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SOTB (12-0587)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) '777-7011 INSPECTIONS (760) 777-7153 LQPERMIT Date: 5/24/12 Application Number: 12-00000587-' Owner: Property Address: 79958 MISSION DR . E DON TULL - APN: 649-750-004- - - 79958 MISSION DRIVE EA Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253 ll Property Zoning: LOW DENSITY RESIDENTIAL (u9q MMAV �y t7 Z0f2 Application Valuation: 3000 Contractor: CITY OF LA QUINTA Applicant: Architect or Engineer: CALIFORNIA POOLS & SPAb FINANCE. DEPT. F PO BOX 2889 PALM DESERT, CA 92261 Y (� �Ir (760)000-6141 ` Lic.•-No.: 185102 ---------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty'of perjury one of the following declarations: Section 7000) of Division of the Business and Professionals Code, and my License is in full force and effect: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: 13 C53 License No.: •185102 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ s- issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor - • - Bate: l z ntractor_. - / Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier ARCH INS CO Policy Number WC260048200 . following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a. permit to I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for -the _ person in any manner so as to become subject to the workers' compensation laws of California, _ permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Codej sha I orthwith comply with those provisions. 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)-: ate: �/i plicapi• (_) 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 - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.)- - APPLICANT ACKNOWLEDGEMENT - (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - - 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of ,conditions and restrictions set forth on this application. - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is.made, each person at whose request and for s pursuant to the Contractors' State License Law.).. whose benefit work is performed under or pursuant to any permit issued as a result of this application, ( ) I am exempt under Sec. , B.&P.C. for this reason 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. Date: Owner: 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 CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the :I certify that I have read this application and state that the above information is correct. 'I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.1• city and county ordinances nd state laws relating to building construction, and hereby authorize representatives of this my to en�tjer up the above-mentioned property for i s ecti purposes. ' - Lender's Name: J!' `G ignature (Applicant or Agent)r� Lender's Address: LQPERMIT Application Number . . . . . 12-00000587 ' Permit . . . ELEC-MISCELLANEOUS Additional desc Permit Fee . . . 17.25 Plan Check Fee 3.94 Issue Date Valuation 0 Expiration Date 11/20/12 Qty Unit Charge Per. Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 -------------------------------------------------------------=----------_--- 2.25 Permit . . PLUMBING Additional desc . Permit Fee 18.00 Plan•Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 11/20/12 Qty Unit Charge Per 'Extension BASE FEE 15.00 1.00 3.0000,EA ..PLB GAS PIPE 1-4 OUTLETS 3.00 Special Notes and Comments RELOCATE BBQ & ADD FIREPIT @ OLD BBQ LOCATION. RELOCATE EXISTING GAS & ELECTRIC TO NEW LOCATIONS. 2010 CODES. -------------------_-------------------------------------------------------- Other. Fees . . . . . . BLDG STDS ADMIN (SB147,3) 1.00 STRONG MOTION (SMI) - RES .50 Fee summary Charged Paid Credited Due Permit Fee Total 35.25 .00 .00 35.25 Plan Check Total 8.44 .00 .00 8.44 Other Fee Total 1.50 .00 .00 1.50 nrnnei mr,ral. as 1 a nn nn as 1.a LQPERMIT Ar 7 — — -- — — — NEW t'I RZ r%T- KAISLU I L' fiA>nsN; J'�ifit'fl.>41 t��Si IA9��R�vrE�/�i+. - %,1'Faioa; Smkil9LASS } Ne 4s 6UM, °k4LAmZ F;allig, MATkA E-Xlsii .&LtA01JrE VE-A)JER QN 31)IF60 X5E-5IDE TuU6 Awo Paia)T'oA) A,%uie' S; De- _ y T )1rb Tva -sN &L=-Arer* TAjFs PREPARED FOR: T U 11 FAm-►1y r�,ST (Dors T&K.) STREET -71' iM�is*,ra1 i)A Uak EA -sr - CITY ZA'AiA RES. PHONE BUS. PHONE Map Bk. Ref. Filter �} Pump Eiev. Pl. O Hose Bib Elec. Meter Gas Meter Actuator I CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE® GENERAL SPECIFICATIONS Size x Volume Gallons Surface Square Feet, Perimeter - Feet Depths: Minim9m Feet, Maximum Feet EXCAVATION • Elevation at Gradins HrS• Debris Dirt Trees Deep End Ramp Access Other STEEL Special R: B. Beam PLUMBING • Pipe Size: Suction Returns Filter Pump H. P. Heater BTU Vent by Fill Line - Ft Skimmer tt_� Gas line byf•. Length Ft. Backwash to Stub: 0 Yes ❑ No Spa ' Special - GUNITE •- Special Rope Rings - Grab Rails Seats COPING Color and ,or type Special -- TILE Special ELECTRICAL By 5:664 Up To Ft Lights • # watt Time Clock Special DECKING • By Up to Sq. Ft. Color A1AIaM Texture Special FENCE • By To Meet Local Code PLASTER r • SPECIAL NOTES • Pool Cleaner Adjust. Ret. Chlorinator Rails Diving' Board Slide Notes: • • - FOR CONSTRUCTION ►ly''_ t'®�IS-7-)111v,+;,IDA( DATE -7- 412BY CJS CAMFORNIA PSPM CONThACTOR'S LIC NO. t86102 OWNER: To determine approx. elevation of pool on day of (� I excavation. To wel,. down concrete shell at least twice daily for seven days. Return Grob Skim. Eye vac. fce; Cleaner Air OWNER: Approves plan, pool and equipment locations. Rall mer ball Stub, Iniectoi Signed Date Bin. # City of La Quin-ta Building a Safety Division Box 1504,78-495 Caffe Tampico Ia.Wnta, CA 92253 -:(760) 777-7012 Building Permit Application• and Tracking Sheet Perinit #P.O. Project Address: C(_ i i N "106 t6 A5T OwneesName:. A. P. Number. Address: . -9S�M1Ss:,� r Legal Description: City, ST, Zip. y....... .. Contractor. n /S Telephone: Address: WX 6q Project Desoriptiorpm Rs t 63Q City, ST, Zip: o -P _ P; -r Telephone:) 7-)1- 11,t 4 ( �. - lnouE _ , State Lia # : 'Z City Lic. #; ' Arch., Engr., Designer �:' �,,, ✓ v w -�.. Address: City, ST, zip: Telephone: Construction Type: Occupancy: State Lie. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:OA -J Sq: Ft.: # Stories: # Unit;: Telephone #.of Contact Person: Estimated Valae of Project: 3 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd'Rec'd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calea Reviewed, ready for corrections Plan Check Deposit, . Truss Cates. Called Contact Person Plan Check Balance. Mde24 CAW. Plana picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan r! Review, ready for correctionsfissue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L ELO-A- Approval Plans resubmitted Grading IN HOUSE:- 7id Review; ready for eorreedonstissue Developer Impact Fee Planning Approval Called Contact Person Pub. VVka. Appr Date of permit issue School Fees Tota, Permit Fees