BRES2019-0227tilLlv{/ VOICE (760) 777-7125
78-495 CALLS TAMPICO DFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/17/2019
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Owner:
Application Number: BRES2019-0227 JAMES FRICKLETON
Property Address: 80090 VIA CAPRI 3012 W 117TH ST
APN: 777100064 LEAWOOD, KS 66211
Application Description: MICKLETON / PLUMBING / ELECTRICAL FOR WATER FEATURES
Property Zoning:
Application Valuation: $3,600.00
Applicant: Contractor:
DESERT MIRAGE POOLS & SPAS / '� \ DESERT MIRAGE POOLS & SPAS
P O BOX 10050 D L"! —� P O BOX 10050
INDIO, CA 92202 INDIO, CA 92202
JUL 2 2 2019
0 (760)702-9222
CITY OF LAQUINTA Llc. No.: 999928
DESIGN & DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed urrde ovisions of Chapter 9
{commencing with Section 70001 of Division 3 of the Busi ess nd rofessions Code, and
my License is in full force and effect.
License Class: C53 License No.: 999928
wcl-ZZ-/
OWNER-BUILDEP DEC RATION
I hereby affirm under penalty of perjury that Iam a mpt from the Contractor's State
License Law for the following reason (Sec.70 .5, usiness and Professions Code: Any
city or county that requires a permit to constru , 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 Na
Lender's
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:
Car r ) 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 come jest to the workers'
compensation laws of California, and agree that, if shout ome subject to the
workers' compensation provisions of Section 370 of th La or Code, I shall forthwith
comply with those provisions.
R1tarA — 7 L - 1 L'i
WARNING: FAILURE TO SECURE WOR ERS' OMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TkC511MINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ( 0,000). 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 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 infor lion i to rect.
I agree to comply with all city and county ordinances and state laws re ting b iding
construction, and hereby authorize representatives of this city to ent r up t above -
mentioned property for inspection purposes.
/. " 1'7 wA9a*imWpplicant or
Date: 7/17/2019
Application Number:
BRES2019-0227
Owner:
Property Address:
80090 VIA CAPRI
JAMES FRICKLETON
APN:
777100064
3012 W 117TH ST
Application Description:
FRICKLETON / PLUMBING / ELECTRICAL FOR WATER FEATURES
LEAWOOD, KS 66211
Property Zoning:
Application Valuation:
$3,600.00
Applicant:
Contractor:
DESERT MIRAGE POOLS & SPAS
DESERT MIRAGE POOLS & SPAS
P 0 BOX 10050
P 0 BOX 10050
INDIO, CA 92202
INDIO, CA 92202
(760)702-9222
Llc. No.: 999928
"t
Detail: UNDERGROUND PLUMBING AND ELECTRICAL FOR [2] WATER FEATURES.WATER FEATURE SHELLS NOT PERMITED. PER 2016 CALIFORNIA
BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION 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
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.68
Total Paid for ELECTRICAL: $53.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$26.68
Total Paid for PLUMBING FEES: $53.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Project Address: Q J 9 ' 1 try
APN #:
Applicant Name: ,
Address: EGX 00 a
City, ST, Zip: E n G,
Telephone: (-7 , )
Email ^
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Project Description:
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Valuation of Project $C��
/8495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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OFFICE USE ONLY
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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