BPOL2019-003578-495 CALLE TAMPICO D f, , VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Date: 3/4/2019
POOL/PRIVATE
Owner:
BPOL2019-0035
JAMES FRICKLETON
80090 VIA CAPRI
3012 W 117TH ST
777100064
LEAWOOD, KS 66211
FRICKLETON / POOL WITH ATTACHED SPA AND SEPERATE MASTE SPA
$58,900.00
Applicant:
DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050
INDIO, CA 92202
i
FP
MAR 04
LICENSED CONTRACTOR'S DECLAR TION
I hereby affirm under penalty of perjury that I am licensed Oder pr is ns of Chapter 9
(commencing with Section 70001 of Division 3 of the Busin ss and ro ssions Code, and
my License is in full force and effect.
License Class: C53 License No.: 999928
Date:" Contractor
I hereby affirm under penalty of perjury tha k, am94empt from the Contractor's State
License Law for the following reason (Sec. 70 1. 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
Da
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
Contractor:
DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050
INDIO, CA 92202
(760)702-9222
Llc. No.: 999928
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
oft wo For which this permit is issued.
i have and will maintain workers' compensation insurance, as required by
Se on 3 00 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:
Car 'e . x MPT Policy Number:_
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 be
a subje o the workers'
compensation laws of California, and agree that, if I sh❑ bec subject to the
workers' compensation provisions of Section 3700 oft Lab r C de, I shall forthwith
comply with those provisions.
Date: �" -7 - f -( ,Applicant:
WARNING: FAILURE TO SECURE WORKER4 CO ENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CR M)MAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10 , 00). 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.
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.
I Date: Signature (Applicant or Agent):
Lender's Address:
Date: 3/4/2019
Application Number:
BPOL2019-0035
Owner:
Property Address:
80090 VIA CAPRI
JAMES FRICKLETON
APN:
777100064
3012 W 117TH ST
Application Description:
FRICKLETON / POOL WITH ATTACHED SPA AND SEPERATE MASTE SPA
LEAWOOD, KS 66211
Property Zoning:
Application Valuation:
$58,900.00
Applicant:
Contractor:
DESERT MIRAGE POOLS & SPAS
DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050
P 0 BOX 10050
I N DIO, CA 92202
I N DI O, CA 92202
(760)702-9222
Llc. No.: 999928
Detail: POOL, SPA, AND ADDITIONAL SPA AT MASTER PATIO AND [2]FIRE PITS AT REAR YARD [JOHN HENRY HACKER ENGINEERING] THIS PERMIT DOES
NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING
CODE.
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $3.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.68
Total Paid for PLUMBING FEES: $40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DETACHED SPA/WATER FEATURE/OTHER
101-0000-42404
0
$200.12
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$200.12
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$108.87
Total Paid for POOL / SPA: $509.11
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Za 62azfcra
PERMIT #
Project Address:
APN #:
Applicant Name:
Address:
City, ST, Zip:
Telephone:
Email:
Contractor Name: t
.JCL r�lClC'
Address: r1 , C x '00 SW
City, St, Zip
Telephone.
Email:
State Lic: (I q qz y City Bus Lic:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
Address:
City, ST, Zip ti}
Telephone:
Email:
f�
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Valuation of Project $ �Q -
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories
SF
SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements. -
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000
PERMIT #
Project Address:
APN #:
Applicant Name:
Address:
City, ST, Zip:
Telephone:
Email:
Contractor Name: t
.JCL r�lClC'
Address: r1 , C x '00 SW
City, St, Zip
Telephone.
Email:
State Lic: (I q qz y City Bus Lic:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
Address:
City, ST, Zip ti}
Telephone:
Email:
f�
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Valuation of Project $ �Q -
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories
SF
SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements. -
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000
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