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RPL (04-5945)54165 Avenida Martinez 04-5945 1 T4hf 4 4 Q" ). Box 1504 495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 lumber . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153' 04-00005945 Date' -'- ,8/16/04 . . . 54165 AVENIDA-MARTINEZ 774-221-019-7 -000000- . . . POOL - RESIDENTIAL . . . COVE RESIDENTIAL . . . 20000 Owner Contractor ------------------------ BUFFIN THOMAS ------------------------ PICAZO POOLS & SPAS P 0 BOX 134 82365 HIGHWAY 111, SUITE #101 LA QUINTA CA 92253 INDIO CA 92201 (760) 347-5855 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB: 836900 04/30/06 CCC: C53 ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 207.00 Plan Check Fee 134•.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date . . 2/16/05 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 Expiration Date 2/16/05 Qty Unit Charge, Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ------------7--------------------------------------------------------------- Permit ... . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/16/05 Qty Unit Charge Per Extension ♦t\ N P.O. BOX 1 5 0 4• l I I VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- JQy Jam" Date: a-/B•(9S/ Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: a 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 my License is in full force and effect. D D i.Mense Class C- Aicense No. CI ntractor C A L o POoL CQ L1 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 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 04-j 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.). 6 A as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' 1' 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 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. `La 1 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-incurertbe carrier and policy number are: Carrier 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 forthwith comply with those provisions. N 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. 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 Ouinta, 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 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. ate D S ure(ApplicantorAgent): 19; L-nza'4906L6S P,t 5 Application Number 04-00005945 Page 2 Date 8/16/04 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 2/16/05 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 ----------------- ---------- Permit Fee Total 309.00 Plan Check Total 160.05 Grand Total 469.05 Paid Credited Due ---------- ---------- ---------- .00 .00 309.00 .00 .00 160.05 .00 .00 469.05 CITY OF LA QUINTA SUBCONTRACTOR LIST JOB ADDRESSS .• QT( PJ EZ PERMIT NUMBER OWNER F--A.l L-E� BUILDERPIe- A 2-C,CJ �'7'o P0>0L'5 This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Fail a to COM131V will result in a stoppage of work and/or the voidance of building permit.. For each applicable trade, all information requested below must be completed by applicant. °•" On File" is not an acceptabler se ponse. Trade / Classification Contractor State Contractor's License 1lorkers Compensation Insurance '' City Business License Company Name Classification . (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) R.&PVV G L' -l2 fetoOoS S• • O da •! • t / T g 3'3t'v5 CONCRETE (C-8) g 2Z - -p c. n-rArF—m -e3 Z •j•04 go&3 /0'3/'04 FRAMING (C-5) ' STRUCT. STEEL (C-51) On 4-30-ogoS I.O MASONRY (C-29) PLUMBING (C-36) FQQ LS e— , © •® $. CK LATH, PLASTER (C-35) KENT WE5'Tf A-t- E L' _moo. EAapLOyMgS C40M P •o 'Soe •l•© �,05 DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) �LT e-.- O •31.O's ROOFING (C-39) . SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) SEWAGE DIS,. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) POOL IC -531 til 6>0lU (TMJ ii • • 3o -c5 -.--TA. TS�� _ O'4(P'�Gb�:3® (•d. • OS fD g �S' 3 �' I4G *11 SPA. RAISE b + tW5T. WALL lo- D 7a L. 3t- U 13= AGO I UGN c vC JouN ..L'Trca.c,y FA,,Le. 54.1!05 MArMsiel L 540AL6--%gt=11•0 R5AJI (E-. QUIP.15LIMbTo M IZA K-157 UVA Lt 15 E4Xt5C.1l ALL_ Swimming voolftva spwificafi®ns r E Pool specifications type we /4 o X 30= Surface tool area 07 dy PedrncwjS&g depths min L 4inax.ISO Spa specification SiaelX_'—�_sq.ft �L 9 tb Spa dam wall2�_raised spa at •4 l Spillway type # of jcts 4 Special notes Excavation & steel Access from Ef.AR type Fence or wall removal Concrete removal P�_sod rernoval Tree removal by -- krigatian removal by — Irrigation repair by — Elevation deep end ramp Love seat tan shelfdepd Centers rock pockets 6" r.b.b. 127rb.b. 18" r.b.b. 9 S- '24 r.b.b. gunite r.b.b.SPP+tS deep end ramp Loveseat spiuway type Extended Zed step Decking Sq. 8. 7-9 Z b finish Cantilever YES a gwwn jointsF�cLT Deck drains - dekko drain - StepsfIPLA 1Jstep face Curb core sand & visqueen Tile base ribbons Masonry & the Coping tyto,(,�A- spiuway type T U.F+ r.b.b. facina steps-f-IY _.e.L _ _ AI — Retaining walls planter walls Prop.ext. wails. eq. WallsATl—&I&) Firepit b.b.q. r.b.b. the Watertile Trim file quarter round Tile type Plumbing & electrical Plumbing size 2" Skimmert3wRC- JG-eaADE-fiu linegJMcL-_ Gas line 663 &I. Ila Line HeaterAtlt-il- AY size ZSQ 1L Filter A9 E K size 3 2,O d? Pool pumpuULdWE�- size 2!4 P Jet pump size Xtra pump — sire Sub. Panel time clockT.lcti4 Gfic V F S xtra gfic Spa ligbt M VTE� pool Stub set eq. gas stubs - - Plaster or pebble ..+`