05-4463 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
Ti&t °f 4.Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
�05-00004463J
53770 AVENIDA RUBIO
774-153-002-23 -000000-
POOL - RESIDENTIAL
COVE RESIDENTIAL
14000
LTJ
Architect or Engineer:
U L OCT 0 6 1005
�Id CITY OF LA QUINTA
-----------------
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: License No.:
tDaefO� 0 Contracto . Cr SIS +%.?r, Lr is /�•
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 _) 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 1 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:
LQPERAM
Owner:
POWER FINANCE
P.O. BOX 134
LA QUINTA, CA 92253
RContractor:
ICAZO POOLS & SPAS
CC: STATE FUND
C: 1828357-2005
SLB: 836900
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
09/01/06
04/30/06
Date: 10/05/05
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 C53 Policy Number --------- -
- ----
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 tothe workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
i�ttfpplicant"Q ! /1� D P f .i1 L:%
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 ($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 the above-mentioned prope/rty or/m/s,➢.,e�ctionpurposes.
Dignature (Applicant or Agent)✓ //
Application Number . . . . 05-00004463
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
4/02/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING
POOL
30.00
Permit . . . BLDG POOL.PERMIT
Additional desc .
Permit Fee . . . .
153.00 Plan Check
Fee
99.45
Issue Date . . . .
Valuation.
. . .
. 14000
Expiration Date
4/02/06
Qty Unit Charge
Per
Extension
BASE FEE
-
45.00
12.00 9.0000
-=-------------------------------------------------------------------------'-
THOU BLDG 2,001-25,000
108.00
Permit . . . PLUMBING
Additional desc . .
Permit Fee
27.00 Plan Check
Fee
6.75
Issue Date
Valuation
. . .
. 0
Expiration Date
4/02/06
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
POOL ONLY (NO HEATER).
ALARMS/BARRIERS
SHALL BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENT
ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited
Due
---------------------------
Permit Fee Total
--------------------
225.00 .00
----_-----
.00
225.00
Plan Check Total
117.'45 .00
.00
117.45
Grand Total
342.45 .00
.00
342.45
LQPERM►T
X
Permit #
Project Addrus
"City --of La Quinta*
Building 8[ SafM Division
P.O. Box 1 SO4, 78-495 Calle Tampico
La Quina, U 922S3 - (760) 777-7012
Building Permit Application and Tracking Sheet
J Ow-te{s Name:
A. P. Number
Address: .O. box- 04
Ciry. ST. Zip: Z -Z-53
.~
'�FTdephon: -
jeer Description: j ® P C.,
Leal Description:
Contractor.
Address: �,•
4 5 E_-
City, ST. Zip:
- O6A4s L4 A_l
Telephone: % .a
State Lic. r : A.3
Arch.. Engr.. Designer
City Lic. p:
Address:
a 10,
City. ST. zip:
Telephone:
'7s; _..- -
-limatied
Conumclion ype: Occupancy:
State Lic N:
ject type (circle one): New Add'n Atter Repair Demo
rso
Name of Contact Pen: bSLAPJOPG-,Q
FL:
M Stortes:
1 M Units:
Telephone n of Contact Person: •s 5
Value of Proieet: al
APPLICANT: DO NOT WRITE BELOW THIS UNE
r
Submittal
Req -d
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed. ready for corrections
Plao Check Deposit
Truss Calts.
Called Contact Person
Plan Check Balance
Energy Cala.
Plans picked up
Construction
Flood plain plao
Plans resubmitted
Mechanical
Grading plan
Y Review. ready for eorrectioosrnsoe
Electrical
Subcontictoi• List -
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SAM.
H.O.A. Approval
Hans resubmitted
Grading
IN HOUSE:-
'"' Review. ready for eorreetionliissoe
Developer impact Fee
Planniag Approval
Called Contac Person
A.I.P.P.
Pub. MILL Appr
Date of permit issue
School Fees
Total Permit Fees
1.130
Fly &E� OF LU95
I
Il
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE—±0o 15`0" ' -
SWIMMING POOL SPECIFICATIONS
POOL SPECIFICATIONS e
type: CSU 1 _si7e: j(*— X
surface area: erimeter:
depths: min. O max. to�-
SPA SPECIFICATIONS
size: X su cc area: perimeter.
dam wall width: Ie spa raised:
spillway type: u of jets:
notes:
EXCAVATION/STEEL
type of dig: Bolbr-A T access:
elevation: .D .
wall/fence removed by: ---
wall/fencc type
conc.removal: sod removal:
tree/stump removal:
6"r.b.b. 12"r.b.b. 18"r.b.b.
surcharge: 'Ks bench/loveseat:
tanning shelf water depth:
GUNITE
6"r. b. b. 12"r. b. b. 18"r. b. b.
bench/loveseat: extended 2 step: -
spa dam wall width:
spillway type:
DECKING
SQ.FT.finish:
color:
cantilever: expansion joints:
steps: type:
deck drains: decco-drain:
curb core: sand&visqueen:
DC S
TILE & MASONRY
coping type: L,
spillway type:
6"r.b.b. 12"r.b.b. •----- 18"r.b.b
r.b.b. facing: trim tile:
the type:
equipment wall: • X type:
PLUMBING & ELECTRICAL
plumbing size: fill line:
skimmer type: g_ a
gas line: clect.line: S
heater: size: - -�
filter Le
�Z_size:
pool pump: tIS FLO size: 1• NP
jet pump: size:
sub -panel: time clock: T. ReA
GFIC. AT "0 Ip extra GFIC.
pool light: 400LZ spa light:
gas stubs: elect.stubs:
plaster: color:
pebble: colo
5 S
NAME:QQ��i�C 1Z iJ
Job address: 5 1
City: LA IQ O
1/ Qof
: 1
scale: f0 � —r-) date: f! •o