BPOL2019-016978-495 CALLE TAMPICO " p D � � VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/7/2019
Permit Type/Subtype: POOL/PRIVATE Owner:
Application Number: BPOL2019-0169 MARIE ANN & ROBERT CHISWELL
Property Address: 78970 CALLE BRISA 78970 CALLE BRISA
APN: 602130006 LA QUINTA, CA 92253
Application Description: CHISWELL / POOL, SPA, AND FIREPIT AT REAR YARD
Property Zoning:
Application Valuation: $15,000.00 D D
Applicant: Contractor:
FRANSICO CELEDON / BLACK DIAMOND POOLS & DESI N AUG 0 7 2019 BLACK DIAMOND POOLS & DESIGN
88-351 AVENUE 58TH #6 88-351 AVENUE 58TH #6
THERMAL, CA 92274 THERMAL, CA 92274
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT (760)619-1362
Llc. No.: 977341
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: License No.: 977341
Date: Contractor:xsL uL��
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.),
(_) 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
Datev
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 Ad
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.
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: STATE COMPENSATION IM URANCE FIND Policy Number: 9164633
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: Applicant:
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.
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
-onstruction, and hereby authorize representatives of this city to nt upon the
above-menti ed property for inspection purposes,
Date: t
Signature (Applicant or Agent): _
i
Date: 8/7/2019
Application Number: BPOL2019-0169
Property Address: 78970 CALLE BRISA
APN: 602130006
Application Description: CHISWELL / POOL, SPA, AND FIREPIT AT REAR YARD
Property Zoning:
Application Valuation: $15,000.00
Applicant:
FRANSICO CELEDON / BLACK DIAMOND POOLS & DESIGN
88-351 AVENUE 58TH #6
THERMAL, CA 92274
Owner:
MARIE ANN & ROBERT CHISWELL
78970 CALLE BRISA
LA QUINTA, CA 92253
Contractor:
BLACK DIAMOND POOLS & DESIGN
88-351 AVENUE 58TH #6
THERMAL, CA 92274
(760)619-1362
Llc. No.: 977341
Detail: POOL, SPA, AND FIRE PIT AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. PER 2016 CALIFORNIA BUILDING CODE.
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
Credit Card Fee
101-0000-43505
0
$6.57
Total Paid for Credit Card Fee: $6.57
Total Paid for PLUMBING FEES:
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 CITY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
PERMIT # SFU29) I I a- 0/
-----^(-:.�LWOORNIA
Project Address: !
APN #:
S,4�_ i Project Description:
e
Applicant Name: rNia cv Ce(ect01-
Address: — f'O W(AC 6I�Vs/�-
City, ST, Zip: �(�it,� - C4—
Telephone:
Email: �'y� / Valuation of Project $
Architect/Engineer Name: Construction Occupancy:
Address; Grading:
City, St, Zip
Telephone: Bedrooms: Stories: #Units:
Email:
State Lic: City Bus Lic:
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
I
Fire approval
City Business License
Jack Lima
From:
Frank Celedon <fceledonpools@live.com>
Sent:
Friday, August 2, 2019 3:11 PM
To:
Jack Lima
Subject:
Fwd: City of La Quinta (Chiswell)
EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening
attachments, clicking links or responding to requests for information.
Heres auth form
Sent from my T-Mobile 4G LTE Device
-------- Original message --------
From: RayMartinDesign Office <office@raymartindesign.com>
Date: 8/2/19 1:02 PM (GMT-08:00)
To: fceledonpools@live.com
Subject: FW: City of La Quinta (Chiswell)
From: ANNE MARIE GRANT <annegrant@shaw.ca>
Sent: Friday, August 2, 2019 12:38 PM
To: RayMartinDesign Office <office@raymartindesign.com>; amagallan@laquinta.gov
Cc: Ray Martin <ray@raymartindesign.com>; RayMartinDesign Info <info@raymartindesign.com>; dchiswel@mymts.net
Subject: Re: City of La Quinta
To whom it may concern,
Please accept this as authorization for Black Diamond Pools to commence construction and act as contractor of record
on the project at our property at 78790 Calle Brisa, La Quinta CA 92253.
Regards,
Anne Marie and David Chiswell
On Aug 2, 2019, at 2:05 PM, RayMartinDesign Office <office Oraymartindesi n.com> wrote:
Mr. and Mrs. Chiswell-
Good afternoon. We've submitted the plans to Armando Magallon at the City of La Quinta. He
is now asking for a Letter from you authorizing Black Diamond Pools to commence the
construction of the firepit and be the Contractor for this job. Please send the email to
amagallon@laquintaca.gov
Thank you,
Karla Jimenez
Office Manager
Ray Martin Design Corp.
780-060 Calle Estado Suite #15 & #16
La Quinta, CA 92253
Office: 760-698-9696
office@ raymartindesign.com
9