13-0485 (RPL)P.O. BOX 1504
78-495. CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
G�fTI1,Acs=s,,�tt
r --
13-00000485
81333 PEARY PL
767-680-020-58 -330761-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
80000
T4hf v 440
uu &
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
P&
Co►JTK~IIJV• *t bO &A.1AV&11JG 5FD
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm and penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000 vision 3 of the Business and Pr fessionals Code, and my License is in full force and effect.
License Clas B License No.: 660454
XDate: BIZ Contractor:
O ER BUILDER DECLARATION
1 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.).
(_ 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.).
(_ 1 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:
LQPERMIT
�� VOICE (760) 777-7012
'-"'"-" FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/13
Owner:
100 EAST CALIFORNIA AVENUE LLC
301 W HUNTINGTON DR
ARCADIA, CA 91007
WANCE
MDSrELITE GENERAL CONSTR2040 CUMMINGS DRIVE
LOS ANGELES; CA 90027(323)873-3800
Lia. No.: 660454
------------------------------------------
WORKER'S COMPENSATION DECLARATION
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 STATE FUND Policy Number 1336291
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 f rthwith comply with those provisions.
(Date: �i—C M"I,Applicant:
WARNING: FAILURE TO SECURERS' O�ANDCIVIL
OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI�NALPENALTIEINES 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 Director of Building and Safety 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, indemnity 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 county to enter upon the above-mentioned property for inspect' / rposes.
Date: i . Signature (Applicant'or Agent):
Application Number . . . . . 13-00000485
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
549.50 Plan Check Fee
357.18
Issue Date . . . .
Valuation
80000
Expiration Date
10/15/13
Qty Unit Charge
Per
Extension
BASE FEE
414.50
30.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
135.00
Permit . . MECH POOL
Additional desc
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
10/15/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
-------------------------------------------------7--------------------------
EA MECH FURNACE >100K
11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation
0
Expiration Date
10/15/13
` Qty Unit Charge
Per
Extension-.
BASE FEE
15.00
1.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date..
10/15/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB. FIXTURE
12.00
1.00 3.0000
EA PLB WATER INST/ALT%REP
3.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00.
----------------------------------------------------------------------------
Special Notes and Comments
POOL W/FIRE BOWL AND SPA AT REAR YARD
LQPERMIT
LQPERMIT
:Application Number . . . . . 13-00000485
----------------------------------------------------------------------------
Special Notes and Comments
[POOL ENGINEERING INC] THIS PERMIT DOES
NOT INCLUDE EQUIPMENT WALLS. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
April 18, 2013 3:18:11 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
4.00
Fee summary Charged Paid
Credited
----------
Due
.-------------------------------------
Permit Fee Total 653.50 .00
----------
.00
653.50
Plan Check Total 383.18 .00
.00
383.18
Other Fee Total 4.00 .00
.00
4.00
Grand Total 1040.68 .00
.00
1040.68.
LQPERMIT
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Bin.# Qty ®f Loa QiJl;ftta
Building 8T Safety Division
Permit # P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application• and Tracking Sheet
Project Address:%. M3Owner's Name:.
A. P. Number. Address:
Legal Description: City, ST, Zip:
Contractor. h Telephone:
Address:au_CU Project Description:
City, ST, Zip: u Prh o V
Telephoner
State Lic. # : y City Lic. #;
Arch , En ., Designer.
Address: /J
City., ST, Zip:
Telephone: Construction Type:. Occupancy:
State Lic. #: 6 Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: ri PQSq. Ft.:
Telephone # of Contact Pelson: v Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE — ---- -- "'�
N
Submittal
Req'd
Recd
TRACKING PERMUFEES
Plan Sets
Plan Check submitted item Amount
Structural Calm
Reviewed, ready for corrections Pun Check Deposit. .
Tess Cates.
Called Contact Person Plan Check Balance
Tide 24 Cates.
Plans picked up Construction
Flood plain plan
Plans resubmitted,' , Mechanical
Giading plan
2'! Review, ready for correctionsfissue Electrical
Subcoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up ViLL
H.O.A. Approval
Plans resubmitted J Grading
IN HOUSE:-
''' Review; ready for eorreetio 0 3 Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�� I-�y` a� yr
IP m
Ifl` 11 11 '53 0,000 93 O"WO
H1
A ;j,19 1 16-1001
30
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La Quinta, California 92253
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