BPOL2019-007578-495 CALLE TAMPICO Tit�/ U�ti
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: POOL/PRIVATE
Application Number: BPOL2019-0075
Property Address: 54065 AVENIDA DIAZ
APN: 774194015
Application Description: GALLAUDET POOL AT REAR YARD
Property Zoning:
Application Valuation: $20,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
GALLAUDET INV
79225 TORONJA
LA QUINTA, CA 92253
Applicant: Contractor:
GALLAUDET CONSTRUCTION D� 1--�_� �} GALLAUDET CONSTRUCTION
54-065 AVENIDA DIAZ D54-065 AVENIDA DIAZ
LA QUINTA, CA 92253 APR 12 2019 LA QUINTA, CA 92253
CI f OF 1.A QIUI y A (760)413-7552
DESIGN! & UEUL.LOPI"''EENT DEPARTMENT Llc. No.: 919430
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 License No.: 919430
Date:_ 2 • Q Contractor:
OWNER -BU ER 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
Date: 4/12/2019
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.
I have and will maintain workers' compensation insurance, as required by
Section 3700 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:
Carrier: MP Policy Number:
rtify that in the performance of the work for which this permit is issued, I
sh mploy 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 C shal ith
comply with those provisions.
Date: iq 4 �� Applicant:
WARNING: FAILURE TO SECURE WORK[ 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 the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent)
Application Number:
BPOL2019-0075
Property Address:
54065 AVENIDA DIAZ
APN:
774194015
Application Description:
GALLAUDET POOL AT REAR YARD
Property Zoning:
Application Valuation:
$20,000.00
Applicant:
GALLAUDET CONSTRUCTION
54-065 AVENIDA DIAZ
LA QUINTA, CA 92253
Owner:
GALLAUDET INV
79225 TORONJA
LA QUINTA, CA 92253
Contractor:
GALLAUDET CONSTRUCTION
54-065 AVENIDA DIAZ
LA QUINTA, CA 92253
(760)413-7552
Llc. No.: 919430
Date: 4/12/2019
---------------------------------------------------------------------------------------------
Detail: POOL WITH ELECTRICAL FUTURE FOR SPA 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.
DESCRIPTION
BSAS SB1473 FEE
ACCOUNT QTY
101-0000-20306 0
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
AMOUNT
$1.00
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.68
Total Paid for ELECTRICAL:
$53.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$200.12
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$108.87
Total Paid for POOL / SPA:
$308.99
DESCRIPTION
ACCOUNT QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
CALIFORNIA
PERMIT # hl�
M --ECL
-75:
PLAN LOCATION:
City, St, Zip
Project Address: 54-0(66' AsJM%10A
:Project Description:
Patio/Porch SF
APN #:
Fire Sprinklers SF
State Lic: 91guk3o City Bus Lic-
ic:
No 50W
Applicant Name: (��4LC•q�17�^� Gp,�^�T.
6 !t.]
Address: S`(-fXoS Ana-va it 'V>(A c.
(Alco -096'5
1�.r4Twaft
City, ST, Zip: A Qu
Telephone:
Email: �ga.��o+y�+.-j = Goy
Valuation of Project
Contractor Name: L.�
Architect/ Engineer
New SFD Construction:
Address: /r
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: 91guk3o City Bus Lic-
ic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:&ALt,+,..p6f l �ftNew Commercial/ Tenant Improvements:
Address: ` dt Z IL S�' T&R.orjoj�r Total Building SF
City, ST, Zip A, �v` Construction Type: Occupancy:
Telephone:
Email:
73495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Required
Received
Plan Sets
'Structural -Calc§
Truss Calcs
Title 24 Calcs
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
i
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
..... ..
Public Works approval
Fire approval
City Business License
....
v� v�7v��7ftw�
eCCITY OF LA QUINT/ SUB-CONTR CTOR_ LIST
JOB ADDRESS .� PERMIT NUMBEOWNER I tr—L . BUILDER
This form shall be posted on the -job the-jobwith the Building Inspection Card at_alI times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade 1 Classification
Co.n..lr.:aCtor
State Contractor's License
Worlkers Compensation Insurance City 8usiness..Licen.s..e
-
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/);x/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number Exp. Date License Number
(Format Varies) (xx/xx/xx) Ixxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-72):
CONCRETE (C=B)
FRAMING (G-5)
STRUCT. STEEL IC=51')
MASONRY (C-29)
`
PLUMBING (C-36)
LATH, PLASTER. (.C,35)
DRYWALL (C-9)
HVAG (C-20)
ELECTRICAL (C-10).
ROOFING (C-39)
SHEET METAL (C-43)
FLOORING (C-15)
GLAZING (C-17)
INSULATION (C-2)
SEWAGE DISP. (C-42)
PAINTING fC-33.)
CERAMIC TILE (C-54)
CABINETS (C-6)
-FENCING (C-13)
LANDSCAPING (C-27)
POOL (C•53)
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