RPL (12-0465)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: t-12_=00000465
Property Address: 50035 .MONTELOMA CT .
APN: 777-250-017-
Application
77-250-017 Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 21500
A nnH-t-
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ILI
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 5/23/12
Owner:
GERALD WOYCHESITYA
50035 MONTELOMA CT
LA QUINTA, CA 92253.
D Q D
Contractor: .
CLASSIC POOLS & SPAS MAY 23
79461 40TH AVENUE 7 202
BERMUDA DUNES, -CA 92203. `
(760) 345-8302 CIiYOF(AQUINTA
Lia. No.: 634338 FINANCEpEPT,
V
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- 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 70001 of Division 3 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 Cla s: C10 CS License 4338
.
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/" ^
Date) oA ontract
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
OWNER-BUILDE ECLARATION
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 CASTLEPOINT INS Policy Number WCPBC1252212
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 that, if 1 should become abject a workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
the Labor Code. I a f hh Pie
with ee provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
0
any applicant. for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
,aa/grreee
ate: alFg
(_ 1 I, as ownerof 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' C MPENSION 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 IL 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, DAMAGESAS 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 1, 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 contractorlsl licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
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 I am exempt under Sec. , BAP.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
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:
LQPERMIT
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the above information ' correct ree to comply with all
city and county ordinances and state laws relating to building constr tion d h y aut rize representatives
of this county o enter pon the above-mentioned property for in ectio es.
/Date: � ignature (Applicant or Age 1:
Application Number
12-000004.65
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
225.00 Plan Check Fee
146.25
Issue Date
Valuation
21500
Expiration Date
11/19./12
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20.00 9.0000
THOU .BLDG 2,001-25,000
180.00
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan'Check Fee
6.50
Issue Date . . .
Valuation . . .
0
Expiration Date
11,%19/12
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
11/19/12
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 . . . .
33.00 Plan Check Fee
8.25
Issue Date
Valuation . . .
. 0
Expiration. Date
11/19/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA.. PLB FIXTURE
12.00
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
Permit . . .
WALL/FENCE PERMIT
,;;
Application Number 12-00000465 -
Permit .. . WALL/FENCE PERMIT"
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date . . . . Valuation
192
Expiration Date 11/19/12
Qty Unit Charge Per
Extension
BASE FEE
15.00"
----------------------------------------------
" Special Notes and Comments
- DEMO EXISTING POOL. BUILD.NEW POOL,SPA,
FIREPIT, 12.L.F. 4' EQUIPMENT WALL, CITY
STANDARD. ALARMS/BARRIERS SHALL.BE IN
PLACE AT PRE-PLASTER"INSPECTION. 2010
CODES.
Other Fees . . . . . . . . . BLDG STDS ADMIN .(SB1473)
1.00
Fee summary Charged Paid Credited
Due.
Permit Fee Total 344.00 .00 .00
344.00
Plan Check Total 172.25 .00 .00
172.25
Other Fee Total 1.00 .00 ."00
1.00
Grand Total 517.25 .00 .00
517.25
.. LQPERMIT - - -
J +18" RAISED
'BOND BEAM
/ TANNING LEDGE WITH,
12' ; UMBRELLA SLEEVE
FIRE -6 SPA
—4a
PIT 16, -g' 11 9.x9.
'
6'x9' TANNING'
� t - _, -r.- LEDGE
1 f PAVERS LL r
e
E�
i
.�;
.EXISTING PATIO'
POOL EQUIPMENT w
CITY OF LA QUINTA
BUILDING & SAFETY DEPT. 0a 4Q Cot
APPROVED t2 �.r �ac4'
GRAY COLOR
FOR CONSTRUCTION' CONCRETE
—12' — BROOM FINISH 1
DATE 6 - a3-M6Y A
EXISTING
RESIDENCE -
7a
- w r.. �..F•. -. . t . r 4�Vl.r+P / �•.'./._ � ... !"+--.i ✓^ +�.rrT —" wa^ � i _ -1y, .'. _ .� �.
GAS O /
ELECT. ® f
DRIVEWAY
• s
AREA SCHEDULE
'
POOL
640 SQ.FT
POOL PERIMETER
56 LN.FT
POOL COPING
56 SQ.FT
SPA
81 SQ.FT
SPA PERIMETER
27 LN.FT
SPA SPILLWAY
10 LN.FT
SPA COPING
27 SQ.FT
4' HIGH BLOCK WALL
16 LN.FT
NAME GERALD WOYCHFSITYN
THESE PLANS, DRAWINGS AND SPECIFICATIONS ARE NOT TO BE REPRODUCED; ' ADDRESS: 50-035 VIA MONTELOMA
CHANGED OR COPIED IN ANY FORM OR MANNER WHATSOEVER WITHOUT THE
EXPRESSED CONSENT OF CLASSIC POOLS AND SPAS. 1 CITY: LA QUINTA, CA 92253
Bin #
City of La Quinta
Bu11d1nt a Safety D!v[slon
P.O. Box 1504, 78-49S Caf(ee Tampko
La Qtdnta, CA 92253 - (760)'777-7012
Building Permit Application and Tracking Sheet
p # , ��
Pmject Address: SO — 03 S 4irQ (a rune,
A. P. Number:
Legal Description:City.
Contractor Is 'C Poo� S AS
Address. t -l61 CCU�,Y A J
Owner's Name: C 814
Address: 5' O .. `3 S to ✓Vl uf-
ST, zip:
Telephone: ,b -.Z _ . 3O a
ProjedDescription: pdd(- E i�p�CZ1'>k Tr
City. ST, '14010 C.q Q O 3
r man. ' o h C
Telephone: 7 G o 3 U
State Lic. # : G -339 City Lie. #; 67596
Amh. Engr., Designer:
Address:
L - eal .
City, ST. Zip:
Telephone.
State Lic' #.
Name of Contact Person: �� on hi f v e 2
Construction Type: Occupancy:
Project type (circle one). N Add'n Altar Repair Demo
Sq. Ft:
# Stories:
# Units:
Telephone # of Contact Person: 760 7
Estimated Value of Project • 0,
APPLJCANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRA(XMG
PERMIT FEES
Plan Sete
Plan Check submitted
/Z
item
Amonat
Shwtaral Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 2/ Cala.
Plans picked up
Construction .
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'' Review, ready for correc iouMssue
Electrical
Sabcostaetor List
Called Contact Person
Plumbing
Grout Deed
Plans picked sup
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
- -
''� Review, ready for correctionslissae
Developer Impact Fee
Planning Approval
Called Contact Person
AyP,P.
'Pub. Wks. Appr
Date of permit issue
School Feu
Total Permit Fees