BPOL2019-011178-495 CALLE TAMPICO Titvl DVOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/22/2019
Permit Type/Subtype: POOL/PRIVATE Owner:
Application Number: BPOL2019-0111 BELLA VISTA TITLE TRUST / WALDEN, GREGORY
Property Address: 78653 COMO CT 27702 CROWN VALLEY PKWY
APN: 609530025 Gregory
Application Description: WALDEN / POOL, SPA, AND BBQ LADERA RANCH, CA 92694
Property Zoning:
Application Valuation: $30,000.00
Applicant: Contractor:
FRED ROCK POOLS INC %, Da FRED ROCK POOLS INC
P O BOX 790 L//"L�\, P O BOX 790
CATHEDRAL CITY, CA 92235 CATHEDRAL CITY, CA 92235
MAY 2 2 2019 (760)343-6279
Llc. No.: 924163
CITY OF LA QUINTA 0
--------------------------------- DESIGN HEVELOPM€NT-DEPARTAIIENT------- -_--_-__-________-_-__----__
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: C53 License No.: 924163
Date: 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.).
(_) 1, 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 Addre!
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 or which this permit is issued.
ave and will maintain workers' compensation 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 policy number are:
Carrier: WESCO INSURANCE ,CQD,P, NAY Policy Number: WWC3354320
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.
Date. f le-1114 Applicarrkt
WARNING: FAILURE TO SECURE WORKER ' OMPENSA N AGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO IMINAL PEI9ALTIE 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 shal I
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 relating to building
construction, and hereby authorize representatives of this city to enter upon the above -
mentioned property for inspection purposes.
Date:. 7 Sigp". 1 (Applicant or Agent):
Date: 5/22/2019
Application Number:
BPOL2019-0111
Property Address:
78653 COMO CT
APN:
609530025
Application Description:
WALDEN / POOL, SPA, AND BBQ
Property Zoning:
Application Valuation:
$30,000.00
Applicant:
FRED ROCK POOLS INC
P 0 BOX 790
CATHEDRAL CITY, CA 92235
Owner:
BELLA VISTA TITLE TRUST / WALDEN, GREGORY
27702 CROWN VALLEY PKWY
Gregory
LADERA RANCH, CA 92694
Contractor:
FRED ROCK POOLS INC
P 0 BOX 790
CATHEDRAL CITY, CA 92235
(760)343-6279
Llc. No.: 924163
Detail: POOL,SPA AT REAR YARD,[1]GAS FIXTURE TWO DROWNING SAFETY FEATURES AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER
INSPECTION. PLEASE PROVIDE WET STAMPED POOL ENGINEERING SHEET ON SITE FOR 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 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
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
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
CITY
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
Contractor Name:
Address:
City, St, dip C
Telephone:
Email:
State Lic: City Bus Lic:
GeN Ll 1� 1.151
1 qa�1--15-'Ioy
Architect/Engineer Name:
Address:
City, St, Zip -�
Telephone: Z17-
[ L
Email:
State Lic: f5 fJ /,City Bus Lic:
Property Owner's Name:
Address: G
City, ST, Zip
Telephone:
Email:
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction
Grading:
Bedrooms: I Stories:
_SF
_SF
_SF
SF
Occupancy:
# Units:
I-Af, New Commercial / Tenant Improvements:
C Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# 1 Submittal , Required � Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
Contractor Name:
Address
City, St, Zip
Telephone:
Email:
State Lic:
City Bus Lic:
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
Ad d ress :
City, ST, Zip
Telephone:
Email:
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction
Grading:
Bedrooms: I Stories:
_SF
SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements:
Total Building __SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA,, CA 92253
760-777-7000
OFFICE USE ONLY
'I —F--
# Submittal Required I Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
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