RPL (11-1336)57191 Medinah
11-1336
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1i --0000133.6 ^ .
Property Address: 57191 MEDINAH
APN: 762 -110 -010 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000
Tavl 4 4 Qumk
Applicant: Architect or Engineer:
• 'alp
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT
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.
Lice ee clll : B C53 License No.: 552140
C tractor.
'OWNR• BUILDEWDECLARATION
I hereby affirm under penalty of perjury that I am exe m 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 contractorW licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. B.&P.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: -
LQPERMIT
Owner:
MACNEILL
57191 MEDINAH
LA QUINTA, CA 92253
VOICE.(760) 777-7012
FAX (760) 777-7011'
INSPECTIONS (760) 777-7153
Date: 12/19/11
Contractor:
CAL PACIFIC POOLS D n
P.O. BOX 1804
PALM SPRINGS, CA 92263 } ? j
LiCo)32
No7:8649 552140 1 e= 1 Lo11 E
CITY OF iA 01.61AITA
----------------------------------------
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.
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 ULLICO INS Policy Number UWRP48100006910
_ 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 b ode, I shall forthwith comply with those provisions.
1 plic
WARNING: FAILURE.TO SECURE WORKERS' COMP SATION C RAGE IS LAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A INES UP TOONE 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 -asa 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. 11 .1 -
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 b ' ing construction, and hereby authorize representatives
00eoft 's ountyry/go enter upon the above-mentioned pr ert for ' ection purposes.
l ' Si t6 ure (Applicant or Agent).
Application Number 11 -0000,13316 -
Permit . . .. BLDG POOL PERMIT
Additional desc
Permit Fee 207.00 Plan Check
Fee
134.55
Issue Date Valuation
20000
Expiration Date 6/16/12
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 26.00 Plan Check
Fee
6.50
Issue Date Valuation
0 _
Expiration Date': 6/16/12 .
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 .6/16/12
Qty; Unit Charge Per
Extension
BASE FEE
w. 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 6/16/12
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
Permit ... . . WALL/FENCE PERMIT
LQPERMIT ..
Application Number . . 11-00001336
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee 00
Issue Date Valuation 256
Expiration Date 6/16/12
Qty. Unit Charge Per. Extension .
BASE FEE 15.00
-----------------------------------------------
Special Notes and Comments
POOL/SPA, BBQ, 16 L.F. 4' EQUIPMENT
ENCLOSURE, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. 2010 CODES.
Bin #
of la Quin
in
Building 8r Safety Division
Box 1504; 78-495 Catie Tampico
La Quinta, CA 92253- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
Project Address:
IIJ 41".
Owner's Name: MAC t,3 L_L_
A. P. Number_-
Address:
Legal Description:
City, ST, Zip: LA QLA 0-A
Contractor: (2.AL,
Telephone:
Address: 13047-
Project Description:
City, ST, Zip:' r_N t_ MVJ6( ,
.
Qpn,
Telephonej-(,O__ ,,-adfl
......
:UQL L te"
State Lic.
Arch., Engr., Designer:
City Lic. #..
Z41&6t_14?
-AQ
Address:
City., ST; Zip:
Telephone:
State Lic. #:
Nae of Contact Person
X
Construction Type: Occupancy:
Project type (circle .6e): New _)dd'n Alter Repair
Sq. Ft.: # Stories: # Units:
Demo
Telephone # of Contact Person: —1 t.Q_
2De,' - A Q
Estimated 'Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Reqld
Rec1d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2!d Review, ready for correctionVissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for.correctionsrissuc
Developer Impact Fee'
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
S
INSTALLATION CI<.'l Tll 1CA'1•l C-6WAIECH-03
Pool And Spa Heating Systems (Page I of 2)
Site Address: Enforcement Abend': Permit Number:
5'1 • i Q 1 M LIN, QU 1 r rt- A LA clv 1 13 3
Pool and Spa Heating Systems requirements
§114(a): Systems and Equipment.
Gi{ 1. Heater has a thermal efficiency that complies with the Appliance Efficiency Regulations:
2. Has a readily accessible on-off switch mounted outside of the heater.
C1 3. Weatherproof plate or card containing operating instructions for the pool or spa heater.
51 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.
[A 5. Heating system has no pilot light.
§1 14(b): Installation.
C 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 -
19 2. A cover for outdoor pools or spas that have a heat pump or gas heater.
Cf 3. Pool system has directional inlets to adequately mix the pool water
lei 4. Time switch which will allow the pump to be set or programmed to run during off-peak periods only
§150) Pump Sizing and flow rate specification
1. 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.
3. The pump is capable of operating at 2 or more speeds (not applicable if pump is less than 1 horsepower).
N( 4. 'Each auxiliary pool load is served by either a separate pump, or the system is served by a multi -speed pump.
na.,1 c;,ina rvat„er ara hased nn n maximum allowable turnover rate of 6- hours)
Max Pool
Volume Min Pipe D or Greater
(gallons) inches
Min Filter Area or more
(sqare feet)
Max Pump
Flow (6m)
Return
Suction
Cartridge Sand
DE
13,000
1.5
1.5
100 2.4
20
36
17,000
1.5
2
130 3.1
25
47
21,000
2
2
160 3.9
30
.58
28,000
2
2.5
210 5.2
40
78
42,000
2.5
3
320 7.8
60
117
48,000
3
3
360 1 8.9
70
133
Note: For pumps greater than [ hp. 1 ne maximum. rump riow as ane iowesa speeu uc-juuu,/uc, u« rI ..
5. Calculated volume of pool U 0 0 (gallons).
[ 6. Return Pipe Diameter I (inches).
f 7. Suction Pipe Diameter '2's (inches).
[1 8. Filter Type C Q 2:t -p_ r_>LiE (Cartridge, Sand, DE).
It 9. Filter Surface Area 4-•2.0 (sfl•
13 10. Max Pump Flow nZ (gpm)•
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIhICATE CIL612-MECH-03
I (Page 2 of 2)
Pool And Spa Heating Systems
Enforcement Agency: Permit Dumber:
Site Address:.
S9 • I ` 1t t-Ae" r L(a ! 1 N "A env 1 AJ*'L 1 • O 33
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).
2. The design uses low pressure drop fittings (sweep90's)
Pipe Diameter
(inch
Required Pipe Length
leadin into um (inch
1.5
6
2
8
2.5
10
3
12
Filtration Equipment
❑ 1. If a backwash valve is used: The diameter of the backwash multi -pori valve is 2 inches or as large as the
circulation pipe, whichever is greater
DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• I 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).
• I 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.
• I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -1 R that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) 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.
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Responsible Person's Name: Re o sible 15n's Signature:
CSLB License: Date Signed: Position With Company.(T le):
S 1 7— Z2 0
2008 Residential Compliance Forms August 2009