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BPOL2020-000578-495 CALLE TAMPICO D 4P Q" LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: POOL/PRIVATE Application Number: BPOL2020-0005 Property Address: 51475 CALLE JACUMBA APN: 770165022 Application Description: MAGALLON / POOL, SPA, AND 67LF GARDEN WALL AT COURTYARD Property Zoning: Application Valuation: $20,000.00 Applicant: D MAGALLON, SERGIO 51475 CALLE JACUMBA LA QUINTA, CA 92253 JAN 15 2020 19 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: License No.: 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).: (A) 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.). Q") 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: St�,� 0JJ� a 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/15/2020 Owner: MAGALLON, IRMA 51475 CALLE JACUMBA LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: 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: Carriev: _ 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 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: !.5 2-6 —Applicant: _ J� ►i 0 i I� Ti� fQ .. tl 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 city t enter upon the above - mentioned property for inspection purposes. Date:Signature (Applicant or Agent): ) Date: 1/15/2020 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: MAGALLON, SERGIO 51475 CALLE JACUMBA LA QUINTA, CA 92253 BPOL2020-0005 51475 CALLE JACUMBA 770165022 MAGALLON / POOL, SPA, AND 67LF GARDEN WALL AT COURTYARD $20,000.00 Owner: MAGALLON, IRMA 51475 CALLE JACUMBA LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: Detail: POOL,SPA AND 65LF OF 6' GARDEN WALL AT FRONT YARD [TODD LACHER ENGINEERING.] 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. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. SPECIAL INSPECTION REPORT REQUIRED AT PRE PLASTER. 2016 CALIFORNIA BUILDING CODE FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100LF 101-0000-42404 0 $53.67 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100LF PC 101-0000-42600 0 $67.08 Total Paid for BLOCK WALL 2019: $120.75 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 SWIMMING POOL/SPA 101-0000-42404 0 $201.25 DESCRIPTION ACCOUNT CITY AMOUNT SWIMMING POOL/SPA PC 101-0000-42600 0 $109.48 Total Paid for POOL / SPA 2019: $310.73 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 ,; TUY 4 4Qa&rw P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building pgLmit has been s rr tted in your name listing,yourself as he builder of the property improvements specified at We are providing you with an Owner-BuI der Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verb this information. M"I. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. � 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. Sk3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 5f 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. '5V 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of ti y construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. +�6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential stru tares cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any tina cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. S 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Serv6, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party lega11 and financially responsible for ro osed constructio activity t the following address: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: GFiJ1 JeA I)FtiF:Ftif'L-1 PERMIT # p0 s PLAN LOCATION: Project Address: 7 i G F► Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: I oo l$ s P A Applicant Name: ia,) Oro r-P rld, J 61 L Address: 4eS `NA A City, ST, Zip: O�^ A A. Telephone: �-- Email: v �� Valuation of Project $ Contractor Name: _ ] J, New SFD Construction: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email; Fire Sprinklers SF State Lic: City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: Property Owner's Name: 1 } New Commercial / Tenant Improvements: Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 NOTE: 1. "ALL EQUIPMENT WILL SHALL BE SEISMICALLY ANCHORED 2. MASONRY EQUIPMENT WALL SHALL BE BUILT PER CITY STANDARD SPECIFICATIONS 3. ALL GFI OUTLETS WILL BE WEATHER AND TAMPER PROOF 4. ALL OUTLETS SUPPLIED BY SINGLE-PHASE, 15A AND 20A, 125V OR 240V BRANCH CIRCUITS FOR SWIMMING POOL PUMP MOTORS ARE REQUIRED TO HAVE GFCI PROTECTION 5. PROVIDE 36" WORKING CLEARANCE FOR THE POOL EQUIPMENT MOTORS ARE REQUIRED POOL SAFETY BARRIER: EXIT ALARMS ` SELF -CLOSING SELF -LATCHING DOORS SPA TO BE EQUIPPED WITH ANTI -ENTRAPMENT DEVICE (SEC. 1404 FEDERAL SWIMMING POOL AND SPA DRAIN COVER STANDARD) PROVIDE LOCATION OF ANTI-ENTRAPMENTNORTEX COVERS MEETING CURRENT STANDARDS OF THE AMERICAN SOCIETY FOR TESTING AND MATERIALS (ASTM) OR THE AMERICAN SOCIETY OF MECHANICAL ENGINEERS (ASME), IDENTIFY A MINIMUM 3 FEET SEPARATION BETWEEN ALL DRAINS AND NOTE HYDRAULICALLY BALANCED SAFETY FEATURES: (E)SLOCKWALL A ALL ANTI -ENTRAPMENT COVER INSTALLATION MEETING CURRENT STANDARDS OF THE AMERICAN SOCIETY FOR TESTING AND MATERIALS OR THE AMERICAN SOCIETY OF MECHANICAL ENGINEERS (ASME) ELECTRICAL: EQUIPOTENTIAL BONDING REQUIREMENTS SHALL BE INSTALLED TO ELIMINATE VOLTAGE GRADIENTS IN THE POOL AREA AS PER CEC ART. 680.26. 9awwces>RAuBe VeUkmomwowD KLP I4T641gai LA TO iB Or 4DM BRADE(av'M ArIOBI "SWWO OVIN9JIO ANN.1'e110LIPO0l/SPA. 2019 CALIFORNIA BUILDING CODE(BASEDON20151BC) 20 1 9 CAL I FORMA MECHANICAL CODE (9ASEDON2015UMC) so AcRn cavµr000i o 201 9 CALIFORNIA PLUMBING CODE(BASED0N2015UPC)mm:­ 2❑19 CALIFORNIA ELECTRICAL CODE(BASEDON2014NEC) 2❑ 1 9 CALIFORNIA ENERGY EFFICIENCY STANDARDS MAIN DRAMS TO BE 9' APART WIiH GOVERNMENT CODE SECTION 4216.2. (a) (1) EXCEPT IN AN EMERGENCY, ANY PERSON PLANNING TO CONDUCT ANY EXCAVATION SHALL CONTACT THE APPROPRIATE REGIONAL NEWMASONRY BLOCK WALLATaW NOTIFICATION CENTER, AT LEAST TWO WORKING DAYS, BUT NOT MORE THAN 14 CALENDAR DAYS, PRIOR COMMENCING THAT EXCAVATION, IF THE EXCAVATION WILL BE CONDUCTED INSTALLATIONS OTHER THAN THE UNDERGROUND FACILITIES OWNED OR OPERATED BY THE EXCAVATOR AND IF PRACTICAL, THE EXCAVATOR SHALL DELINEATE WHIT WHITE PAINT OR OTHER SUITABLE MARKING THE ARE TO BE EXCAVATED INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH SECTION 114-MANDATORY REQUIREMENTS EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS TO THE POOL o POOL HEATER, POOL EQUIPMENT SHALL BE INSTALLED PER MANUFACTURE'S RECOMMENDATIONS AND IN ACCORDANCE I- WITH LOCAL REGULATIONS DRAWN BY G�U � E 1 it 'stilt I. ra.w oW (E)BLOCKWALL EXISTING RESIDENCE Pe DESERTGOLD )f - _.. seiBec . J •I i EXISTING.R RESIDENCE C T F.F• NJ. o EXISTING GARAGE f EXISTING CASITA I 1 J H Eic19 TINOflRNEWRY AaovNonoO�.A�vA CITY OF LA QUI NTA BUILDING DIVISION REVIEWED FOR CODE f COMPLIANCE DATE + By I. AeK o-- (E)BLOCK WALL )NE SERVICE BOX N SERVICE BOX owim twmn. ANO SHALL SVVH AWiHAROAHgYNta3900� f 6PA �VAWT DRMETO RUN PULP&M TO EOUIPMEJT LO TMN POLY•EMELENE OAS LINE VMM 10 L MUN OAW6 TO&a i AaART 1NrH ANII-0OV6R0 w'-ww"I A9PR m CL AVENIDA DEL PADRE SPECIFICATIONS POOL POOL SIZE 200' X izal SURFACE POOL AREA tee 9F POOL PERIM%ETER_ SF POOL DEPTH6,70 sa' SPA SPA SIZE: 61-V X 6—V SURFACESPAAREA: 30 SF SPA PERIMETER:__ 22 SF SPA DEPTH&_ _ TO m PLUMBING POOI&P.jRoL•7,A�ON PUMP: Jrrru`_.uw' FILTER AnrM a6. =- HEATER: ="^"i°01"'v CONTROLSYSTEM- IMERxMK:*un+ SRIMMER._pAr�rn LIGHTS 0rromnu.�rn:ro L-T Ii i NHrAP w+n IR.Ltl•T SPA JET&'- EXTRAKAMA r FINISHES TILNSTONE:+ $rsu-Aft-Iu urN ., PEBBLEIPLASTER,,± f 'L+ PaaLwelNaxursN: =...�a.L. CONCRETE/PAVER• rn, rrK+rn _SF OIdA43_ _ OWNER RESPONSIBILITY Bne9nxE TOEuwRonw,e¢EvncR 9F aoa cR Ta• •r nEuromoxwv aFExcr:.mN a r f TKArrosLA wECF PAIUYE9F�T. c rkr sel�.Tu,<sr.�xrECN�r FaR se.ar °TwT.'oersa a ak ON.NTAB tWK.9VrwWS OvrvNi.0.cmtsu e c fa nw��a+�a.e.uoernoxBKffnacu tsawlul. renLsno..RerRA. ronrsAunm T. f4 4Po�ugpiTp,v A•IMfLNp9.IfOLWk TXL.WOAOi WIN..�•�y�p F I19R:l IrUf MYAr+MaNFR tlu•w _ �LTwr.N. �n�aamm�fAw. ArnaxR IW lK••. Laay�i4r wwnarsLws Tw RefgwwARpAr,OBnTAME MAxAMRAI ]�1r No, fhridnn Inue Dale roa euo OWNER BUILDER Fbfecl 1NTe W •Y.•• M�7GA�L I�� N�R FEA I D E N C E LA QUINTA, CA 1 EELJO kwV q CITY OF LA QUINTA SLAB -CONTRACTOR LIST JOB ADDRESS. S` �� �`r Cn � ,J •mil 9a 1 _ PERMIT NUMBERS NER L _ _ BUILDER This form shall be posted on the job with the Building Inspection Card at all 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 resi)onse. Trade ! Classification Contractor State Cantractor' s,License Company Name Classification License Number . . Exp. (e.g. A, B, C-8) (xxxxxx) (xx/) EARTHWORK (G-12) � < all — CONCRETE (C-8) FRAMI NG: I C-5) STR.UCT. STEEL (C-51) MASONRY (C-29) - PLUMBING (C-36.) LATH, PLASTER DRYWALL (C-9.): ;HVAC I.C:=20): ELECTRICAL (C 1 a) ROOFING (C-3.W SHEET METAL (C-43) FLOORING (C-1:5) GLAZING (C-17i INSULATION (C.-2) SEWAGE D.ISP. (C-42)- PAINTING :(C-331 CERAMIC TILE (C-54) i I - CABINETS (C-6). F]~NCING (C-13) LANDSCAPING (C-27) POOL (C-53) Workers Cori -pensation; Insurance City B.usin:e.ss. Li.c.e.nse . .. Date Carrier Name Policy Number Exp. Date License Number Exp. Date x/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx)