BPOL2018-0174 Revision 2,,L ced�v 64P QU
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78-495 CALLE TAMPICO D� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/28/2018
Permit Type/Subtype: POOL/PRIVATE Owner:
Application Number: BPOL2018-0174 JVLM INVESTMENTS INC
Property Address: 78631 DEACON DR E
APN: 770230003
Application Description: JVLM / POOL,SPA AND [2]GAS OUTLETS AT REAR YARD
Property Zoning:
Application Valuation: $32,000.00
Applicant: / Contractor:
MARK A TEMPLE CONSTRUCTION INC V [-7---� MARK A TEMPLE CONSTRUCTION INC
699 INDIAN TRAIL D699 INDIAN TRAIL
PALM SPRINGS, CA 92264 SEP 2 8 2018 PALM SPRINGS, CA 92264
CITY OF LA QUINTA 0 (760)323-5310
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 430358
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: B License YNo.: 430358
Date: �� Contractor
OWNER -BUILDER DECLA
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 ofthe 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
Lender's Address:
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 r which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
!el 00 of the Labor Code, for the performance of the work for which this permit is
issue . y workers' compensation insurance carrier and policy number are:
Carrier:CALIFORNIA Policy Number:4600563503
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 bor Code, I shall forthwith
comply with those p rovis ions.
Date- ��i�Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATI COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMI IES 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 ofthis 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 relatln building
construction, and hereby authorize representatives of this city to en r h ove-
mentioned property for ins ection purposes.
6ate.5 ' �� �� Signature (Applicant or Agent .
Application Number:
BPOL2018-0174
Property Address:
78631 DEACON DR E
APN:
770230003
Application Description:
JVLM / POOL ,SPA AND [2]GAS OUTLETS AT REAR YARD
Property Zoning:
Application Valuation:
$32,000.00
Applicant:
MARK A TEMPLE CONSTRUCTION INC
699 INDIAN TRAIL
PALM SPRINGS, CA 92264
Date: 9/.28,0'-'18
Owner:
JVLM INVESTMENTS INC
Contractor:
MARK A TEMPLE CONSTRUCTION INC
699 INDIAN TRAIL
PALM SPRINGS, CA 92264
(760)323-5310
Llc. No..430359
Detail: POOL, SPA, AND [2] GAS OUTLETS AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE.
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
s
DESCRIPTION
BSAS SB1473 FEE
DESCRIPTION
Credit Card Fee
DESCRIPTION
Credit Card Fee
DESCRIPTION
DEVICES, FIRST 20
DESCRIPTION
DEVICES, FIRST 20 PC
DESCRIPTION
GAS SYSTEM, 1-4 OUTLETS
DESCRIPTION
GAS SYSTEM, 1-4 OUTLETS PC
DESCRIPTION
SWIMMING POOL/SPA
DESCRIPTION
SWIMMING POOL/SPA PC
DESCRIPTION
RECORDS MANAGEMENT FEE
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT QTY
101-0000-20306 0
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
ACCOUNT
101-0000-43505
ACCOUNT
101-0000-43505
AMOUNT
$ 2.00
$2.00
QTY
AMOUNT
0
$0.94
QTY
AMOUNT
0
$6.43
total Paid for Credit Card Fee: $7.37
ACCOUNT
101-0000-42403
ACCOUNT
101-0000-42600
QTY
AMOUNT
0
$26.01
CITY
AMOUNT
0
$26.01
Total Paid for ELECTRICAL: $52.02
ACCOUNT
101-0000-42401
ACCOUNT
101-0000-42600
QTY
AMOUNT
0
$13.00
QTY
AMOUNT
0
$26.01
I otal Paid for PLUMBING FEES: $39.01
ACCOUNT
101-0000-42404
ACCOUNT
101-0000-42600
QTY
AMOUNT
0
$195.05
QTY
AMOUNT
0
$106.11
Total Paid for POOL / SPA:
ACCOUNT QTY
101-0000-42416 0
Total Paid for RECORDS MANAGEMENT FEE:
ACCOUNT QTY
502-0000-43611 0
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$301.16
AMOUNT
$10.00
$10.00
AMOUNT
$5.00
$5.00
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