RPL (10-0321)P.O. BOX 1504
78-495 CA LLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4t!� 4 4 Q"
Application Number: 10=00000321_
Property Address: 49520 MISSION DR W
APN: 649 -490 -012 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------=-------------------------------------
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.
License Class: C53 License No.: 800680
te: w 2 nlx ctor:
OWNER -BUILDER DECLARATION.
1 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).:
1 _ 1 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.). .
( ) 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: - a
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 '
4/14/10
Owner:
ANDRE MEDINA
49520 MISSION DRIVE WEST
LA QUINTA, CA 92253•
G7
Contractor:
REMBRANDT POOLS & SPAS INC
P.O. BOX 6411
LA QUINTA, CA 92253
!
(�
(760) 771 -2 12 1
C�� -��J
Q— a
Lic. No.: 800680
--------------------------- - -------------------
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 EXEMPT Policy Number EXEMPT
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 1 should become subject to the workers' compensation provisions of Section
/ 3700 of the Labor Code, I shall forthwith comply with those provisions.,
gaCe• il�-��Ap 'ant: �—
/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
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 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 thea ove-mentioned property for inspection purposes.
D e: L�V
��Sign a (Applicant or Agent):
Application Number 10-00000321
Permit . . . MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check Fee
6.50
Issue Date . . Valuation
0
Expiration Date 10/11/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
----------------------------------------------------------------------------
11100
Permit BLDG POOL PERMIT
-Additional desc .
Permit Fee 90.00 Plan Check. Fee
58.50
Issue Date Valuation . . .
. 7000
Expiration Date
Qty Unit Charge Per
Extension
BASE FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
45.00
Permit . . ." PLUMBING
Additional desc".
Permit Fee. 27.00 Plan Check Fee
6.75
Issue'Date . . Valuation .
. 0
Expiration Date 10/11/10
Qty Unit Charge Per
Extension
..BASE -FEE
15.00 -
1,00 6.0000 EA PLB FIXTURE
6.00
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
SPA ONLY. NO NEW EQUIPMENT. COURTESY FOR
NEW BBQ.ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.'
EQUIPMENT ENCLOSURE NOT INCLUDED. 2007
CODES.
----------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 143.00 .00 .00
143.00
Plan Check Total 71.75. .00 .00
71.75
.LQPERMIT -
.'
LQPERMIT
Mar 01 10 09:51a Rancho La Quinta HOA
.7607778961 p.1
RANCHO IA. QUI
TA ' -
MASTBR AlsomT10N
• Arckitectural Control Committee:
February 26, 2010
-
Mr. Andres Medina
49-520 Mission Drive West
'
La Quinta, CA 92253
Re: 49-520 Mission Drive West
roval V Submission
The Architectural Committee reviewed your submission
for an addition of a
Spa, hardscape and Bar BQ. The submission as pr
sented is approved upon
condition of
The Committee requires the following:
• All work is to be done in accordance with all
applicable requirements of
governmental entities, including the City of iz
Quinta and in
accordance with all Homeowners Association
architectural guidelines
and governing documents.
If applicable, a City of La Quinta building permit
be obtained and copy
_•
furnished to the Association prior to commericement
of work.
• No access from the Golf Course may be use
.
When the work has been finished, please return "
otice of Completion" to the
Association Office. The Association's architectural
onsultant will perform a
final inspection after receipt of such notice; when
erification of the approved
plan modifications have been concluded, your Sect
inty Deposit will be
processed for refund.
Thanking you in advance and if any questions plea
ie do not hesitate to call
me at t e on-site office 777.8807.
,
ely,
Mary E. W er, CCAM
Associatio General Manager
Email : mwalker(a)drminternet.corn
cc: Architectural Comm.
I�
P.O. BOX 6419 • LA QUIivTA, CA 92248-6419 • 760-7
i
7-5807 • FAX 160-771-8961
Bin #
City of La Quinta
Building M Safety Division
Permit #. .
P.O. Box 1504, 78-495 Calle Tampico
�\
La Quanta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking_Sh-e-et _
Project Address: �l �— ��p r, [55", V J C
Owner's Name: �� SS
A. P. Number:
LI G v
Address: [ a M l s51 cl 1
Legal Description:
t ,,f-
City, ST, Zi
njT
1t `p:
�/�
Contractor: b fA,) �T :•::•:r.;;:.,.�•:
S c, f Telephone: ' ''.:: .
V %; .moi
Address: `-�'���t �✓
Chlb Project Description:QN
City, ST, Zip:
CA -/ I
Telephone: G U - (�
t770�
nJ O d vv
."°`ME
:Kaiyt.
State Lie. # : pp(� C7City
Lie. #.:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Conshuction-T e '{ yP —1r2=EJ— - -� Occttpattsy:
State Lie.
:. Project type (circle one):C� Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: iC Our .—
APPLICANT: DO NOT WRITE 13ELOW THIS LINE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Celled Contact Person Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2" Review, ready for correctionstissue 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 corrections/issue Developer Impact Fee
Planning Approval
Called ContEPer_sonEEJEA.I.P.P.
Pub. Wks. Appr
Date of perm
School Fees
Total Permit Fees
'a
CITY- OF LA QUINTA SUB -CONTRACTOR LIST
vcJ �-S �
JOB ADDRESS PERMIT NUMBER OWNER BUILDER _��,(1'1"lr f
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 wor$
on this job. Any: changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidanc(
of building. Dermit. For each aoolicable trade. all information reaiuested below must he emmnfeter( by annlicant_ •t1n File• is not an accentahlo resnnnse-
a
Tirade / Class�fic tion
T
Contractor
�.
S tatQ-Contractor lkepse
:: `1a
Busitles Uc�nse`;<.
Company Name
Classification
(e.g. A. B, C-8)
License Number
(xxxxxx)
Exp. Date
Ixx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
lxx/xx/xx)
License Number
(xxxx)
Exp, Date
(xx/xx/xx)
EARTHWORK IC -121 ..
1
AJ G. t1Nti I y r k
. — S3
�7 5 S i -7
L13� r c�
lU5 U ,
(9� D K rM c�a0 Lim
-3- n
�4
7'31' l (7
Cow" ....:.
firti� ��NS� �
C—.�
G 313 ci
P(o
(�5 i 601063t/o 1
t coo -UW 3
FRAMING (C-5)
_
STRUCT. -STEEL (G.51)
Q
��/-f�! /d h� UN`` ( f�
�i - ��
�� �S ��
�l ' I v
Pe, S C •
O 1) 04 aaUD�(JS7
MASONRY tC-29)
�v5 � ry
—a-
q�i3 $(�2
a-�9-
:�7 CU/►� _7A3,
17� �( b ��
I& -Ho
(by
L(-30-10
PLUMBING (C-36)
�n�' ru vN�� E%jcwl�
����
�7�Tt/%
-(' '�`�
(�S �i�S Cv
CO,; -DK �n ����/e S7
?-3-IJ
/0( V-
7-3
LATH,- PLASTER (C-35)
DRYWALL (C-9)
HVAC.. (C -20r
ELECTRICAL. (C4Q)* s',.`,
R06FING'IF391`'.:?:> >.
SHEET -METAL (C'=431
GLAZING (C-17) .' .. .
INSULATION:'(C-2)
SEWAGE DISP; (G-42) .
PAINTING (C=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING IC -13)
LANDSCAPING (C-27)
(O 0�
POOL(C-53) '�
(�C1S«A.) &,,wI �'
/�
r�J�S G 5
ao�7o40�0003
-1-��
fj�Oa1o�
.7-3i'�`
- i •.
�/