12-1081 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4t�l 4 4 Q"
Application Number:
12-00001081
Property Address:
77655 AVENIDA MONTEZUMA
APN:
773-083-025-2 -000000-
Application description:
POOL - RESIDENTIAL
Property `Coning:
COVE RESIDENTIAL
Application valuation:
16000
Applicant: Architect or E ineer:
c�
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
sap
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.
License Class: C53 LicenseNo.: 946375
Dater Contractor. au Cb C IIIJCiC ;
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.).
(_) 1, 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. , BAP.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:
LQPER IIIT
VOICE (760)
FAX (760e-5
INSPECTIONS (760)
Date: 9/21/12
Owner:
RW REAL STATE INC. FF
P.O. BOX 92247
LA QUINTA, CA 92253(760)619-7611
Contractor: Ci yT OF LA QUINTA
FINANCE QF'T•
NOGUES, JULIO CESAR
46625 DESERT VILLA #1
INDIO, CA 92201
(760)397-7699
Lic. No.: 946375
---------------------------------'-------------—
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:
Carrier EXEMPT Policy Number EXEMPT
_ 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. �• ]Z Applicant: CI I i I- 1 6 s N3 C�9UCZS
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 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 1 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 county to enter upon the above-mentioned property for inspection purposes.
Date:9 Signature (Applicant or Agent):
Application Number . . . . . 12-00001081
Permit . . .
MECH POOL
Additional desc .
Permit Fee . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
3/20/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
Permit
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
171.00 Plan Check
Fee
111.15
Issue Date . . . .
Valuation
. . .
. 16000
Expiration Date . .
3/20/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
14.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
126.00
Permit
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
3/20/13
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
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
3/20/13
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 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
LQPERMIT
Application Number . . . . . 12-00001081
----------------------------------------------------------------------------
Special Notes and Comments
POOL ALARMS /BARRIERS SHALL BE IN PLACE
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 275.00 .00
.00
275.00
Plan Check Total 137.15 .00
.00.
137.15
Other Fee Total 1.00 .00
.00
1.00
Grand Total 413.15 .00
.00
413.15
LQPERMIT
GATE
3' SHALLOW
3' GRE21'
END
I
CONCRETE
9" DEPTH
UMBRELI
SLEEVE
storage
RESIDENCE
ITY OF LA QUINTA
B ILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DRIVEWAY
DATE%Z-gy 137
,4 6A454ec
-3'
5' DEEP
END
26'
4• SHALLOV
�/
12'END
5'
EXISI ING CONCRETE
LIVING ROOM
POOL ONLY
IIILt
77-655 AVENIDA MONTEZUMA
LA QUINTA CALIFORNIA 92253
SIZE CAGE CODE DWG NO
1
P
E
16'
SKIMMER
AUTO FILL
elect)
pane
JOB- ADDRESSOF LAC
This form s all be i2osted on tho job -11th the JIM" I
on this job. Any changes to this list must *be atqthe��Vod by I
of buildinn normit P- -k Hkle #-4. A1Um&2__ �"lvislon
OR LIST ks'
AUILDE
r t hir' e ees uthbrized to worli
Only persdhs -appearing on this list or t ear
st 0
t 0
to commencement of work. Failisre to comply W4 resift In new9ffanud/or the voidance
a eo
rade
TradeadoClassification
'
u uy
-un rue- is not an aq
c
appacanx. opxapie response.
city. &.inau
ia
fLEARTHWORK
Company Name clagauhan
UrA�
x
1 tw
Carrier Name' Pqlky NuMber
Fund, CalComp) IFDMMI VarI43)
Exp. Date
txxhm/xx)
Uctinse Number
(XXXX)
Exp, Date
(xxlxxhc)g)
THW IC -12)
k4aQ w R�%SAW �Ns
1 .25-13
1 Q9Z,
12-3 1 IZ
It),31-12
CONCRETE (C_-8)
U 5 54( 37 2
FRAMING I G C_r
FRAMING IC -6)
STRUCT.'STEEL (d.5.1) _tA1,L2&) -,C
V/ 2-
12-31 A
M S
MASONRY
MASONRY id -29)
C
P�UMB
PIUMB1iNG (C -36i
LATH; PLASTER (C�36)
JAL_ tp,
112l
F-Myl
2)-12.
DRYWALL (c-9)
HVAC ;0)*
IELECTRICAL (C=10)
0
ROOFING [SHEET
SH METAL (C-43)
F0 RING J4_;P'.J6V:,
L
G6L�Azl ING (C -p).:
INSULATIOU (C-21
W
SEwAGE PIS:fL (C-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
PIxU a116 4—P-1 C
yd NLaki
er6wt
loq?el
12-�Z
CABINETS (C-6)
5,
FENCING (C-13)
LANDSCAPING (C 27),
POOL (C-63)
JOB ADDRESS P
This form shall he n, L=1161
on this job. Any changes to We list must be by the
of buildingpermit. For each able trade,
Trado / Claeelrlcutn.. w _.
Company Name
OF LQ OR UST
BUILDEAt an gal
a cons `
Only pera6ts appearing on this list or th r e ees uthorized to worl
Mv Olvlsfon Mor to ctlmmencement of work. Failure to comply vad0 remit In a st e oand/or the voidance
w must be co
rnlated nt. "O File" Is not an-accaptillble res on
y :
C IJf:Onas...
as
LW
bb-
04 A. B.�! b0
EARTHWORK (C•12)
i
Cauls Name POUCY Number
G-0• State Anld, CalComp) IFamM Vad")
Exp. Date License Number Exp. Data
(xx/xx/xx) (xxxxl (ux/xxhoc)
y
CONCRETE JC -8) ,
FRAMING (C-6)
?
3 -t 2
1"VAC
STRUCT. STEEL (C•61)
MASONRY (C•29► K _
12
PLUMBING (C-36 KAutous/
LATLASTER (C-3s)//'�l�
H, P
��
4 2- -,
�D( MYr
I 108261 (231-12-
DRYWALL (C-9)
IC -20) I
EL4CTRICAL (C -to) .
ROOFING (0-391 •
SHEET METAL (C•431
FLO RING 1F1 B)
GLAZING (C,17) - ---^— --
INBULATION (C-21
BfiWAGE DISP. (C-421
PAINTING (C•33)
CERAMIC TILE (C-84) I*,NCU 1
CABINETS (C.(;)
FENCING (C-13)
LANDSCAPING (C-271
Er,E,
a 12-30Z
bb-
Total Permit Fees
rsm ff–
I
City of La Quinta
Building 8t Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
X
Project Address:
tt -� wner's Name:
A. P. Number:
(l�
Legal Description:
Address: �
l �l
Contractor:
City, ST, Zip: � .)�
Address:
elephone: 0--(-/0--� G —741
e6r;Y�
'
Project Description: ( X
-�
Ciq•. ST, Zip: �
t
Telephone: D^ Ot-j,
/
State Lic. # :
a
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
7.7777777777
Construction Type: �` Occupancy:
State Lic. #:
Name of Contact Person,
Project type (circle one): ex% Add'n Alter Repair Demo
�-I
Telephone # of Contact Person:
;Sq::F:t�l# Stories: # Units:
,_3ctI_ (,�'
6
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Recd
TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted
Structural Calcs.
Item Amount
Reviewed, readv for corrections
Truss Calcs.
Plan Check Deposit
Called Contact Person
Title 24 Cales.
Plan Check Balance
Plans picked up
Flood plan plan
Construction
Plans resubmitted
Grading plan
Mechanical
?•' Review, readv for corrections/issue Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
II-O.A. Approval
S.M.I.
Plans resubmitted
IN HOUSE:-
Grading
''' Review, readv for corrections/issue
Planning Approval
Developer Impact Fee
Called Contact Person
Pub. Wks. Appr
A.I.P.P.
Date of permit issue
School Fees
Total Permit Fees
INSTAI:I;A`I'IONI -CERTIIN KATE
P061 Atid Spa Heatln . S stems
She Address: R Enforcement Agency:
to -C)7 -W
CMWMECH-0
a eIof2
Permit Number:
a7. S/1�21
Pool and Spa Heating Systems requirements
§114(a): Systems and Equipment. ,t
❑ 1. Heater has a thermal efficiency that complies with the Appliance Efficiency Regulations.
O 2. Has a readily accessible on-off switch mounted outside of the heater.
❑ 3. Weatherproof plate or card containing operating instructions for the pool or spa heater.
O 4. No electric resistance heating except for listed package units that has fully insulated enclosures and tight fitting
covers that are insulated to at least R-6. Or if documentation is provided that at least 60 % of the annual heating
energy is from site solar energy or recovered energy.
❑. 5. Heating system has no pilot light.
§ I I4(b): Installation.
O 1. System is installed with at least 36" of pipe between the filter and heater, or dedicated suction and return lines,
or built-in or built-up connections for future solar heating.
QC 2. A cover for outdoor pools or spas that have a heat pump or gas heater.
�Rl 3. Pool system has directional inlets to adequately mix the pool water
❑ 4. Time switch which will allow the pump to be set or programmed.to run during off-peak periods only
§f50(p) Pump Sizing and flow rate specification V
I . The pump specified is listed in the CEC database of certified pool pumps.
2. The pump flow rate shall be calculated based on pool sizing table below.
O 3. The pump is capable of operating at 2 or more speeds (not applicable if pump is less than 1 horsepower).
❑ 4. Each auxiliary pool load is served by either a separate pump, or the system is served by a multi -speed pump.
Pont swine N.1- - 6-__J _
Max Pool
- - -- ..•■■..u■ wuvvauwc turnover rare 010- noun
Volume
Min Pipe
D or Greater
Min Filter Area or more
Max Pump
(gallons)
inches
s uam feet
Flow m
Return
Suction
Sand
DE
1.5
1.5
-cartridge
100 2.4
20
36
1.5
2
130 3.1
25
47
2
2
160 3.9
30
58
2
2.5
210 5.2
40
2.5
3
320 7.8
60
1
117
449,000
3
1
'mn
Note: For pumps greater than 1 hp. The maximum Pump Flow is the lowest speed default filtration
O 5. Calculated volume of pool � ®6 0 (gallons).
❑ 6. Return Pipe Diameter - 2i
(inches).
❑ 7. Suction Pipe Diameter_ 2t�
(inches).
❑ 8. Filter Type;r (Cartridge, Sand, DE).
❑ 9. Filter Surface Area (s{).
O 10. Max Pump Flow_ 4;q fs 8 (8Pm)•
2008 Residential Compliance Forms August 20(
'ALLATION CERTIFICATE ' `.;"' CF=6R-&IECH4
And S a Heatin ,S stems' A e 2 of
ddress:. Enforcement Agency: Permit Number:
-- .� - 5 uln.lilts�, )M1- La c I "T L 12-10® i
System Piping
1. The suction side pipe is straight for at least 4 pipe diameters before entering the pump (See table below for the
required straight run lengths for various pipe sizes).
>it7 2. The design uses low pressure drop fittings (sweep90's)
Pipe Diameter
inch
Required Pipe Length
leading into um inch
1.5
ti
2
g
2.5
10
3
12
Filtration Equipment
O 1. If a backwash valve is used: The diameter of the backwash multi -port valve is 2 inches or as large as the
circulation pipe, whichever is greater
DECLARATION STATEMENT
• 1 certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
• 1 certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• l reviewed a copy of the Certificate of Compliance (CF -1 R) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -IR that apply to the installation have been met.
• 1 will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
Winks) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand
that a signed copy of this installation Certificate is required to be included with the documentation the builder provides to
the building owner at occupancy.
2008 Residential Compliance Forms August 200'