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05-0579 (RPL)WIF O� BUILDING & SAFETY DEPARTMENT 1504 (760).777-7012 7N 9 LLE TAMPICO FAX (760) 777-7011 FEB QU T , CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 C�rrOf QU1NTA BUILDING PERMIT r -11H CEO Application Number . . . . . Property Address . . . . . .. APN: Application description.. Property Zoning . . . . ... . Application valuation . . 05-00000579__/ Date 52250 AVENIDA MONTEZUMA 773-241-009- - - POOL - RESIDENTIAL COVE RESIDENTIAL 20000 2/14/05 Owner Contractor S & J ASSOCIATES CONTEMPORARY HOMES INCORP PO BOX 1484 P.O. BOX 1141 LA QUINTA CA 92253 LA QUINTA CA 92253 (760) 777-7.330 WCC: STATE FUND WC: 16764082004 07/01/05 CSLB: 736920 03/31/05 ---------------------------------------------------------------------------- CCC:. B Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 162.00 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 9.0000 ------------------ --------------------------------------------------------- EA MECH FURNACE <=100K 9.0'0 Permit . . . . . . ELEC POOL PERMIT -RES Additional desc . . .. Permit Fee 45.00 I Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Applicant: Applicant's Mailing Address: T4hf " BUILDING & SAFETY DEPARTMENT o lv i eiA -lc� T© VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: at /�• f Architect or Engineer: Architect or Engineer's Address: 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 C�Ode, and my Li�sa�ce and effect.` icense Class Li se No. (� Mte _ContractoV" V__ 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 1, 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. BA P.C. for this reason Date 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 aintain �"�,orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for.which this permit is iss M work rs' compensation insurance carriera� pelicy� eLatzy _ arrier � s w -' C 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 J// forthwith comply with those provisions. Zate D !/ Applicant. WARNING: FAILURE TO SECURE WORKERS' COMPEN ATION COV RAGE 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 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. I certify that I have read this application and state that the above information is correc I agree to comply with all city and county ordinances and state laws relating to building const�ction, and hereby authorize representatives of this countenter upon th ove-mentioned property for inspection purposes. 7Date 7 % aSignature (Applicant or Agent):�yto `� Page 2 Application Number . . . . . 05-00000579 Date 2/14/05 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 ---------------------------------------------------------------------------- 3.000Q EA PLB GAS PIPE 1-4 OUTLETS 3.00 Special Notes and Comments POOL & SPA. ALL ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary ----------------- Charged Paid Credited Due Permit Fee ------------------------------ Total 309.00 .00 .00 ---------- 309.00 Plan Check Total 160.05 .00 .00 160.05 Grand Total 469.05 .00 .00 469.05 :z Qh 1 - SWUPl>I1RNG PGGL SP ECI1FICATiION ]I3 POOL SPECIIRCA'l`RONS tvnr2 — _ cis• 1 O X _ surface area: Z.')I & perimeter._ depths: min. ' max. SPA SiPl;CifF IICATIIONS size: &! XDl A. surface area: 33& perime dam wall width:length: l (o spa rais spillway type: tt of jets:_ notes: EXCAVA'TH®ld / STEEL type of dig: 80 6r -A-_ access: elevation: S•.$ .b. wall/fence removed by: — ve waWfence type — cone.removal: sod removal: — �� t! ststamp oval: �trl2 6"r.b.b. 12r.b.b. Ia"r.b.b. tanning surcharge: benchAovesea helf water depth: t — 6"r.b.b. 12%GUNffEb.b, l a"rb.b._ bench/loveseat• extended 2°d step:� spa dam wall width: I J\ / spillway type: SVAe�G�S'T®aJ DECIUNG i SQ.FT. finish. - color cantilever. expansion joints: steps: type: ® ❑ i deck drains: decco-drain: Icurb core: sand&visqueen: TIIE..E & MASONRY coping type: spillway type: bf.�IiKST�w1 EJ 6"rb.b. 12"rb.b. I o"r.b.b._ r.b.b. facing trim tile: �► the type: Iequipment wall: X type: FLf& �"cy PII,�G & EH.EC7i"i 6CAIL fo ® plumbing size: fill line: s, Tamer e: 4-I x' SPA: 6-Izl,& so 33 ' Id im gas line: electline: 1 1 heater, size: CON?PO�' i4lZ�( 4dONl filter. size: 2•ZSo I A U•lvl&A.% �Z.JNLS- pool pump: Sae � jet pump: size: sub -panel: time clock: I r GFIC. extra GFIC. 1 t^ . �• `�1 `� ` pool light spa light ' 1 gas stubs: electstubs: plaster color pebble: color NAME o zo / - � �' • Job address: 5 � ���,� ��.�•btJ`W AIEw:�`u`Y�E V city: scale: date: J 1