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BPOL2017-0068LICENSED 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: B. C27, C53 License No.: 975543 �q r ;bate: - I,�'�7 Contractor:: - OWNER -BUILDER DF RATION' 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 taw.). (_) 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: (760)345-9500 Llc. No.: 975543 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 ork for which this permit is issued. have and will maintain workers' compensation insurance, as required by S 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5034966 _ 1 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. Date: IS-_ 1 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 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 upon the above- mentioned property for inspection purposes. 9 - Date:� Signature (Applicant or Agent): r�_�J% VOICE (760) 777=7125 ' 78-495 CALLE TAMPICO• D LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/18/2017 Application Number: BPOL2017-0068 Owner: Property Address: 58825 QUARRY RANCH RD QUARRY PROJECTS, LLC APN: 766060072. P 0 BOX 1573 Application Description: QUARRY PROJECTS LLC. / POOL AND SPA W/ADDITIONAL SPA RANCHO MIRAGE, CA 92270 z Property Zoning: m n Application Valuation: $45,000.00 ;:A o E; I f m � Applicant: Contractor: o z o cl PICASSO OUTDOOR LIVING INC PICASSO OUTDOOR LIVING N D ti 77700 ENFIELD LANE SUITE C #1 77 700 ENFIELD LANE SUITE @tl PALM DESERT, CA 92211PALM DESERT, CA 92211 ? e --y 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: B. C27, C53 License No.: 975543 �q r ;bate: - I,�'�7 Contractor:: - OWNER -BUILDER DF RATION' 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 taw.). (_) 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: (760)345-9500 Llc. No.: 975543 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 ork for which this permit is issued. have and will maintain workers' compensation insurance, as required by S 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5034966 _ 1 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. Date: IS-_ 1 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 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 upon the above- mentioned property for inspection purposes. 9 - Date:� Signature (Applicant or Agent): r�_�J% I • Date: 5/18/2017 Application Number: BPOL2017-0068 Owner: Property Address: 58825 QUARRY RANCH RD QUARRY PROJECTS, LLC APN: 766060072 P 0 BOX 1573 ' Application Description: QUARRY PROJECTS LLC. / POOL AND SPA W/ADDITIONAL SPA RANCHO MIRAGE, CA 92270 Property Zoning: Application Valuation: $45,000.00 Applicant: Contractor: PICASSO OUTDOOR LIVING INC PICASSO OUTDOOR LIVING INC 77 700 ENFIELD LANE SUITE C #1 77 700 ENFIELD LANE SUITE C #1 PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)345-9500 Llc. No.: 975543 Detail: POOL AND SPA AT REAR YARD WITH SEPARATE PLUNGE POOL AT EAST SIDE YARD [DENISE POELTLER ENGINEERING]. THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURES, FIRE PITS, BBQS OR WATER FEATURES. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE. I FINANCIAL INFORMATION 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 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 A 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 # City Of %a Qutnta - Building 8t Safety Division P.O. Box 1504,"78-495 Calle Tamptco — v�� La'Q�ta' CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # P(� L 2 evl Project Add[ess: 8 - Z GULNt 41 CH Owner's Name:. & j�Q,, I LT-S4Z-7Z- A. P. Number. Address: . O '601" 1S-13Legal Description: QU/kR1Z 1•-0T.City,STZip: Vf 1 Gft M12q-GI �Contractor. U6SO' OVTO�Z UVINC-1 qq = 1O0 = FIGLD L,4,4 s. ST 'G1 Telephone: - SD - ! :,,.^Address: Pmjeot Description: OOLCity, ST, Zip: P� O(S T e/ac Z2 I �� t L C1�r 0O Telephone:'�t7v' State Lia # : q 1 City Lic. #; 0 111656 Arcfi, Eng., Designer. Address: City., ST, Zip: Telephone: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft :# Stories: #Univ: State Lia #: Name of Contact Person: %1(Z1 Telephone # of Contact Person: 'I%0 -999 — 7sy'0 Estimated Value of Project 5 0W APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG 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 Mile 24 Cults. Plana picked up Construction Flood plain plan Pians resubmitted' Mechanical Grading plan 2ib Review, ready for correctionsPkssue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S3LL H.O.A. Approval Plana resubmitted Grading IN HOUSE:- 1n° Review, ready for corrections/issue Developer Impact Fee Planning Approval. Called Contact Person AXP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees MAY 14 2017 CITY OF LA QUINTA PLANNING DEPARTMENT