RPL (13-0295)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
A�
13-00000295
52070 AVENIDA MENDOZA
773-233-004-19 -000000-
POOL - RESIDENTIAL
COVE RESIDENTIAL
16000
Architect or Engineer:
�(�(
k, \
46
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CT PROPERTIES
3194 AIRPORT LOOP DR. #C2
COSTA MESA, CA 92626
LICESED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an fes ' s Co nd my License is in full force and effect.
License C' ss: C53 ense 818149
Date Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from 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.).
(_ I 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.).
(_) I am exempt under Sec. , BAP.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:
1
LQPERn11T
f
Contractor:
LAGUNA FALLS CUSTOM POOL/
P.O. BOX 2322
INDIO, CA 92202
(760)347-8977
Lic. No.: 818149
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/18/13
tsMAR i s2ot3 I�,
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.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
UP Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number LAWC010355
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 bec me subject to the workers' compensation provisions of Section
78g00 of the Labor Code, 1 sh I forthw' ly with those provisions.
Date: X7 Applicant:
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.
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 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 have read this application and state that the above nformation is correct. I agree to comply with all
city and county ordinances and state laws relating to building co stru ion a d hereby authorize representatives
of this coup to nter upon [he above-mentioned property for i on p
Date: y ,� �� Si6nature (Applicant or Agent):
Application Number .
. . 13-00000295
Permit
BLDG POOL PERMIT
Additional desc
Permit Fee . . . .
171.00 Plan Check Fee
111.15
Issue Date . . . .
Valuation . . .
. 16000
Expiration Date . .
9/14/13
Qty Unit Charge
Per,
Extension
BASE FEE
45.00
14.00• 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
126.00
' Permit
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date '.
9/14/13
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 . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation
0
Expiration Date
9/14/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL AND SPA ONLY, NO
HEATER. ALARMS AND
BARRIERS REQUIRED TO
BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
---------------------------
Permit Fee Total
------------------------------
243.00 .00 .00
243.00
Plan Check Total
129.15 .00 .00
129.15
Other Fee Total
1.00 .00 .00
1.00
Grand Total
373.15 .00 .00
373.15
LQPERNIIT
Application Number . . . 13-00000295
LQPMIIT
Bin.#
City of La ' Qumta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 5'7- v AV wt.- A4,044181 2.4-
Owner's Name: rc J ie
A. P. Number: q7 3 - ? -
Address: _31 y!/'
Legal Description:
City, ST, Zip: n1 -6i /vlf✓f 2 44 9 26 26
Contractor: //,,,,^
I'Wm$ AA(—S
Telephone:
Address: 1?/ 7 3 o
Project Description:
City, ST, Zip: o. r0 is t �! 2,2-o t
Telephone: 7(0 3 7.7
State Lic. # : W I� 3
City Lic. #:
Arch., Engr., Designer:q�
Address:
013
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: a l W?L r
CIT' OF LA QUINTA
Construction Type: Occupancy: LOPMENT
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 760, 2V-,.'�-7t J—
Estimated Value of Project: O v0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING . PERMIT FEES
Plan Sets
Plan Check submitted Item
Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted fi EN im,—
Grading plan
2"d Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
d"' Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A,I,P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
CITY OF LA OUI'. TA
BUILDING & SA FETY DEPT.
otal Pe
mit Fees
4 R.
0
GARAGE
RESIDENCE
EIEDTRIfAL AND RNMdNG
LEGEND
EQUIPMENT
UST OF MATERIAL
OI UGNi JN11DTION &)%
EI TOOL EOIAPMEM
Q
STANDAWFW Mp TER
O DUAL-KTSMMMER
O PENTAIR WHUPERgp1..I PUMP
Q
AT FOOL WATERLINE
OMP ..—AUTO -L
a GENTAIR 2W SQ. FT. CARTRIWEf4TER
Q
TOSEDONESYGENERAL
OSPOT MAN DRAIN
—FOOL--
Q
fRDONE SY GENERAL
8 ELECTRIGL PANEL BO%
O
E8 POOL TIME 40Gx
SELF LLOSING AND
I
SE b GATE
TO SE DONE by GENERAL
OB 6A9 METER
/O
a�.S POOL DEMENSIONI
OYLUMBW6 LWE9
QSDtlAGE
RETURN lWE9
TPK
9UE110N UNE9
p❑j ro SE DONE SY GENERAL
2 --
SCALE: 1/6'= 1'
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA -/� BY eS7
0
Laguna Falls Pools, Inc. Phone: (700) 347-8977 Designed by LFP13-204 CT Properties, Inc.
81-730 Highway 111, Ste 2 Fax: (700) 347-8975 J. Mancilla Designed 52070 Avenida Mendoza
Indio. CA 92201 E -Mail: Jalmeolagunafallapw1a.wm 2/8/2013 for: La Quinta CA 92253