04-5363 (RPL)BUILDING ft SAFETY DEPARTMENT
P_.O.BOX 1504.
c l. (760)-777-7012
tpg�n�V 9 78495 'n E TAMPIC.O FAX (760) 777-7011
LA QUINI�A� CALIFORNIA 92253 INSPECTION REQUESTS. (760).777-71.53
SEP 2 9 Zook BUILDING PERMIT
C17Y OF LA QUINTq
FINANC IDEP-r
Application Numbe . . 0.4=00=0=0:5:3-63�_ Date 9/29/04
Property Address 54640 AVENIDA RUBIO
APN':'. 774-272-007-18 _000D00 -
Application description POOL - RESIDENTIAL
Property Zoning COVE RESIDENTIAL.
Application valuation 15000
Owner Contractor
WILLIAMSON KERRI KqREN DEVINE SWIMMI=NG POOL DESIGN
E N'&410 al:- 8.0844 BOULDER DRIVE
CA -9-9�'�'9 I ND I O CA : 9 220-1
(760)..989;='0354
WCC: STATE FUND..
WC:. 1641733 07/01/05
CSLB::. 786814 11.%30/04
....
CCC: C53
Permit BLDG POOL PERMIT.
Additional desc
Permit Fee 162.00 Plan Check Fee 105.30
Issue Date 7/08/04.. Valuation 15000
Expiration Date. .1%05/'0`5
Qty Unit. Charge.''Per :. Extension
BASE 'FEE. 45.Q0
13• .0'0...:. ,9. 0000 ".THOU.:. BLDG 2; 001=25,.0.00..` 11.7:00
-- ---------------
- =----------------- -
---- --_ -----------
Permit MECH POOL
Additional desc
Permit.Fee 24..00 Plan.Check.Fee 6':00
Issue, 7/08/04 Valuation 0
Expiration Date 1/05%05
Qty 'Unit Charge Per. Extension
BASE FEE 15.00
1..00 ..9,.0000 EA MECH FURNACE <=100K 9.00
Perriiit ELEC.POOL PERMIT -RES
Additional. desc'
Permit Fee .. 45.00 Plan. .Check. Fee 11:25
Issue Da.te.. 7/.08/04' Valuation 0
Expiration Date.. 1/05/05
Qty Unit Charge Per Extension
r
P.O. Box 1504 VOICE (:770) 777 -701-2
78-495 CALL a T FAX (760) 777-7011 .
LA QUiNTA, CALIFORNIAFONI922.53 Qumrcv'INSPECTIONS (760)-777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: OZ4 Date: 'owl
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
(16.7 -
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 License is in full force and effect
License Class License No.
Contractor
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 fife 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.fhe alleged exemption. Any violation of Section 7031.5 by. any applicant for a permit subjects
the applicant. to a cM1 penalty of not more than five hundred dollars ($5110).):
U 1; 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 forsale (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.).
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 o 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
zq_9
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:.
_ I have and will maintain a certificate of consent to self4nsure 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 pemult is
Issued. My workers' compensation Insurance carrier and policy number are:
Carrier Policy Number
_ 1 certify -that, in the performance of the work'for which thW per 1t Is Issued, I shall not employ any person In any, manner so as to become subject to the workers'
compensation laws of Cardomia, and agree that, N 1 should become subject to the workere compensation provisions of Section 3700 of the Labor Code, l shad
fotimith comply with those provisions/ . .
1� 'd pficanf ��A�(^i /4 &JAA--
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
37
SECTION 08 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,perfornance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lenders Address N
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 0uinta, 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 Ifwork 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 ent pon the above -mention A property for inspection purposes.
ate �-I —zCl "dature (Applicant or Agent):
Page 2
Application Number . . . . 04-00005363
Date 9/29/04
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 . . 7/08/04
,Valuation ,
0
Expiration Date 1/05/05
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. ALARMS/BARRIERS SHALL
BE IN PLACE PRIOR TO PREPLASTER
INSPECTION. EQUIPMENT ENCLOSURE
NOT
INCLUDED IN PERMIT. ****Note:
Change
of contractor on 9/29/04. $4.50
fee
assessed, new job card printed
------------------------------------------------------------------------------
Other Fees . . . . . . CHANGE OF CONTRACTOR
4.50
Fee summary. Charged
Paid Credited
Due
Permit Fee Total' 258.00
258.00 .CSO
.00
Plan Check Total 129.30
129.30 .00
.00
'"Other Fee Total 4.50
.00 GO
4.50
Grand Total 391.80
387.30 CIO
4.50
NOTICE OF CANCELLATION .
To: Purrfect Pools
From: Homeowners; Jeff and Kerri Williamson
Date: September 27, 2004.
Re: Cancellation of Pool Contract .
CC: City of La Quinta and County Recorders Office
This letter is to serve as a Notice.of Cancellation for the Pool Contract on 54640 Avenida Rubio, La Quinta CA.
This Contract is held between Jeff and Kerri Williamson and Purrfect Pools.We reserve the right to cancel
this Contract due to the following circumstances:
The Contract that was signed on June 15, 2004 by the Contractor and Homeowners states that
Pool Excavation was to begin within 20 days of the date the contract was signed. The Excavation did not
actually start on this pool until August 21, 2004. This is 67 days after the Contract was signed.
The Contract states that the pool is to be completed within 60 days of proposed Excavation. This would
put the pool completion date to be September 3, 2004. As of September 27, 2004 the pool has not yet
passed Electrical Inspection or been Gunnited. This will put the completion date of the pool to be way past.
the date that was proposed to us in the contract.
We have been informed that the flex installed in the Spa is of questionable materials and not UL Listed
Approved for Application. Therefore, the materials installed must be removed and replaced with UL Listed
Materials.
The only option that was, given to us for the placement of the Pool Equiptment, was in a location that would
not be within .code unless a barrier wall is installed around the Equiptment. This wall would be an additional
cost to the owners. We have since found that there are several other locations that the Equiptment can be
installed without additional cost to the owners.
Due to the length of time and the problems we have encountered, we the owners, choose to cancel this contract
and seek other contractors to complete this pool. We believe that this is in our best interest.
All fees owed to Original Contractor will be payed for work completed up to Pre-Gunnite Inspection.
This includes First Draft of Contract, all Labor' and Materials installed to this date. These fees will be paid
upon receipt of Unconditional Waiver and Release form along with signatures of all Material Suppliers,
Sub -Contractors and Laborers involved in this Phase of Construction. This Release form is as persuant to
Section 3114 of the Civil Code and must be provided prior to payment of work completed on draft one.
Upon reciept of Release Forms and Payment, Contractor will be released of any Contractual and Legal
Obligations to this property.*
Sincerely,
�7'/n
Jeff Williamson and
Kerri Williamson
Tdf
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 0=4--00` 500 366 Date 7/06/04
Property Address 5464-0AVENIDA RUBIO
APN: 774 -272 -007 -18 -000,000 -
Application description . POOL - RESIDENTIAL
Property Zoning . . . . . COVE RESIDENTIAL
.Application valuation . . 15000
Owner Contractor
WILLIAMSON KERRI KOREN /Jtj�p PURRFECT POOLS & CONSTRUCTION
I E P.O. BOX 1524
//�� CA -9�� PALM DESERT CA 92261
��•�o�f�!%fi /io X22.53 (760) 568-4963
WCC: STATE FUND
WC: 1680230 10/01/04
CSLB: 483498 12/31/05
CCC: C53
------------------------- --------------
MECH POOL
Additional desc
Permit Fee . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation 0
Qty Unit Charge Per�a �'�0�� to sion
BASE FEE •5.00
.1.00 -- -_--9_0000 EA MECH FURNACE <=10% '��' (�v��R. 9.00
------------- ----- Q"
Permit BLDG POOL PERMIT
Additional desc
Permit Fee . . 162.00 Plan Chec ee 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
1.00 30.0000 EA ELEC,PRIVATE SWIMMING POOL. 3'0.00
P.O. Box 1504
78-495 CALLS TAMPICO � VOICE (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date:
Applicant: I Architect or Engineer:,) A
Applicant's Mailing Address: n
Architect or
Lic. No..
t3UILUINU 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 Lic'II forV anM
Cr License Class License No _q ' '` &
Date to Contractor 4.-P Q ��
OWNER -BUILDER DECLARATION
1 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. , BA P.C. for this reason
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
is5�e�� M wo rs' om en anon insurance carrier nd policy ber a
_Cartier - _4.C-� policy Number��j 0
V _ 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 3700 of the Labor Code, I shall
forthwith comply with those provisions.
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.
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
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 property for inspection purposes.
r---- -Date '+c Z9 8 Signature (Applicant or Agent): C�
a y
Page 2
Application Number 04-00005363
Date '7/06/04
Permit . . . . . PLUMBING
Additional desc
Permit Fee . . . 27.00
Plan Check Fee
6.75
Issue Date . . . .
Valuation
0
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. 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 258.00
.00 .00258.00
Plan Check Total 129.30
.00 _00
-129.30
Grand Total 387.30
00 .00
387.30
.i
07/04/2004 05:38 760-360-9829 PURRFECTF'OOLS PAGE 06/06
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CITY OF LA QUIN`FA
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1.
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DATE BY C-\ ��'�j .
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
.,APPROVED
FOR CONSTRUCTION �llrf��tt
DATE
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