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RPL (04-5114)V � , BUILDING & SAFETY DEPARTMENT c P.O: Box 1504 (760).777-7012 O.F--Tt�9 Z8-49 GALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 �, 3 0 2004 BUILDING PERMIT '(0 FI Appli!ca4t�i�ori=Nu^mber 04-0 6--0'0 11 Date 6/23/04 Prop y Address . . . . . 5 0 0 3 0'-MONTELOMA� CT APN: 772-250_-999-53 -30357 Application description . POOL - RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation 15000 Owner Contractor TOLL CA V REMBRANDT POOLS & SPAS C/O KEVIN D DUERMIT 789.10 VIA VENTANA 8901 `E MOUNTAIN VIEW 200 LA QUINTA CA 92253 SCOTTSDALE AZ 85258 (760) 7.71-2121 WCC: STATE � FUND WC: 17,44664 10/01/04 CSLB- 8100680 10/31/05 CCC: C53 Permit . . . . MECH POOL Additional desc Permit Fee . . 24.00 Plan Check Fee 6.00 Issue Date Valuation : 0` Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=1.00K 9.00 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 162.00Plan Check Fee 105.30. Issue Date Valuation 15000 Qty Unit Charge ..Per Extension BASE FEE 45.00 13.00 9.0000 THOU BLDG 2,001-25,000 -117.00 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check.Fee 11.25 Issue Date Valuation 0 Qty Unit Charge., Per Extension BASE FEE ' 15.00 JW .>r, a P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: CO -Y1 .t Al Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engine Ad ress: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Licen s in fullf rc�nd effect. License Class License No. �� a (0 Orn Date 3 u `� Contractor Mx__-Ylic OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , B.& P.C. for this reason Date WORKERS' 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 is .roQ M)Lworket;:eompensation insurance carrier and oli y n rpber are Carrier 7 G�� �•�•-�-C/ Policy Number __L b b _ I certify that, in the performance of the work for which this permit is issued, I thall 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 Labor Code, I shall forthwith comply with those provisions. Date 013l) Applicant 64 . ( WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV RAGE 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. 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 Lenders Address 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, indemnity and hold harmless the City of La Ouinta, 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 the above-mentioned property for inspection purposes. Date V 3 b U Signature (Applicant or Agent): yk,4t� PIC t, j Page 2 Application Number .0 04-00005114 Date 6/23/04 Qty Unit Charge Per Extension. 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 Qty Unit Charge Per - Extension BASE FEE 15.00' 2.00 6.0000 EA PLB FIXTURE 12.00 1.0.0 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 , POOL & -.SPA , ONLY . ALARMS. BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION: EQUIPMENT .ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 264.00 .00 .00 264.00 Plan'Check Total 130.80 .00 - .00 130.80 . Grand Total 394.80 .00 .00 394.80 t . t t. - +18" SPA W/ QUARTZITE SPILLWA Y p!L WAL 10'-0" 6.'-6" 7'-0" It r "16 dd m BENCH BENCH 86' FROM P/L 30'-0" 4 Slow " P/v SKINNER C\ � AUTOFlLL m 15'-0" CITY OF LA OHINTA BUILDING & SAFETY DEPT. • • ::EXISTING /APPROVED FOR CO S T RUCTION :: t. S DATE By t HEIDENREICH RES . P.E. •A RE -INSPECTION FEE OF $1 1.4-- 36' FROM P/L t WILL BE CHARGED IF THEA PRO PLANS AND JOB CARD AR NOT THE SITE FOR A SC 'DUL INSPECTION. NO EXCEPT ON . A/C m 34' FROM P/L -► EMBRAND POOLS & SPAS INC . CA. LIC. 800680 C-53 78-910 VIA VENTANA LA QUINTA CA 92253 TEL (760) t71-2121 FAX (760) 771-2181 POOL & SPA SPECS POOL SIZE: 30'X 13' POOL AREA: 383 SF POOL PER: 93 POOL DEPTH: 5' TO 3'6" SPA SIZE: 7'X 7' SPA AREA:.49 SF ' SPA PER: 28 DECK AREA: 989 SF COLOR/FINISH: PUMP: 2 HP FILTER: 400 SF HEATER: 400K BTU CONTROL: AQUA SWITCH CHLOR: AQUA RITE CLEANER: NAVIGATOR PLASTER: PEBBLE TILE: GROUP 1-3 POOL LIGHT: 2-400 W SPA LIGHT: 1-100 W RBB: MISC: HEIDENREICH RES. LDRAWN 0030 MONTELOMA QUANTA MTN. VIEW DEV. 6/02/04 "=8' BY: JOSE• I LANDSCAPE NOT INCLUDED I I.