BPOL2018-0189OWNER -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 of county that requires a permit to construct, after. Improve, demolish, or repair
any structure, prior to Its issuance, also requlres the appllcant 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 !s 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
($S00).:
(_) 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 huildlng 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
78-495 CALLE TAMPICO D 1� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 DESIGN &DEVELOPMENT DEPARTMENT FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/11/2018
Permit Type/Subtype: POOL/PRIVATE Owner:
Application Number: BPOL2018-0189 MC LENDON
Property Address: 79195 TOM FAZIO LANE NORTH
Application Description: MC CLENDON / POOL, SPA, FIRE PIT, AND FRONT WATER FEATURE
Property Zoning:
Application Valuation: $50,000.00
Applicant: Contractor:
MC INTYRE POOLS & SPAS INC MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45 D n 83-695 AVENUE 45
INDIO, CA 92201 OCT 1 2O1U INDIO, CA 92201
0F LAOU NTA 342-3612
CITY (760 )
DESIGN & UEVELGPMI NT DEPARTMENT Llc. No.: 614611
---------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation,:as provided for by Section 3700 of the Labor Code, for the performance
License Class: CS License No.: 614611 of the work for which this permit is issued.
G � I have and will maintain workers' compensation insurance, as required by
Dat-i:er % d Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit
r
Is issued. My workers' compensation insurance carrier and policy number are:
Carrier: SOUTHERN IN$URANCE COMPANY Policy Number; QDWC100. 25 _
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 those provisions.
Dite: 017 Apli t:
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• e
above-menti a property for inspection purposes.
q / Signature (Applicant or Agent
Date: 10/11/2018
Application Number:
BPOL2018-0189
Property Address:
79195 TOM FAZIO LANE NORTH
APN:
766032027
Application Description:
MC CLENDON / POOL, SPA, FIRE PIT, AND FRONT WATER FEATURE
Property Zoning:
Application Valuation:
$50,000.00
Applicant:
MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45
INDIO, CA 92201
Owner:
MC LENDON
Contractor:
MC INTYRE POOLS & SPAS INC
83-695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Llc. No.: 614611
------------------------------------------- ------------------- ---------------
Detail: MC LENDON / POOL,SPA,[1] GAS OUTLET AT REAR YARD AND [2] WATER FEATURE AT ENTRY COURT YARD[TODD L LACHER]. TWO DROWNING
SAFETY FEATURES AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION.. NEW EQUIPMENT MUST BE LOCATED IN AN APPROVED
LOCATION EITHER WITHIN THE REAR YARD SETBACK OR 5' MINIMUM FROM THE SIDE P/L FIELD VERIFY. THIS PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. 2016 CALIFORNIA BUILDING CODE.
DESCRIPTION
BSAS SB1473 FEE
DESCRIPTION
GAS SYSTEM, 1-4 OUTLETS
DESCRIPTION
GAS SYSTEM, 1-4 OUTLETS PC
ACCOUNT
CITY
101-0000-20306
p
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
ACCOUNT
CITY
101-0000-42401
p
DESCRIPTION
DETACHED SPA/WATER FEATURE/OTHER
DESCRIPTION
SWIMMING POOL/SPA
DESCRIPTION
SWIMMING POOL/SPA PC
DESCRIPTION
RECORDS MANAGEMENT FEE
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT
CITY
101-0000-42600
0
Total Paid for PLUMBING
FEES:
ACCOUNT
CITY
101-0000-42404
p
ACCOUNT
CITY
101-0000-42404
0
ACCOUNT =]
CITY
101-0000-42600
p
Total Paid for POOL / SPA:
ACCOUNT
CITY
101-0000-42416
0
Total Paid for RECORDS MANAGEMENT FEE:
ACCOUNT
QTY
502-0000-43611
p
Total Paid for TECHNOLOGY ENHANCEMENT FEE
AMOUNT
$2.00
$2.00
AMOUNT
$13.00
AMOUNT
$ 26.01
$39.01
AMOUNT
$200.12
AMOUNT
$200.12
AMOUNT
$108.87
$509.11
AMOUNT
$10.00
$10.00
AMOUNT
$5.00
$5.00
( OF LA OUINTA
JILDING DIVISION --
3E-viEWED FOR
CODE
COMPLIANCE
Ib 6Y r—
PEPE.W/CCF.
G 1�EL M7i�W W 1107 7a1 1
Q ,Y R 14DH FILTER i�'!i i�
f
■ ■1TlVtiTT{R
PARCEL 1
r. (PMB 238/84-85)
� PARCEL MAP NO. 36602
1Q7.4s is
(PE=112.0} \ ? I
VACANT 'rp r I 107.15 UP
I . nra iaeuw
SCALE 1`=I0' ll� 1 �
(OLD LOT .58N Q 5 l° 20
(TRACT MAP NO. 27728) 3°
pa�LOB 249/1-13) \/0"7.w
'107 70TG 4 107.7 1 1 7.74 1 105.69 TC I I aa�r wm
Am "A
1 f 1 \ 2:1
- ,!A„
FA 10 . O1G 1
CEL 2
2 I PARC L " NO. 38602
{EOm LOT 57)
_ (TRACT MAP N0, 27728) FOYE
(MB 249/1-13) I ��
I FF=108.50 ,
I PE=108.0)
r
CLO
l .___. 107.90TG 31 iD?.79
PANTRY
DINING
KITCHEN
PR BUTLERS
N7
_FP
HALL
ROOM
4
SH014'LR r
+ I p
WGI3B P I II . v. :ce'. wn"m.+—
H0021'28'W 21Q,40' I
—y—
f {r Z
1 G ! LI . — — — lL EXIST. 8" CURB I
f AND cum I I
107.yDTG I 2 Z rTELE�Ak I I
yrs 105.9D TC
a I II
0e __ . — ;-. �I I 10b 57 UP J
- o I f
1 4 4 �ING' } i05.16 TC I
2 i�Q.' 5'
_ O jCLOSET I 104-8911P
CU£ST CA5i1A L-- BhI- I 00
cm
1 148.DFG I •' � '�- 2� L cm
2 Z l� �' i CIF of I F--
,�7
z 2
' 2 '� i t I
Z T f I 104.45 TC
108'� 1' I I 104.12 LIP I 1 t it
108. 10&4VS
107 1 1 7.70T 1 NNN 'S" IN CURB
.4 BATH
OFf10E BEDROOM 13 r ! } L 111 05)'
i I j
1R3.6 TC I I
103.36 LIP., _. I
1a7.sarc 101:4H;tIP }
CLO. 107SOTG .` I
CIA, GARAGE f 1 1 ; 18.50, t8 50
11 108.3CART 2 10.00 I 1
4 10
YFJ%A 1 7 QO F 1
BATH BEDROOM 12-
LAUNDRY
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Project Address:
APN #:
Applicant Name:��������
Address:
City, ST, Zip:
Telephone:
Email: °
Contractor Name: t
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Address: Lt
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City, St, Zip + �7
Telephone: 0 �i. � "j '2 J C I0�
Ernail: l�
State Lic:�+GJ3 �l1 JII City Bus Lie: `(
Arch/Eng. Name:
Address:
City, St, Zip
°
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Nam
Address:
City, ST, Zip
Telephone:
Email:
PERMIT #
f PLAN LOCATION:
• �" Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
i� .• Cur" .
Valuation of Project $ So
New SFD Construction:
Conditioned -Space
SF
Garage
SF
Patio/Porch
SF
Fire Sprinklers
SF
Construction Type:
Occupancy:
Grading:
_.
Bedrooms:
Stories:
# Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253'
760-777-7000