BPOL2019-015078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
MICHAEL
78975 RIVER ROCK RD
LA QUINTA, CA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
POOL/REMODEL
BPOL2019-0150
54470 AVENIDA J.UAREZ
774233027
KEATING, MELANIE
$1,800.00 F
JUL 11 2019
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
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: C53 License No,:
% Con
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 F
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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/11/2019
Owner:
KEATING, MELANIE K.
54470 AVENIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
MICHAEL'S POOLS
78365 HIGHWAY 111 SUITE 255
LA QUINTA, CA 92253
(760)257-5767
Llc. No.: 1029465
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: FX'MPT Policy Number:
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 3' 0 of the Labor Code, I shall forthwith
comply with those provisions.
Da 7-/—/ i
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 L;;4-
above-mentioned property for inspection purposes.
&gnature(Applicant orAgent):
Date: 7/11/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
MICHAEL
78975 RIVER ROCK RD
LA QUINTA, CA 92253
BPOL2079-0150
54470 AVENIDAJUAREZ
774233027
KEATING, MELANIE
$1,800.00
Owner:
KEATING, MELANIE K.
54470 AVENIDAJUAREZ
LA QUINTA, CA 92253
,Contractor:
MICHAEL'S POOLS
78365 HIGHWAY 111 SUITE 255
LA QUINTA, CA 92253
(760)257-5767
Llc. No.: 1029465
Detail: RELOCATION OF EXISTING POOL EQUIPMENT FROM SOUTH 51DE YARD TO NORTH SIDE YARD..EQUIPOTENTIAL BOND TO BE INSPECTED BEFORE
PAVER INSTALLATIION. A MINIMUM OF 5' BETWEEN GROUND MOUNTED EQUIPMENT AND PROPERTY LINE SHALL BE PROVIDED. THIS PERMIT DOES NOT
INCLUDE EQUIPMENT CHANGEOUT OR EQUIPMENT SCREENING. 2016 CALIFd(NI''R60IEDIIqtCODE.
DESCRIPTION
INFORMATIONFINANCIAL
ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.68
Total Paid for ELECTRICAL: $26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$26.68
Total Paid for MECHANICAL: $66.70
DESCRIPTION
ACCOUNT
CITY AMOUNT
PERMIT ISSUANCE
101-0000-42404
0 $101.40
Total Paid for PERMIT ISSUANCE: $101.40
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
TOTALS:
Project Address: 3i7Vj�,¢
APN #:
Applicant Name:111A�4%rJ4*77 /4
Address: .j VY70
City, ST, Zip: 1.4 Q1%'1A%rP Ci4
Telephone:
Email:
Name: ///Afoas' lnx�4-S
Address: 7,f36s//w7 /// ST ;,=
City, St, Zip /-A- 6)vA/7W-, �A 9�aS3
Telephone: 7,00 Email:
State
State Lic: /0d�9j46_�— City Bus Lic:
Architect/Engineer Name:
Address:
City, St, Zip
Telephone
Email:
State Lic:
City Bus Lic:
'�755Y
Property Owner's Name: 41E1-^A11f' jC rj (
Address: 5WR) f E-Allm �V
City, ST, Zip �f�tQV/�tliE1� e�4 Fd,
Telephone:rl/
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17pm
Project Description:
/4��Lez-q-TE
Valuation of Project $_
New SFD Construction:
/tea L 6✓ V/
Conditioned Space SF
Garage SF
Patio/Porch SF
Fire Sprinklers SF
Construction Occupancy:
Grading:
Bedrooms: ; Stories: I # Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# 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
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SIGNATURE PAGE
Any alterations or deviations from the above specifications, including but not limited to any such
alterations or deviations involving additional material and/or labor costs will be executed only when a
written order for such changes is submitted by Michael's Pools, signed by Owner/Agent and Contractor,
and if any charge for alteration or deviation, the additional charge will be added to the contract price.
The following constitutes commencement of work pursuant to this proposal and contract upon signing.
This proposal is submitted and duplicated; the return of one copy with our signature will constitute a
contract.
ACCEPTANCE: You hereby authorize Michael's Pools to furnish all materials and labor required to
complete the aforementioned in this proposal for which I/We agree to pay the contract price in
accordance with the terms thereof.
I have read and agree to all the terms of this statement.
Accepted by:
Lr4- 'A 0)
Owner D
Please specify: Owner N Agent ❑
You the buyer may cancel this transaction at any time prior to midnight of the third day after the date of
this transaction.
7636S HWMN" 111, #255, La Quinta, CA 92253 Lich 1029465 760.257.5767