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RPL (04-5554)50445 Los Verdes Way 04-5554 BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . .'` 04=00005554 Date 7/19/04 Property Address . . . . . . 50445 LOS VERDES WY , APN: 772-250-999-104-30357 - Application description . . . POOL - RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL ; Application valuation . . . . 15,000 Owner Contractor ROBERTS PICASSO POOLS, INC 50-445 LOS VERDES WAY 78078 COUNTRY CLUB DR, #206 LA QUINTA 22 PALM DESERT CA 92211 4 (760) 345-4600 WCC: STATE FUND 1,2/01/04 C SLB: 810195 1 11/20/04 q®,o 1Q0 - CCC: C27 -053-B ---------------------------- Permit. . . . . . . BLD T Additional desc Permit Fee 162.0 Plan Check Fee 105.30 Issue Date Valuation 15000 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU BLDG 2,001-25,000 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 9.00 --------------------------------------------- Permit . . . . . . 7 ------------------------------- ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per 1.00 30.0000 EA Extension BASE FEE 15.00 ELEC PRIVATE SWIMMING POOL 30.00 P.O. BOX 1504 -V 78-495 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 9q- 555e-1 Applicant:. Applicant's Mailing Address: Date: 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 Code; and ss Lice?" . in IYt ce and effect. 10—cense --iicense C7lass No. OWNER -BUILDER DECLARATION city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicI 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 statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 70antr the permit to file a signed ant for 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 fora 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. . 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 maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ss l d M o ers' compensation lasurance carrier ay j4cy gu r arier 7/1-I 7— 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. .;I— WARNING: FAILURE TO SECURE WORKERS' CO"SATION COVErRAGE 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, indemnity 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 haread 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, a ' here1by authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date 4 Signature or Agent): Page 2 Application Number . . . . . 04-00005554 bate 7/19/04 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 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 3.0000 EA PLB GAS PIPE 1-4 OUTLETS ---------------------------------------------=------------------------------ 3.00 Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited ----------------- Due ------ - --- ---------- ---------- Permit Fee Total 264.00 .00 .00 ---------- 264.00 Plan Check Total 130.80 .00 .00 130.80 Grand Total 394.80 .00 .00 394.80 T ±D FACE`,sTUCCO Al EXTERIOR TILED sPIL TANNING L @ +6" WITH ONE UMBRELLA St DECCO DRAIN +I8" BOND BERM 24 LONG 5' set back PIcRSSO POOLS cy"r it LIC #810111 AUTO -FILL: GAS LINE: STUB OUTS: CASCADES: sPRAYHEADs: POOL LIGHTS: 7 SPA LIGHTS: PLUMBING SIZE: STUB SET EQ: G N DEEP END RAMP: 2nd STEP: LOVE sEAT: SPILLWAY TYPE: CANTILEVER: COPING: RB9:5EE STEEL ITLE TILE TYPE: WATERLINE: TILE TRIM: RBB TILE: DECKING COLOR: SQ FT FINISH: EXTRA JOINTS: CANTILEVER: DECK DRAINS: DECCO DRAIN: CURB CORE: STEPS: STEPS FACE: SUB BASE: VISQUEEN: BANDING: STAMPED: RELEASE : MOW STRIP: MASONR COPING TYPE: RBB FACE: SPILLWAY: STEPS: P/L EXT WALLS: PLANTER WALLS: RETNG WALLS: EQ WALLS: GATE TYPE: R&R GATE: 6B4 SIZE: BBQ MODEL: TDP FINISH: SIDE BURNER: FACE FINISH: PEN LIGHT PLUG OUTLET LIGHTS SWITCH: PLAMR PLASTER COLOR: PEBBLE COLOR: POOL LIGHTS: , SPA LIGHTS: ROLLED BOND BEAM: EYEBALLS: um ROBERT5--RE ADDRE55: 50-lw5 LOS VERDE5 WAY i FOR '3IDENCE wz Q U o uj jr Co w 043 - IL ui 0 LLJ N zLu ma QzN <A N 00 3 0 _ a u N o vL i C a u JU O u z foU-5 NL w , K rZ-i } O w _z aw< + Q _\4 N > U 3V LU Lu ''-z Q » N Lu '- 00 w ~ N J j Lu ?S <w ir mQ oc 0 iQ <z : Lu oz :moo << a N Q z 40 m° - U zn- Lu LUX °W ou QSw ¢ N z U 4 W < m a °< ou w Lu 05 z H <m -N oz °ao zLu N ir W N Q i Lij D_ <N W Z 3Z N POOL SPECS SIZE: C AREA:► SE PERIMETER: 96 E -1 7O SPA PECC5 : SIZE: 6X7 vE AR A: DAMWALL: RAISED @: + SPILL TYPE: TILE # OF JETS: 6 LIGHTS: 1 FACE FINISH: DIG EL TYPE: ACCESS: ELEVATION: DEEP RAMP: BENCH/iAN-LEDGE: CONC/SOD REMOVAL: TREE REMOVAL: IRRIGATION REPAIR: RBB LENGHTS: ROCK POCKETS: PLUMBING FILTER: goo sF POOL PUMP: 2 H' BOOSTER PUMP: 1 HEATER: NO 000 M TIME CLOCK: SUB PANEL: RETURN INLETS: s AUTO -FILL: GAS LINE: STUB OUTS: CASCADES: sPRAYHEADs: POOL LIGHTS: 7 SPA LIGHTS: PLUMBING SIZE: STUB SET EQ: G N DEEP END RAMP: 2nd STEP: LOVE sEAT: SPILLWAY TYPE: CANTILEVER: COPING: RB9:5EE STEEL ITLE TILE TYPE: WATERLINE: TILE TRIM: RBB TILE: DECKING COLOR: SQ FT FINISH: EXTRA JOINTS: CANTILEVER: DECK DRAINS: DECCO DRAIN: CURB CORE: STEPS: STEPS FACE: SUB BASE: VISQUEEN: BANDING: STAMPED: RELEASE : MOW STRIP: MASONR COPING TYPE: RBB FACE: SPILLWAY: STEPS: P/L EXT WALLS: PLANTER WALLS: RETNG WALLS: EQ WALLS: GATE TYPE: R&R GATE: 6B4 SIZE: BBQ MODEL: TDP FINISH: SIDE BURNER: FACE FINISH: PEN LIGHT PLUG OUTLET LIGHTS SWITCH: PLAMR PLASTER COLOR: PEBBLE COLOR: POOL LIGHTS: , SPA LIGHTS: ROLLED BOND BEAM: EYEBALLS: um ROBERT5--RE ADDRE55: 50-lw5 LOS VERDE5 WAY i FOR '3IDENCE wz Q U o uj jr Co w 043 - IL ui 0 LLJ N zLu ma QzN <A N 00 3 0 _ a u N o vL i C a u JU O u z foU-5 NL w , K rZ-i } O w _z aw< + Q _\4 N > U 3V LU Lu ''-z Q » N Lu '- 00 w ~ N J j Lu ?S <w ir mQ oc 0 iQ <z : Lu oz :moo << a N Q z 40 m° - U zn- Lu LUX °W ou QSw ¢ N z U 4 W < m a °< ou w Lu 05 z H <m -N oz °ao zLu N ir W N Q i Lij D_ <N W Z 3Z N LO'T# 104 TRAC V REVISIONS: (1) DATE: (2) DATE: (3) DATE: Date Printed I/8 "=IP Scale 4:13 PM 7/15/04 hrnu.rinn &I. 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