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05-3885 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 0.510:0 0:0=3=8 8 5 " 51856 AVENIDA OBREGON 773-164-005-,5 -000000- POOL - RESIDENTIAL COVE RESIDENTIAL 17500` Tihf .4 uit,%v BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION SEP 0 71005 ITY OF LA ®Him rA I hereby affirm under.. penalty of, perjurythatI am licensed under... provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class': - License No.: e4 . 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 ProfessionsCode: Any city or county that requires: e -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 (Chapter9'Icommencing with Section 7000) of Division 3 of the Business and Professions Code) or that he orshe is exempt therefrom and the basis for the alleged -exemption. Any violation'of Section 7031 .5'by any applicantfora permit subjects the applicant to a'civil'penalty of not more than five hundred dollars ($500).: (_ 1 I, as owner of the property, or my employees with wages as their sole' compensation, will do the work, and the structure is notintended or offered for sale (Sec. 7044; Business and Professions Code: The - Contractors' State License Law does noVapply 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 _ 1 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.). ' (_ 1 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: LQPERMIT Owner: BUFFIN THOMAS, BOX 134 QUINTA, CA 92253 C ntractor: P CAZO POOLS & SPAS C: EXEMPT' WC: EXEMPT CSLB: 836900 VOICE (760)-777-7012. FAX (760) 777-7011 INSPECTIONS (760) 777-7153-- 05/31/06 04/30/06 WORKER'S COMPENSATION DECLARATION S Date: 9/02/05 J 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 ofthe 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:carrierand,policynumber'are: - Carrier C53� - Policy Number -- - - - - -- - - -- I certify that,.,in the performanceof the work for which this permit is;issued, I shall not employ any person in any manner so as to become subject.tothe workers' compensation laws of California, and agree that, if I should become subject to _tire workers' compensation provisions of Section 3700 of the Labor Code, I �shall forthwith comply with those provisions. Applican D LFIr N J A/� 1 C0 i O WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN. EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T,O_ONE HUNDRED THOUSAND DOLLARS ($100;0001. IN AD61TI6Wf0'THE COST OF COMPENSATION, DAMAGES AS PROVIDEO FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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. Icertify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinancesand state laws relating to building construction, and hereby authorize representatives of this my to enter upon the above-mentioned property or inspection purposes. Date: �_ Signature (Applicant or Agent Application Number . . . . . 05-00003885 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . . . Valuation . . . . .17500 ` Expiration Date 3/01/06 s. Qty Unit Charge Per Extension. BASE FEE 45.00 L 16.00 9.0000 THOU BLDG 2,001-25,000 144.00 Permit MECH POOL Additional desc.. Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation .0 Expiration-Date 3/01/06 Qty Unit Charge Per Extension BASE FEE 15.00. 1.00 11..0.000-_EA MECH FURNACE >100K 11.00 Permit ELEC POOL PERMLT-RES Additional desc . M{ Perrti't Fee 45.:00 Plan Check Fee 11.25 Issue. Date:, . . . . Valuation 0 Expiration Date 3/01/0.6 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 .30.00`00 EA ELEC PRIVATE SWIMMING POOL 30.00 'Permit . . . PLUMBING . Additional desc . Perinit-Fee . . . 33.00 Plan Check Fee 8.25. ' Issue DateValuation . . . 0. Expiration Date 3/01%06 .. Qty Unit Charge Per Extension BASE 'FEE 15.00 2..00 6.0.000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS : 3.00 ------------------- Notes and Comments POOL & SPA ONLY. ALARMS/BARRIERS SHALL LQPERMIT LQPERMIT Application Number . . . . 05-00003885 ------------------------------- 9pecial Notes and Comments -- - - - - -- ------------------- BE,IN PLACE PRIOR TO PRE-PLASTER INSPECTION.•EQUIPMENT.ENCLOSURE NOT INCLUDED. IN PERMIT.. ``. Fee summary- `Charged` Paid Credited Due .. _ - - -- ----- -- -- -- - - -- Permit. Fee Total 293.00 ..00 --- - - - - -- ---- 00 29.3,.D0 " Plan°. Check Total 148:85 00 0.0 14`8:85 s: Grand total. 441:,8500 .' 00. 441..85 LQPERMIT U A X Bin #City Permit # Project Address: S - A. P. Number: of La Quints Building 8 Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet O%mer's Name: Address: �,� •�gL I Legal Description: City. ST, Zip: � v Contractor: Z—O VC)S O L,5 Address: 823 S lab •' 1 �-r i� •(C)l FTeiephone: Project Description: City, ST, Zip: 1%. v pE • 9L ZO 9A Z� Telcphone: L1 �N 34 1 Ss' State Lic. # : 3 G 900 City Lic. #: -4 `7 Arch., Engr., Designer. Address: City. ST. Zip: Telephone: ? - - Construction Typc:. b() M I T-E, Occupancy: State Lic. Project type (circle one ew Add'n Altcr Repair Demo Seq. Ft.: #Stories: #Units: Name of Contact Person: e-LI U Z© Telephone # of Contact Person: t,7 too 3� 7 ° 85"$ imated Value of Proiect: . �� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted (7S Item Amount Structural Cala. Reviewed, ready for corrections Plan Cheek Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review. ready for correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Great Deed Plans picked up SAA. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- " Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fee Total Permit Fees CITU OF '-LA QUINTA SUS-CONTHACTUR LIS 1 JOB ADDRESS_44b X( PERMIT NUMBER OWN ER-*�rvQ 5F-015-� BUILDER? -T_-,Q US`1WAA- OL - 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 comrnencement of work. Fab a to comply will result in a stoppage of work and/or the voidance _[ L_ I.J:-.�. .. ....:♦ -C... ..4. .,r.r.lin�kI +r�A SII inform Minn rcn, ncctcrl hclr,%A/ rani ict. ha rr%Mrilatar4 by annlicant. �.°nn FiIPI-I is. not an accentable resoon• e_` - UI UUIIUIIRJ. I.JGII111 L.. 1-U1 VOU11 0!JiJ11%-1av1c uauc, a vy a.Irl-...­.-.. —.. ..._ ._ .--- -------,------ ---. ------ .. ' r/ State, Contractor's License - --' orkers Compensation Insurance . City Business License Trade / Classification Contractor Company.Name Classification • (e.g A,; B, C-8) Lice_nse.Number (xzxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy -Number (Format Varies) Exp.'Date (xxlxx/)txl License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (G12) Pte,A—Lo 15-t®AA_ 'CO1.3 �'S� ®J OJ- •3F54(o74 CONCRETE (C-8) _ FRAMING (C-5) STRUCT. STEEL (C -51P G vO� �. O ® ' MASONRY (C-29) PLUMBING (C-36) py A -1.06t= T • ®L: L' •� ��0� `��?• �� LATH, PLASTER (C-35 "Ls�t�S ��►I✓tv ; 'Q •'gEi ��J'^ _ ;) 1'�i 'H I :. • �V ®' DRYWALL (C-9) HVAC.(C-20) ELECTRICAL (C-10) 016 A.?-&,6sS e9+6� C.Sr_-,6_=s • `J 6o -3�,: �;. ( 4 , 'ROOFING (C-39) . SHEET METAL (C-43) FLOORING (C-15) ,GLAZING (C-17). 'INSULATION (C-2) SEWAGE DISP. (6-42). PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13). LANDSCAPING (C-27) POOL (C-53) .j 4a�. A°� 2.S ® �� ��� 5,� ��AbD S�s�•®es l gQ•I•®� 'l M: FrA. C,e, Or 11 SWIMMING POOL SPECIFICATIONS . POOL SPECIFICATIONS type: 6-111 .1 1 size: X i s k surface area IIoO perimeter. S depths: min. max. SPA SPECIFICATIONS size:Lee X surface area:�meter. dam wall width: MW length: Lp-- spa raised:+IZ spillway type: -'i t�7 L # of jets:_ motes: EXCAVATION / STEEL type of dig: in A : ate: nQF elevation:- �'fl• wall/fence removed by: --- wall/fenoe type conc.removal: sod removal: - — tree/stum oval: 6"r.b.b.l2"r.b.b.8"r.b.b. surcharge: YES bench/loveseat: �^ tanning shelf water depth: - - GUNITE 6"r.b.b. 12"r.b.b. 18"r.b.b. bench/loveseat: extended tad step: —' spa dam wall width:JZ.� spillway type: �s1%-Ee_ (DECKING SQ.FT. 94 jnrl-AJF,� finish: color: cantilever expansion joints: steps: toe: deck drains: decco-drain: curb core: sand&visqueen: TILE & MASONRY coping type: LA)J L WJ E_2 Z_ spillway type: LIC -00 6"r.b.b. I 6 12"r.b.b. (Q— IS"r.b.b. r.b.b. facing: trim tile: tile type: T' equipment wall: • X type: PLUMBING & ELECTRICAL plumbing size: It fill line: skimmer type. F-- #-1 -- gas line: _elect.line: �) S heater: size:L�,ln IC. filter. size:1� p� pump: size: t • g 1; P jet pump: - - size: -- sub-panel: time clock: GFIC.4 extra GFIC. --- pool light: spa light:�1)L& gas stubs: electstubs: plaster color. pebble: color. NAME: T oW -D1iG01��_ Job address: 5I'SS (D�.ft. QB- g City: LA 0 ots)TA 1 b� � • Q scale: Yb - 0 date: -/