owner:
SMOKOWSKI
78170 MASTERS CIR
LA QUINTA, CA 92253
Contractor:
MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Llc. No.: 614611
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: WESCO INSURANCE COMPANY Policy Number: WWC325615
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 t ose rro�visions.
Date: 71 f' / Applicant:GL-9
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 up the
above -menti ed operty for inspection pur
Date. 0 Signature (Applicant or A
Date: 9/27/2017
Application Number: 13POL2017-0159
Owne-:
Property Address: 78170 MASTERS CIRCLE
SMOKOWSKI
APN: 770360001
78170 MASTERS CIR
Application Description: SMOKOWSKI'RESIDENCE / POOL, SPA, WATER FEATURE
LA QU NTA, CA 92253
Property Zoning:
Application. Valuation: $100,000.00
Applicant:
Contractor.-
ontractor:MC
MCINTYRE POOLS & SPAS INC
MC IN—YRE POOLS & SPAS INC
83-695 AVENUE 45
83-695 AVENUE 45
INDIO, CA 92201
INDIO,CA 92201 -
(760)342-3612
-----------------------------------------------------------
Llc. No.: 614611
Detail: POOL, SPA, AND WATER FEATURE AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOESiNOT INCLUDE EQUIPMENT ENCLOSURE.
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. PER 2016 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
DESCRIPTION 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
DETACHED SPA/WATER FEATURE/OTHER
101-0000-42404
0
$190.00
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: , $483.36
DESCRIPTION
ACCOUNT
QTY ,
AMOUNT
TECHNOLOGY ENHANCEMENT FEE.
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: .$5.00
u
Bin # City of La Qulnta.
di ' Building 8T Safety Division
'PBox 1504, 78-495 Calle Tampico
iP�"rt # O A. La Quinta, CA 92253 - (760) 777-7012
Ub II - Building Permit Application and`Tracki g Sheet
Project Address: k' �/ Cl Owner's Name: ,
A. P. Number: Address: "
Legal Description: City, ST, Zip: i C�
Contractor C�� S 3 tole. phone:
Address: — 6q S Project Doscription:
City, ST,.Zip: Q;vi Cry 02 020 .
Telephone: 70
State I,ic. # : C 53 - e I ICity Lia: #: _qS
Arch., Engr., Designer. .. .
Address:
City.; ST, Zip:
. .>
Telephone: :.Construction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
-..ri
Name of Contact Person: C Sq. Ft.: #Stories= #.Units:
Telephone # of Coact Person: - S" Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd Reed TRACIONG PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calcs.,
Reviewed, ready for corrections Plan Check Deposit
Truss Calm
Called Confact Person Plan Check Balance,
Tide 24 Cities.
Plans .picked up Construction,
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2T'jReview, ready for correctiouMssge Elect ical
Subcontactor List
Called Contact Person Pinmbing .
Grant Deed
Plans.picked up S.M.L
IL0 A. Approval
Plans resubmitted Grading _
IN-HOUSE:
''a Review, ready for correctionsrissue Deveaoper Impact Fee
Planning Approval
'Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issued
School Fees
Total Permit Fees
CITY OF LA QUINTA
3UILDING & SAFETY DEPT'.
:)PROVED
CONS UCTIO
1l7