BPOL2017-000378-495 CALLE TAMPICO V
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPOL2017-0003
Property Address: 79345 TOM FAZIO LN
APN: 766032009
Application Description: QUARRY PROJECTS LLC / POOL & SPA AT REAR YARD
Property Zoning:
Application Valuation: $38,000.00
Applicant:
PICASSO OUTDOOR LIVING INC
77 700 ENFIELD LANE SUITE C #1
PALM DESERT, CA 92211
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
Dat �- 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: 1/11/2017 •
Owner:
DODD CLASEN
227 COLFAX AVE N STE 200
MINNEAPOLIS, MN 55405
Contractor:
PICASSO OUTDOOR LIVING INC
77700 ENFIELD LANE SUITE C #1
PALM. DESERT, CA 92211 ,
(760)345-9500
Llc. No.: 975543
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate cf consent to self -insure for workers'
compensation, as provided for by Section 3700 o the Labor Code, for the performance
of the work for which this permit is issued.
VHI have and will maintain workers' comoensation insurance, as required by
Se ion 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5034966
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, f I should become subject to the
workers'compensation provisions of Section 370] of the Labor Code, I shall forthwith
comply with those provisions.
Date:'i�, II `I % Applicant:✓
WARNING: FAILURE TO SECURE WORKERS' COM RENSATION 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 Ir, SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLDGEMENT
IMPORTANT: Application is hereby made to the Wilding 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, znd the applicant, each agrees to, and
shall defend, indemnify and hold harmless the Citi of La Quinta, its officers, agents, and
employees for any act or omission related to the vork being performed under or
following issuance of this permit.
2. Any permit issued as a result of this applicati•3n 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 statethat the above information is correct.
I agree to comply with all city and county ordinaries and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: — I (-1 Signature (Applicant or Agent):`
Date: 1/11/2017
Application Number:
8POL2017-0003
Owner:
Property Address:
79345 TOM FAZIO LN
DODD CLASEN
APN:
766032009
227 COLFAX AVE N STE 200
Application Description:
QUARRY PROJECTS LLC / POOL & SPA AT REAR YARD
MINNEAPOLIS, MN 55405
Property Zoning:
Application Valuation:
$38,000.00
Applicant: Contractor:
PICASSO OUTDOOR LIVING INC PICASSO OUTDOOF LIVING INC
77 700 ENFIELD LANE SUITE C#1 77 700 ENFIELD LAFJE SUITE C #1
PALM DESERT, CA 92211 PALM DESERT, CA °2211
(760)345-9500
Llc. No.: 975543
------------------------------------------ ---------------------------------------------------
Detail: POOL AND SPA AT REAR YARD [DENISE POELTLER ENGINEERING) THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE, FIRE PIT OR BBQ.
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
- .. DESCRIPTION
FINANCIAL •• 1.
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
$190.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
Total Paid for POOL / SPA: $293.36
0
B;n.#Citjr
of La Quota
Btlllding 8r Safety Division
P.O Box 1504,*78-495 Calle Tampico
La.Qdnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Perirrit
„
Project Address: —71-3115 � o m �� D � lJ rJ -
Owna's Name . (�j `yq `Z OJT GTs
A P. Number.
Address: -?0 ZOX - `S13
Legal Description:
Contractor. ' \LASS(D CmZ-�l�J1IJ�
City, ST, zap. RAyJc, - 0 Ch 9 ZZ Z�
Telephone: �•
Address: —7-700 F cJ`1 ELD L --IJ Si E C— I
Project Description: PC OL � c R4
City, ST, Zip: P�IiW� ID'ESZO-T CA 9Z .1 .
Telephone: (oo '7; S -`'13
State Lia fl: 61 -7 S S {
City Lir. #c ips
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
x
State Lia #: ~:"'
Conduction Type; . Ooacpanq:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: (q (Z EC -t
Sq. Ft.: g Stories:
# Units:
Telephone # of Contact Pelson: (op - —
Estimated Value of Prvjec 3 Oaf
APPLICANT: DO NOT WRITE BELOW THIS UNE
tt
Submittal
Req'd
Reed
TRACIMG
PERMIT FEES -
Pian Sets .
Plan Cheek submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss C21cs
Called Comet Person
Plan ChedLBaianee _
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechatitical
Gi acting plan
2' Review, ready for eorreetionsrmte
Electrical
Subeontactor List
Caped Contact Person
Plumbing
Grant Deed
Pians picked up
VVLL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review; ready for correedonsrissae
1Developer Impact Fee
Planning Approval
Called Comet Person
A.%P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees