BPOL2017-0064'
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VOICE (760) `777-7125
78-495 CALLE TAMPICO
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FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
p 2017
Application Number: BPOL2017-0064
Owner: N
Property Address: 81600 SHACKLETON WY
SUMMERS RESIDENCE
APN: 767870020
81600 SHACKLETON VR
Application Description: SUMMERS RESIDENCE / POOL, SPA, WF AND FIRE PIT
LA QUINTA, CA 922530 n :—;Cr
Property Zoning:
Application Valuation: $80,000.00
C)
M n t.+
Applicant:
Contractor: Z o_
MC INTYRE POOLS & SPAS INC
MC INTYRE POOLS & Sg5tc
83-695 AVENUE 45
83-695 AVENUE 45 M
INDIO, CA 92201
INDIO, CA 92201A
(760)342-3612 M
LIc. No.: 614611
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed 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.: 614611
Date: 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).:
(_j 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
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.
&4— 1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of tRe 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 ose rovisions. �j/�� /�
Date: J Applicant: Rpy
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.
are not intended or offered for sale. If, however, the building or improvement is sold APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application.
I ) I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, as a result of this application , the owner, and the applicant, each agrees to, and shall
and who contracts for the projects with a contractor(s) licensed pursuant to the defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
Contractors' State License Law.). employees for any act or omission related to the work being performed under or
(_) I am exempt under Sec. . B.&P.C. for this reason 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
Date: Owner: for 180 days will subject permit to cancellation.
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 Na
Lender's Add
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 pr pert for inspection purposes.
r f .
Date: -' // Signature (Applicant or Ag.
•T
Date: 5/11/2017
Application Number: BPOL2017-0064
Owner:
Property Address: 81600 SHACKLETON WY
SUMMERS RESIDENCE
APN: 767870020
81600 SHACKLETON WY
Application Description: ,SUMMERS RESIDENCE / POOL, SPA, WF AND FIRE PIT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $80,000.00
Applicant:
Contractor:
MC INTYRE POOLS & SPAS INC
MC INTYRE 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, WATER FEATURE, AND FIRE PIT AT REAR YARD [JEFFERY COLLINS - POOL ENG. INC.] THIS PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION.
2016 CALIFORNIA BUILDING CODE.
1
FINANCIALIN FORMATION
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
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$25.33
Total Paid for PLUMBING FEES: $38.00
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: $293.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:40
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Y , '
Bin #
Pefmit #
4)0-21-A
Project Address: �� r
A. P. Number.
Legal Description:
Contractor: C-1.1
Address: S*3 - 015
City, ST,.Zip: 1-a a(o-�
Telephone: 7M - 3Lf -3Q,2
State tic. # : C 53 - 61. q e 1
Arch., Engr., Designer. . .
Address:
i
City of La Quinta
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Permitplication and Tracking Sheet
6wner's NNaa m/e: e 1 f q
Address:U/ 6U' e %�C�19
City, ST, Zip: �1
Telephone:
Project Description: S
. L
City.; ST, Zip:
struction Type: Occupancy:
Telephone: W,,,,rqj
State Lic: #: ect type (circle one): New Add'n' Alter Repair Demo
Name of Contact Person: eFt.: #Stories: #.Units:
Telephone # of Contact Person: U - S . `
Estimated Value of Project:EV, ocrcr
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs..
Reviewed, ready for corrections
Plan Check Depait
Truss Cates.
Called Contact Person
Plan Check Bala ace
I.Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical
Subcontactor Iast
Called Contact Person
Plumbing •
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:
'"` Review, ready for correctionvIssue
Developer Impact Fee
Planning Approval '
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fres
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