04-6443 (RPL)BUILDING & SAFETY DEPARTMENT
P0.:Box 1504 - 4 (760) 777-7012
78-495 CALLE TAMPICO• FAX (760) 7.77-7011
LA 'QUINT'k CALIFORNIA92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number
X04-00006443 n 27/04
Property Address
.-5-24-G-0—VE N7rAJBR Q�
APN: "'
773=255-006,- 6 .. - 000 -
Application description' .
�P.00LRESSIDENTI SEP
28
Property Zoning . .
COVE RESIDENTIAL
2004Application.,valuation
23000 COFLAgU11dTA
FOWgPNCIE
Owner
Contr_a.c-t.or
DEFaT
-------------------. -----
------------------------
STROUD GUDELIA S
FREELAND., TRIDON G.
52400 AVENIDA OBREGON ;`
4;8;869 PAtRADI,S-E- AVENU
LA.QUINTAz CA 92253 MORONGO.VALLEY
CA 92256
(76;0.).,,363-7400
WCC "' EXEMPT
WC EXEMPT
09/30/05
CSLBin 837648
05/31/06
CCC: C53
Permit MECH
POOL ,
Additional desc
Permit. Fee
24.00 Plan Check Fee
6.00
Issue Date . . .
Valuation . . .
. 0
Qty Unit- Charge. Per
Extension
`
BASE FEE
15.00
1.00 9.'0'`000:. EA
MECH FURNACE <=100.K
9.00
---------------------------------------
Permit - - - - - - - . - - BIDE,
-- ------------------------------
POOL ;PERMIT
Additional desc J
Permit Fee
234-.00 Plan Check Fee
152.10
Issue Date
!' Valuation'. . . .
. 23000
Qty '`' Unit Charge° Per- .
Extension
BASE, FEE
45.00
21.00 9.000.0* THOU - BLDG-,�2 /, 01=25, 000
189.00
Permit . . . ELEC
POOL :PERMIT, -RES.
Additional desc
Permit Fee
4.5;100 P.lan•.Check Fee
11.25
Issue Date . . .
Valuation
0
Qty Unit ¢•Per
Extension
.Charge-
BASE FEE
15.00
1:00 30.0000 EA
ELEG''•PRIVATE SWI-MMfiNG`POOL
30.00
P.O. Box 1504
78-495 CALLS TaMPICO
fl VOICE (760) 777 FAX (7621.) 777-701101=
La QuINTa, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: t9 —& V 3 I Date:
Applicant:
Applicant's Mailing Address:i,
Architect or Engineer:
Architect or Engineer's Ad r
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 Professionals
Code, and my License is in full force and effect. cT
License Class License No. 7� �3% C0 L1 9
Date _ 7— ! Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. . B.& P.C. for this reason
Date Owner.
WORKERS' 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 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 3700 of the Labor Code, I shall
forthwith comply with those provisions.
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.
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
IMPORTANT Application is hereby made to the Director of Buildingand Safety o ACKNOWLEDGEMENT
1. Each permit subject to the conditions and restrictions set forth on this application.
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, indemnity and hold harmless the City of La Ouinta, 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 buftding
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date�� . 7— Signature (Applicant or Agent):
f ,
\ F
Page 2
Application
Number 04-00.0&6.443-
Date 9/27/04
Permit
PLUMBING
Additional desc
Permit Fee
33. 00 Plan' .Check Fee
8.2.5
Issue Date
. . . Valuation'
0
Qty Unit Charge. Per
Extension
BASE. FEE
15.00
2..00
6.0000 EA PLB FIXTURE
12.00
1.00
3.0.000 EA PLB WATER INST/A, REP
3.00
1.00
3.00.00 EA PLB GAS'`Pi:PE 1=4.OUTLETS
3.00 '
Special Notes,
-aftdL Comments:
POOL '& .SPA.
ALARMS BARRIERS -'SHALL
BE IN-PLACE
PRIOR TO PREPLASTER
INS'PECTI,ON.
EQUIPMENT ENCL•OSURE,NOT
INCLUDED IN
PERMIT.
Fee summary
Charged. Paid Credited
Due
Permit Fee
Total 336'.00 .00 .00•
336.00
Plan Check
Total 177._6.0. .00 .00
177.60
Grand Total
513'.60.,:._. .00 .00
513.60
IOB ADDRES
-n this job. Any changes to this list must be approved by the
f4...:1A. .. c-- - -1-1:--LI- - -J--1. - _ r
IIT NUMBER OWNER la J01, BUILDER_I lr
on Card at all times in a conspicuous Rlace. Only persons appearing on this list or their employeesare authorized to work
Building Division prior to commencement of work. Fai t com I, will reVlt in ' stoppage of'7work and/or the voidance
•
ion. requested De ow Must 136 Complete. _
y,applicant. ;"On: File" is not an -accetable res onse,
Trade / Classification.
Contractor:,
State. Contractor's License
yl�iforkeU a ation Insurance. -`'
City Business License
Company Name
Classification.
License Number
Exp. Date
Carrier Name
Policy Number .
Exp: Date
License Number
Exp. Date
le.g. A. B, C-81
(xxxxxx)
Ixxlxx/xxl
(e.g. State Fund, CalComp)
(Forman Varies)
(xx/xx/xx)
(xxxx)
(xxlxxlxx)
EARTHWORK IC-12!3�
2
CONCRETE (C-$).3
C»C O' E i.IL
G
X5
%
US
T
64 o 0 10 (
1 I.
l (� r2f3f.3�
' c'
STRU.CT STEEL (C-54,
MASONRY I6-29)
..;
-
:.
PLUMBING (C-3�6)
o14C
,
1 rl8-BL16(o-260
'
!i3 o,4
44*? I
o3�o2�hS
LATH,XPLASTER (C-36)
:
—
=s
DRYWALL 1C=8)
IU}
HVAC�!0-201.
N
ELECTRICAL. (C-1 0))
g,:_
-5.
a143�1
12 .
�3c; os
12 _;
110 -BLl0b-W-05
1�,3�04 .
CA4u731
ROOFMa IC -391
N /a _
SHEETI�METAL (C-43)
FLOORING (C-15).Anj
•,
GLAZING IC -17)
N jq'
INSULATION i.0„21f�-
SEWAGE DISP. (C-42)
'NIA ”
—
PAINTING 10-331
N A
CERAMIC TILE (C-54)
N�A
CABINETS IC -6)
IvIA
FENCING IC -13)
IBJ A
4
LANDSCAPING (C-271
�/jC�
44
POOL IC -&31
G1D ..`
'Z5 `10-i
5
.ern pT
LEC _ ..
RESIDENCE
Guadilia Placencia
52400 Avenida Obregon
L.Q. CITY OF LA C UINTA
A RE -INSPECTION FEE OF $30 BUILDING & SAFETY DEPT.
APPROVEDWILL BE CHARGED IF THE 38'9 A Rn\/I r)
PLANS AND JOB CARD ARE NOT ON FOR ,O#FROCTION
—7 PLANS
THE SITE FOR A SCHEDULED
DATE _
INSPECTION.
NO EXCEPTIONS!
TRIDON POOL AND SPA
CONSTRUCTION
48869 PARADISE AVE.
MORONGO VLY. CA. 92256
1 Lie. # 837648
POOL 14 X 27
PERIMETER 72
J
AREA 300 Sq.
SPA 6X7
PERIMETER 22
AREA 35 Sq.
r
s
PUMP, 1.5 HP
FILTER 320 Sq.
HEATER 400 BTU
GROUP 1 PEBBLE TEC
DECK 560 Sq.
WITH CANTILEVER EDGE
GROUP 3 WATER LINE TILE
4 JETS IN SPA
1 FULL SIZE LIGHT IN POOL
1 SPA BRITS LIGHT IN SPA
SALT SYSTEM
DESIGNATED VAC LINE IN
POOL.
GAS LINE NOT INCLUDED IN
PRICE.