RPL (0003-320)44060 Mariposa Ct
0003-320
LICENSED CONTRACTOR 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.
License # Lic. Class Exp.. Date
4310:15' C53 a 7I.31Iaa
Date =,a Signature of Contractor -
OWN ER-BUI LDERDECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
JDate - Signature of Owner
! WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ),"l 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
" ion 3700 of the Labor. Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
FRMIONT COMPENS WN99-337392-01
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 Califorhia, and agree that if I should become
subject to the workers' compensation provisions o`f'Se ct'on 3700 of the Labor
Code, I shall forthwith comply with those pro''sions.
Dater 1 • Applicant r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby -made to the Director of Building and Safety
for a permit subject to ,the conditions and restrictions set forth. on his
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 pursuanf fo
any permit issued, as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property f' inspect'on purposes.
Signature(e Owner/Agent)/-.-- Date
Y
BUILDING PERMIT PERMIT/!
Z, J UOfI.S-3Y{6
• ,DATE ` VALUATION LOT TRACT
$15.000.00
JOB SITE
45)A
ADDRESS 44-060I,ARLPOSA-
-
OWNER
CONTRACTOR/DESIGNER/ENGINEER
LAURA PICHCORRICH
, P.ARZINSKY POOLS CONSTRUCTIOt
44-060 MARIPOSA COURT
570 OLEANDER Rei .
LA OUii+TTA CA 92253
PALET SPRINGS CA 92263
(76Q)324.582' CSJF # 971 Y
USE OF PERMIT
POOL ANDIOR SPA
tp
Y A I
POOL ac Seta. O: iLY-Ai..4►122 iS1BAi2i2.IEi2. S St bALL BE its PI. NCE A'l' R` 31 2000
PR& PL ASTER .IN.WECTION, ✓1
' e ®F LAQU f
VALUATION., 15,000.00 L8
ENTMIATLD COST Of Cii4`tSTKUCT701>i
15,000.00
PERMIT FEE SUMMARY
PLAN CHECK FEE 101-000-43.9•318 S105.34
CONSTRIXTION EEE 101-000-418-000 31.6.11y)
NIECHAN1CAL FEE -- POOL 101-000-421-000 524,W
ELECTRICAL rM, -- POOL 101-000-420-000 545.06
PLiJIvIBINO FEET -- POOL 101-000-119-000 S27. (s 0
SUB -TOTAL CONST RUCTION AND PLAN C1.1ECK
5363.30
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE N. 0411
}f,
-..-4363.30
RECEIPT
DATE
By f /
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
. FR k • '
I 1dy i
LIN
I , 1 7' Raised Spa 18" t A
at G
CP 44\
1 T .IOh
{ rSY•,xe _'+ S \ Specifications
' P
• .., `7 Pool Area
5 , 474
• / \ • '?% \ { +C. , Pool Perimeter '
Shallow Depth
i 0
Deep Depth
15 ft. \ \ r
A RE-INSPECTION FEE OF $30 - Spa Area
WILL BE CHARGED IF THE APPROVED. 38 ,
PLANS AND !OB CARD ARE NOT ON p
S a Perimeter
THE SITE. 'FOR A SCHEDULED 22
INSPECTION. •
y rf Face Tile
.NO EXCEMN91. o
41.
Q
i— 4 \ Coping
Water line from \ rt
Deck Area
edge ofthouse --
D_
\ CITY 362
• ` O F LA Q U I N TA - Deck Perimeter
\ BUILDING & SAFETY DEPT. • 247
s \ APPROVED. Patio Area
• FOR CONSTRUCTION 0
" I W
11 ft. 10 in. Patio Perimeter
.5
3 n .... \ DATE J?I •Q a 0
I
Pool to Equip
9 P
0
D
i
4
P.O. BOX 1504
Building LA gUINTA CAL FORNIA 92253
Address la n A7 «a rw«A n...,.,«
Owner
La Quiuta Associates
manilly
Address
A1_97% i1 * U rut St.
City Zip Tel.
VAI*.% TV^0Art, 91% 1 1AS-75A
Contractor
State Lic. City
& Classif. 493919 Lic. # 1231
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's'License Law for the following
reason: (Sec. 7031.5,Bushness and Professions Code: Any city or county which requires a
Permit to construct, aber, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
&vision 3 of the Business and Professions Code, or that. he 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 chillpenalty of not more than rive 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
bur77s or inproves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poliq No Company
r0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation
or less.)
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.
Date Owrier
NOTICE TO APPUCANr: ft, after making this Certificate of Exemption you should become
suOiect to the Workers' Compensation provisions of the Labor Code, you must forthwith
coney wlth such provisions or this perm!t shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 05179
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number I.Ar-t'sra Flnwo-r
Legal Description
Project Description
'tfh,ocw T9
P7 ,Am 7T%Iz Lac: —a
Sq. Ft. $ rlj2 $
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$97.514
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 330.95
Const.
397.00
Mech.
33.00
Electrical
73. 35
Plumbing
82.00
S.M.I.
6.13
Grading
Driveway Enc.
Infrastructure
1.969.07
TOTAL
Si 791.. Sit '> lc:::
REMARKS
Arl51$,2',
:Ms. b -03 a-, 1t
a. Girt a,_ry
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by:Date22/29/8 Permit
Validated bv:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR S 1� ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
_ S (ROUGH)/(p/g ER LOOP
`
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT.
GROUT
WATER HEATER SERVICE
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO FT ®
WATER SYSTEM
FINAL INSP.
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING S ( C i
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER, B.T.U.
SQ. FT. ® c
BATH TUB
MESH
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT.`FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBING3—)7,J UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR S 1� ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF. 7124)f
_ S (ROUGH)/(p/g ER LOOP
`
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
n
FRAMING v 16 i/
ROOFING S ( C i
i �J
i D�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
OC
LATHING ' N/ Z �i
MESH
INSULATION/SOUND' 6
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t