RPL (05-3616)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:'
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
;EQ7�5—=O 0 0 0 3 �61 6 �
53900 AVENIDA MENDOZA
774-173-'008-17 -000000-
POOL - RESIDENTIAL
COVE RESIDENTIAL
30000
T44t 4 4 Q"
Architect or Engineer:
-----------------
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.
License Class* License No.:
9.fak��61�e57Contractor::
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 lSec. 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 lChapter 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).:
1, 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 ihrough 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 contractor(s) 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-1012
FAX (760) 777-70111
INSPECTIONS (760) 777-7153- �0
Date: 8/12/05
Owner:
WILLIS
53-900 AVENIDA MENDOZA
LA QUINTA, CA 92253
Contractor:
PURRFECT POOLS & CONSTRUCTION
WCC: STATE -FUND
WC: 1680230 10/01/05
CSLB: 483498 .12/31/05
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —
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
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier C53 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
o0i 379P of the Labor Code, I shall forthwith I ith those provisions.
Da a.
Applic Fe'.
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 1$ 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
condition� and restrictions set forth an 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 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 thiwsunty to enter n the above-mentioned pro2e� ' p con purposes.
u
liildt/eg��'t4t.P ?,gn).r. lApplicant or Ageni
Application Number . . . . . 05-00003616.
Permit
BLDG POOL PERMIT
Additional desc
Permit Fee . . . .
284.50 Plan Check Fee
184.93
Issue Date . . . .
Valuation . . .
. 30000
Expiration Date
2/08/06
Qty Unit -Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
32.50
Permit .. . . . . .
MECH POOL
Additional desc
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue,Date . . . .
Valuation . . .
. 0
Expiration Date
.2/08/06
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
2/08/06
Qty Unit Charge
Per
Extension
BASE FEE
15.0-0
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . . . . .
PLUM13ING
Additional desc
Permit Fee
33.00 Plan Check,Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration.Date
2/08/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 13.0000
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 ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number -05-00003616
----------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENT'ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid
----------------- ---------- ----------
Credited
----------
Due
Permit Fee Totalw 388.50 .00
----------
.00
388.50
Plan Check Total 210.93 .00
.00'
210.93
Grand Total 599.43 .00
.00
599.43
LQPERMIT
08/12/2005 10:58
7GO-3GO-9829 PURRFECTPOOLS
14 LF bl9ck, rpa$onry wall
@ +48" heigt;t
O-)d-.riq)r eTWI:0 to rmWh hotme
Now 6 q U1 P WE 41.
Dom sod as owded
.�Xisting wood fenoe
for Pool and rondMe
plaster flnish
12'8 F3��76 -ISF�
85 LF
PFQParta heabar
Aqua -Rite Sait stem
PCS -2106 in W
SW SF tolored ConColete
r AIC wi salt or. Broom Firili�b WC I' WL"If
... ....... ..... .
4
In Feet v
Lggend'
0 U Ljlji4rella Socket i 2 3 4 5 5
ON volleyba!l Net sckrkst E�:"n.g jac=d
Removed By Omer
Gs'* shimfrw
F_Xj3-Tjtjr, �GHCRF-T.-
wow F�,Krz
x:. 13EMO AND REPOUR
r1l
PA
WILLIS RESIDENCE
53900 AVENIDA MENDOZA
LA- QUINITA, CA 92253
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONST RUCTION
PAGE .02/02
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08/12/2005 10:58 760-360-9829 PURRFECTPOOLS PAGE 01/02
Bin #
City of La Quilinta
BuIlding al Safery Divi5ion
P.O. Box I SO4, 78-495 Calle Tampico
Perrnit # La Quinta, CA 92253 - (760) 777-7012
g Permit Application and Tracking Sheet
OY- -6w� Buildin.,
pow.
Project AddreSs;
�=!r sNarne!
771
A. P, N,4mber:
. L 00 ?Ov�
XAddrc5s: 5 i !2
Z102DC2Z4
Leeal Description:
;(City. ST, Zip:
Addrc5s:
Telcpho ne:
e�Prctiect Description:
T. - ip:
S ST. 7-1
State Lic.--#,:
Plan Sets
Arch.. Engr.. Designer:
Iteat
Amount
Address:
Structural Cales,
City. ST. Zip:
Plan Check Deposit
Telephone:
Truss Ciics-
CoWtruction Type:
Occupancy:
State Lic. 0:
prqj,�,ct type (circle one): 'New
Add'n Alicr Rcpair Demo
Name of Contact Person!
Sq. Ft.. -
Plan% oicked up
Construction
Telephone � of'Contact Person:
Valut of Prolecf.
APPLICANT: 00 NOT WRITE 13ELOW THIS LINE
a
Submit(Al
Rcq'd
Rec'd 'VRACKIN,5
PF101IT FEES
Plan Sets
rJan Check submitted
Iteat
Amount
Structural Cales,
Rcviewed, ready for <orrcction
Plan Check Deposit
Truss Ciics-
Called Contact Person
Plan Chrck Balance
Energy Calct,
Plan% oicked up
Construction
Flood plain Plan
Plans resubmitted
Mechanical
('prading plan
V ReVjCW. read.. for correc I ij its, issue
Electrical
Subcontactor List
Called Contact Person
Plurnbin?
Grant Deed
Plans picked up
11.0,A- Approval
Plans resubmitted
Grading
Review. read, for correctimpsli.-isut
I)cvcloper Impact Fee
Planning Approval
Called Contact Person
Pub, Wk s. Appir
Vale of permit issue
School Fees
Total Permit Ffcs