Loading...
BPOL2017-0175LICENSED 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.: 924163 Vn: `/%~ �//=Gontcactdr: �z OWNER -BUILDER DECLARATION 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 a subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: U 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: 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: (760)534-5061 Llc. No.: 9241E3 WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty of perjury one :)f the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 37,70 of the Labor Code, for the performance of•the work for which this permit is issued. ,sc-04 1 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: _ I certify that in the performance of the work for which this permit is issued, l II not employ any person in any manner so as to become subject to the workers' ipensation laws of California, and agree tiat, if I should become subject to the kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith iply with those provisions. Xpp�fi ant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM NAL PENALTIES AND CIVIL flNES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,CD0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to Lie Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this appl-cation is made, each person at whose request and for whose benefit work is perforned under or pursuant to any permit issued as a result of this application , the owner, andthe applicant, -each agrees to, and shall defend, indemnify and hold harmless the Cityof 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 appli:ation 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 cancellatioi. I certify that I have read this, application and s ate that the above information is correct. I agree to comply with all city and county ordi lances and state laws relating to building construction, and hereby authorize represent; tives of this city to enter upon the above- mentioned property for inspection purposes: Lender's Address: Signature (Applicant ar-Age i}: VOICE (760) 777-7125 78-495 CALLEJAMPIC0 �' FAX (760) 777-7011 LA QUINTA,'CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/26/2017 Permit Type/Subtype: POOL/PRIVATE Owner: Application Number: BPOL2017-0175 D DIXON, LEO Property Address:' 51855 AVENIDA MORALES q 1855 AVENICA MORALES APN: 773151005 / ~ �—� �D �QUINTA, CA 92253 Application Description: DIXON / POOL AND SPA AND ELECTRIC Property Zoning: _ Application Valuation: $35,000.00C! '' �C'��L7V'PV Applicant: EPAR��P Contractor: HANDEL CABALLERO FRED ROCK POOLS CONSTRUCTION • -P 0 BOX 790 CATHEDRAL CITY, CA 92235 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.: 924163 Vn: `/%~ �//=Gontcactdr: �z OWNER -BUILDER DECLARATION 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 a subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: U 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: 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: (760)534-5061 Llc. No.: 9241E3 WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty of perjury one :)f the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 37,70 of the Labor Code, for the performance of•the work for which this permit is issued. ,sc-04 1 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: _ I certify that in the performance of the work for which this permit is issued, l II not employ any person in any manner so as to become subject to the workers' ipensation laws of California, and agree tiat, if I should become subject to the kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith iply with those provisions. Xpp�fi ant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM NAL PENALTIES AND CIVIL flNES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,CD0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to Lie Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this appl-cation is made, each person at whose request and for whose benefit work is perforned under or pursuant to any permit issued as a result of this application , the owner, andthe applicant, -each agrees to, and shall defend, indemnify and hold harmless the Cityof 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 appli:ation 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 cancellatioi. I certify that I have read this, application and s ate that the above information is correct. I agree to comply with all city and county ordi lances and state laws relating to building construction, and hereby authorize represent; tives of this city to enter upon the above- mentioned property for inspection purposes: Lender's Address: Signature (Applicant ar-Age i}: Date: 10/26/2017 'j Application Number: BPOL2017-0175 Owner: Property'Address:-=`r451B'55,AVENiDAIWIDRALES DIXON, LEO APN: 773151005 51855 AVENIDA MORALES Application Description: DIXON / POOL AND SPA AND ELECTRICAL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $35,000.00 Applicant: Contractor: HANDEL CABALLERO FRED ROCK POOLS CONSTRUCTION P 0 BOX 790 CATHEDRAL CI—Y, CA 92235 (760)534-5061 LIc. No.: 924163 Detail: POOL, SPA, AND EQUIPMENT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION..ELEC CONTRACTOR SHALL PULL SEPERATE PERMIT FOR SERVICE CHANGE.PER 2016 CALIFORNIA BUILDING CODE J FINANCIAL ./. ::::,DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 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: $301.16 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-000042416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0' $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: I •+t Bin# City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit# Project Address: { /1 ve D 9 ��A�o f /7 Own¢i's argag ® r • A.P.Number L Address: Jav�' Legal Description: Vv/� oi�j�©L City, ST, Zip: /f l vY.a 7 40 Contractor: �' O j ri F✓/� Telephone: Address: Project Description: City, ST, Zip: Telephone: '71 "_ ' V _( A State Lic. #: >r `� City Lic #: % � Arch, Engr., -Designer: '-)06 Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Proj. Type New Add'n Alter Repair Demo Name of Contact: SgFt: #Stories # Units: Telephone of Contact: Estimated Value of Project: v 6 G APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit: Truss Cal es Called Contact Person Plan Check Balance: Title 24 Calcs Plans Picked Up Construction: Flood Plain Plan Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical: Subcontractor List Called Contact Person Plumbing: Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Developer Impact Fee Planning Approval Called Contact Person A.1.P.P. Pub. Wks. Apps Date of permit issue School Fees Total Pe-mit Fees