RPL (12-0432)51120 Mandarina
12-0432
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA .92253
Application Number: <_12700000432
Property Address: 51120 MANDARINA
APN: 776-210-014- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 18000
T-iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WORKMAN
51120 MANDARINA
LA QUINTA, CA 92253
VOICE (760) 777=7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/19/12
Contractor: LJ APR 2 Q 2012 U
Applicant: Architect or Engineer:l TESERRA
P.O. BOX 1280 CITY OF LA QUI NTA
COACHELLA, CA .92236
FINANCE DEPT
(760)398-9222
LiC. No.: 656128
+ LIC SED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I m lic ed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: °
Section 7000) of Division 3 of the Business a Pr essionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers'. compensation, as provided
License Class: ' C8 , 0 , 27, 2 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate:/ 2 Contractor: _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL IN Policy Number 7600006481121
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should becom sub' to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the B usiness and Professions Code) or 00 1 the Labor Code, I sha: License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 00 f the Labor Code, I shall f ith comply with those provisions.
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 (55001.: Date: Applicant:
(_ 1 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 WARN NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Caw does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($700,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is.hereby made to the Director of Building and Safety.for a permit subject to the .
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed - 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 ofthis 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 informatio + corr t. I agree to comply with all
city and county ordinances and state laws relating to building construction, n he by authorize representatives
of this county o an r upon the above-mentioned property for inspection purp s .
Date: Z.1 i Signature (Applicant or Agent):
1
t
Application Number . . . . . 12-00000432
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . 189.00 Plan Check Fee
122..85
Issue Date Valuation . .
18000.
Expiration Date 10/16/12
Qty Unit Charge. Per
Extension
BASE FEE
45.00
16.00 9.0000 THOU BLDG 2,001-25,000
144.00
r .
Permit . . . MECH POOL
Additional desc..
Permit Fee . . . 26.00 Plan Check Fee
6.50
Issue Date . . Valuation
0.
Expiration Date 10/16/12
Qty Unit,Charge' Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.00
Permit . . ELEC POOL PERMIT -RES
Additional desc..
Permit Fee . . . . 45.00 Plan Check Fee
11.25
Issue Date Valuation . . .
0
Expiration Date 10/16/12
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 10/16/12
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 TO.INCLUDE 8.9 L.F. 1 1/2" GAS
• LQPERMIT -
'
Application Number 12-00000432
Special Notes and Comments
LINE FOR HEATER. 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 293.00 .00 .00 293.00
Plan Check Total 148.85 00 .00 148.85
Other Fee Total 1.00 .00 .00 1.00
Grand Total 442.85 .00 ..00 442.85
LQPERMIT
SPECIFICATIONS
• NO EXISTING LANDSCAPE LIGHTING IN REAR YARD
iVRFACEAREA DF n
• NO EXISTING OVERHEAD UTILITY LINES IN REAR YARD PEIBEIHt PERE "'Pool altr aPio.Mr. sly d x
ll1.IT. pB1H8 YN- 7d MAX
• PATIO FURNITURE FOR ILLUSTRATION PURPOSES ONLY
POOLiiPACOIiBSFD ]BSOFP./RLNPT.
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INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WILLCOMPLY WITH
SECTION 114 - MANDATORY REQUNWdENTS
EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
TO THE POOL
POOL HEATERS I PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURERS
RECOMMENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
ALL DECKING EXPANSION JOINTS FOR REPRESENTAION ONLY,
FIELD LAYOUT WILL VARY
CASITA
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POOL EQUIPMENT: 250,000 BTU HEATER
'ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
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I MAC
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INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WILLCOMPLY WITH
SECTION 114 - MANDATORY REQUNWdENTS
EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
TO THE POOL
POOL HEATERS I PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURERS
RECOMMENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
ALL DECKING EXPANSION JOINTS FOR REPRESENTAION ONLY,
FIELD LAYOUT WILL VARY
CASITA
rem
li
POOL EQUIPMENT: 250,000 BTU HEATER
'ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
EXCAV TION / STEEL
TI'PE BOBfAT
SAFETY FEATUREB'
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801 O CALIFORNIA BUILDING CODE (SIMMONTt11
801 O CALIFORNIA MECHANICAL CODE IIEM®ONtI111JIM)
2010 CALIFORNIA PLUMBING CODE ISAW0NSIWOPC)TnuMwAt
2010 OALWORNIA ELECTRICAL CODE (SAI®ONSONED)
2010 CALIFORNIA ENERGY EFFICIENCY BTANDARDB
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S ELE TIONS
CONSTRUCTION AUTHORIZATION
STS WA
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SALES FIELD
BOULDERS WA
DIG
DECK COLOR BY OTHERS
PRE-GUNITE
HAYWARD HAYWARD E -CO D WITH B BUTTON REMOTE
UNDERGROUND
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MASONRY
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DRARAGE NOTE: IN
uA/a oerlrw
PRE -PEBBLE
Bin # ..
GtOf. La Qui 1'
Bulkbg 8z Safety Division ; .. .
P.O. Bor..1504, 78-495 Gale Tampico
IA.Quinta, CA 92253 -:(760) 277-7012
g
MEMNON Building Ap Permit A lication and Trackin Sheet
Permit #
c
Project Address: S i I Z O
/
Owne's Name:.D
dKN) A N
A. P. Number.
Address:51 l2 C) .MA•yD-AICIivst .
Legal Description:
City, ST, Zip: LA Qv 14 11 z zS3
contractor. S'
Telephone:
Address:
Project Description: 0(— fi-
City, ST, Zip: l mit ' Lill- t' `J 2Z 3 G
Telephone: C C _?,,; 6, Sz ZZ-: mn
State Lia # : City Lie k
L
Arch, EW., Designer.
Address:
City., ST, Zip:
Telephone:
Construction Type:. Occupancy:
.
Project type (circle oneAlcw Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
State Lic. #:
Name of Contact Person: i Z
Telephone # of Contact Person: 0 : L ' Q IR
Estimated Value of Project: • Q D
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TTtAC MG PERMIT FEES
Plan Sets
Plan Cheek submitted Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit, .
Truss Calcs.
Called Contact Person Plan Check Balance
Tide 24 Calcs,
P1ans picked up Construction
Flood plain plan
Plans resubmitted.. Mechanical
Grading plan
2-' Review, ready for correctionsfissue Electrical
Subeontaetor List
Called Contact Person Plumbing
. Grant Deed
Plans picked up SALL
H.O.A. Approval
Plans resubmitted Grading
IN 1I0IJSE:-
'rQ Review; ready for correctionslissae Developer Impact Fee
Planning Approval.
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees