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11-0407 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tihf " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00000407'"" `*+c Property Address: 51180 AVENIDA- CARRANZA APN: 773-061-008- - - Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 16000 Applicant: Architect or Engineer: 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: D06 C53 / Licence No.:. 745278 I 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 (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 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 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.). ( 1 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/20/11 Owner: CHAROS JAMES/MEYER SHERI 51180 AVENIDA CARRANZA LA QUINTA, CA 92253 D Contractor: f APS 7 COMMON GROUND SWIMMING'``/ P LS 1 Oil 72877 DINAH SHORE DR J103-1- RANCHO MIRAGE, CA 922 FO FCq(fl (760) 799-9174 Lic. No.: 745278 U/ 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 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 I should become subject to the workers' compensation provisions of Section L7/ 3700 of the Labor Code/, Ij shall forthwith co ply with th osp provisions. ate: Applicant: Q.�A.i'1 � 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 t above-mentioned property for inspection purposes. nature (Applicant or Agent), Application Number . . . . 11-00000407 Permit . .. BLDG POOL PERMIT Additional desc . Permit Fee 171.00 Plan Check Fee'. 111.15 Issue Date . . . .. Valuation . . . . 16000 Expiration Date 10/17/11 Qty Unit Charge Per. Extension BASE FEE 45.00 14.00 9.0000 -------------------------------------------------------------------------- THOU BLDG 2,.001-25,000 .126.00 Permit . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . Valuation 0 Expiration Date 10/17/11 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 10/17/11 . 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 . . . . 27.00 Plan Check Fee'. 6.75 Issue Date Valuation . . . 0 Expiration Date 10/17/11. 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. ALARMS/BARRIERS SHALL BE IN PLACE LQPEPMIT Application Number . . . . . 11-0000040.7 ---------------------------------------------------------------------------- Special Notes and Comments AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010' CODES. ------------------------------------------=--------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473). 1.00 Fee summary =------------ Charged Paid Credited Due - - -- Permit Fee Total -------------------- 269.00 .00 -------------------- .00 269.00_ Plan Check Total 135.65 .00 .00 135.65 Other Fee Total 140 .00 .00 Grand Total 405.65 .00 .00 405.65 LQPERMIT LfCMZq_ CITY OF LA QUINTA SUB-CONTRACTORLIST &fltm Crt�itrl JOB ADDRESS5lfa�j/{'.�'l1dA PERMIT NUMBER OWNER �� V� �3�1 --BUILDER r1 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 work 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 voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. aUo» Contractor. State Con act '3;License. Ci i3usrra ss License Trade / Classr% ........... tr .... or :.:.: Workgrs Compensation Insurance........... . Company. Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date . License Number Exp. Date (e.g. A, B, C-8) (xxxxxx) (xxlxx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx) EARTHWORK;(C.-1:2:1.`' .`` r ;S` J 3/ - O! % /0 FRAM(N:.G-1d=5) _ ::.;....: RE EMMA _`lt " 1 Mo.i DRYWALL :HVAC tG=20)...: G1.ELECTRICAL.: ( ,.: Cal pnz) l I/ 71 '.SHEET;METAL1G43 SVNAGEDISP{C2 PAINTING (C:=33)... CERAMIC .TILE:IG-�.r4i 4 CABINET$ FENCING.' C LANDSCAPING .0'=27) . POOL (C=53.1. .• Y: �- 3a n 3 C®V►/l "rL r©Wad' C Cir �t✓-t� �re� l� 149 .3 Bin # City of La Quin to Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #rj o 1 Project Address: tip' 1 �A ��rao,��. Owner's Name: S A. P. Number: Address: e- Q Legal Description: City, ST, Zip: 10 t�awite&r9aa6�3 Contractor:/. Telephone: ;::�>;<:>^::s::;rE::>:»<<<i:<:>::' �>.»• •;: Address: e Project Description: City, ST, Zip: ' Cil._ Telephone:1-e ,91 - <.......:>:::..:..... State Lic. # 7 W 7 9 City Lic. Arch., Engr., Designer: Address: City, ST, Zip: }�:•\tiiiiilry>.�4,+.'riii::::::'v'�>.:'r:iiiiiT' Telephone: State Lic. #: !:.>:•>:"»>;>;>::^.:::'� <;:«^'«:>: :: :. Construction Type. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: L - 7 t'9- V1 '7Y Estimated Value of Project# /I. APPLICANT: DO NOT WRITE BELOW THIS LINE 11 Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Pian Check submitted '� t� tem Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans.resubmitted Mechanical Grading plan 2pd Review, ready for corrections/issue 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 Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Existing landscape protect place Existing cas and electric meters protect place Saw cut driveway, i pool \,--plumbing in sleeves ! • s I r • i placenew concrete Existing driveway and approach protect in place ■ �■�®♦im■®■®soo ®®■ ®®®■gym®■®■s■s®m�m�se6■ e BUILDING & SAFETY DEM APPROVED FOR CONSTRUC'nON DATE '4 `'�U/If i ��` Al— m protect place Existing concrete slab to remain add flagstone New flagstonepatio concrete MTM i r i i! • i.. 2, V-0" wide spillways -Existingproperti line wall protect place POOL SPECS SIZE: SQFT: DEPTH: PERIMETER: EST TOTAL GALLONS: SKIMMERS: RETURNS: INTERIOR MATERIAL: SPECIAL: TILE: NOTES: SPA SPECS $ SIZE: — SQFT' A31�i DEPTH: e PERIMETER: EST TOTAL GALLONS: SPILLWAY: RAISED HEIGHT: SKIMMERS: RETURNS: TILE: INTERIOR MATERIAL: 11 SPECIAL: NOTES: PLUMBING RETURNS: Y _ SKIMMERS: POOL MAIN DRAINS: SPA MAIN DRAINS: CLEANING SYSTEM: a1%R f6 ` e—& ' °T VAC LINES:%j ROBOT VAC: WATER FEATURES:T� SPA SPILLWAY: "- --- -- LIGHTS IN POOL: LIGHTS IN SPA: TOTAL PIPE: SPECIAL: NOTES: DECK DECK TYPE: ELEVATION: TOTAL DECK SQFT: i1R,1R3IALFTiSR; RAISED BEAM: LIP STYLE: MATERIAL l: MATERIAL 2: SPECIAL: NOTES: EQUIPMENT POOL PUMP:2ND PUMP: FILTRATION: � l f� ✓a"%eyfFILTER SIZE: _ - HEATER: N_ l ,f +° 4�D 00 6-1"a INLINE: TIMER:C;�j��r (d(�Ye GAS: —_ SPECIAL: (C9.�1I 4 cILLte_r--c�s�_ NOTES: --- — F_ CHANGE ORDERS CD?t DESCRIPTION DATE Untitled Common Ground Swimming ® ■ ools 72877 Dinah Shore Drive Suite: 103172 Rancho Mirage, Ca 92270 () 799-917 NAME: _ +Ig-_°' ADDRESS: i- CITY: p s )�f�_ j.�{-- SPATE: `i PHONE: _ ZIP: --�--- WORK: CELL: 1CIB#: I have reviewed and I give my approval to proceed with the construction of this project. x Customer Date