11-1300 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 00001300
Property Address: 5T86.0 A ADINVER MIREZ
APN: 773-171-006-19 -000000=
Application description: POOL -RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 20000.
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/05/11
Owner:
TAMIAS JOSE A
51860 AVENIDA RAMIREZ
.LA QUINTA, CA 92253
!f� 0
i
Contractor: DECOGUES , JULIO CESAR "' 0
46625 DESERT VILLA 01
INDIO, CA 92201 � CITY OF
(760) 397-7699 Ir)�'�+�G't:13'%PT.*
Lic. No.: 946375 — -
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION "
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: -
Section7000) 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 'Class: C53 License No.: 946375
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
'
issued.
ate: t� ah
.I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor '
.tractor: ,1
Code, for the performance of the work for which this permit is issued. My.workerscompensation
OWNER -8 ILDER DECLARATION
insurance carrier and policy number are: ,
I hereby affirm under penalty of eerjury that am exempt from the Contractor's State License Law -for the
Carrier EXEMPT _ Policy Number -EXEMPT
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{equires the applicant for the
person in any manner so as to becomesubject 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 agree that, if I should becomesubjectto the workers' compensation provisions of Section "
License Law (Chapter 9 (commencing with Section. 7000) of Division 3 of the Business and.Professions Code) or
3700 of.the Labor Code, 1 shallforthwith comply with those provisions.
that he or she is exempt therefrom and the basis for -the alleged exemption. Any violation of $ection'70.31 .5 by .
any applicant for a permit subjects the applicant to a civil,penalty'of not more than five hundred dollars 155001•:
D- Applicant:.
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work; and
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECU,j WORKERS' CbMP.ENSATION 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. RIMINAL PENALTIES AND CIVIL 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, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is soldmithin
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 I, as- owner 'of the property, am exclusively contracting. withlicensedcontractors to construct the project (Sec..
IMPORTANT Application is hereby madeto 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 contractor(s) 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 ofthis application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
of La Quinta, its officers, -agents and employees for any,act or omission related to the work being
performed underor 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 thja coun�entereabove-mentioned property for. inspection purposes.Date: (Applicant or Agent): -"
i
Application Number . . . . . 11-00001300
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. . .
. 20000
Expiration Date . .
6/02/12
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
6/02/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
--------------------------------------------------------------------7-------
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
6/02/12
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
6/02/12
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
LQPERMIT
Application Number . . . . . 11-00001300
Permit . . .' WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 31.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 1300
Expiration Date . . 6/02/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
8.00 2.0000 HND BLDG 501-2,000
16.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 52 L.F. 6' BLOCK 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 342.00 .00 .00
342.00
Plan Check Total 160.55 .00 .00
160.55
Other -Fee Total 1.00 .00 .00
1.00
Grand Total 503.55 .00 .00
503.55
LQPERMIT
CITY OF LA QUINTA.SUB-CONTRACTOR LIST
JOB ADDRESS PERMIT NUMBER OWNER BUILDER
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. i -or eacn.appiicadle trade, all intormation requested below must be completed by applicant. "On File" is not an acceptable response.
Trade: /Classification
Cdill"otor .
State: Contractor's Lrcense
1N0*iers Compensation
insurance
City.Businoss License,
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date.
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
EARTHWORK (C-12)
C-53'"�
' _(Z_
v b Z
p(xx/xx/xx)
CONCRETE (C-8)1
VCA
OL
1'.
Q -3(A
S Qf N(-QeAPCV
10 620\ _10-51-a
.FRAMING (C=5)
STRUCT. STEEL (CG5.1)
Leo
C
�C�-tG3�s--�2
N
NI;a
reap
z_
MASONRY (C-29)
U .��.t✓J Al-
6
12-3t-1%
- 5-12,
(.� 5
.A
N.- -
PLUMBING (C-36)
ooa 1 W G
/r
�1 ,
I
6 �
i
WGIbowi16
_
10 1 q21
.y..
LATH PLASTER. (C-35)
f
DRYWALL (C=9)
HVAC IC.", 2U)
j
ELECTRICAL.(C_1 01
v (; X15 '�cA.' '
- lJ
3Z•
l?r "��:,,.
v'f VY� :1
.I
_ '12
;�� !-�Vi
-ZC-IZ
ROOFING: (C-39). •-
;
SHEEVMETAL (C-43)
FLO.ORIN.P.J.P 15)
GLAZING (C-47)
: r
INS0LATION::(-.=2)
r ,
SEWAGE *DISP: (C-42) .
PAINTING: (C-33)
CERAMLC.•TILE (C-54) ,, C. b3
CA61NET-S:(C-6)
FENCING (C-13)
LANDSCAPING (C-27)
POOL (C-531
x
Bin #
City of La Q'uinta. ,
Building0 Safety;"Division
O Box 1504, 78.495, Calle:Tampico'
La Quints, CA`Q2253 = (760) 777-7012
Building Permit Appl[cation :and Tracking Sheet
Permit #P
`, \3
Project Address:. ,. Aje . _,t
Owner's Nacre: ` •
A. P. Number:
Address: /
6
Legal Description: Toot- 5 q LCity;
ST, Zip;;CA2
Contractor:
'Telephone:
Address: G46- 2•
Project Description:
?06L_ WD
City, ST, Zip: 2!0 .
Telephone:
� S
•
State-Lic #9 City Lic. #: , . ".
Arch., Engr:, Designer:
CJ 6 i'O Gk: i't/lt
Address:
City, ST, Zip:
Telephone:
`':>::^s;,>r`«�>z<:>.<:� w>;>::°�%::, :.,:�;�.::
yiU}:}�q-0FIYN:'��'::'rfi•;:,3;$i`.?i.'$x,:`'.,�,jix,.}
;h < ...�
`Construction Type: Occupancy:
State Lic. #:
_
Project type (circle one); Add'n Alter Repair Demo
Name of Contact -Person: (Q .
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 7ec: -
Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW -THIS UNE
#
Submittal
. Req'd .
Reed
TRACKING;
PERMIT FEES
Plan Sets
Plan Check submitted
�2/ l
Item-
Amount
Structural Calcs. t
Reviewed; ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
;Plan Check Balance
Title 24 Calcs.
Plans picked up
-
;Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsfssue
Electrical
Subcontactor List
:Called Contact. Person 1
Plumbing
Grant Deed
Plans. picke&,up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
'Developer Impact Fee
Planning Approval.
Called Contact Person
FA.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
E'
,Total Permit Fees
I
N) RAISED BOND SEAM AT ;+I2" / +18
WITH CONCRETE GAR, TILE VENEER TO
Z 0 N E
R,E'5lDEN(,,,E
5" BELON ViATERLINE, THREE WATER
EMITTINC7 500NOES TO RUN OFF �
CIRCULATION FRUMP HITH MANUAL SHUT �y
OFF VALVE. I I I 15 r{n ni
(N) STONE STAMP --
CONCRETE AREA
(N) POOL -----
(N) PLANTING ----
AREA
(E) EGRET ------
AREA TO BE DEMO
AND REMOVED
(E) A/C CONDBNCER
TO REMAIN
RC, ZONA
R��IDEN�E
V -01i
SETBACK
(E) MA50NRY KALL
w/ SATE AND AUTO
LATCH TO REMAIN Lu
a
L
O -
(E) GA5 METT ER
TO REMAIN
(E) OONORET
MiVE WAY
TO REMAIN
} a14
ROOM,
6E #J!314!3
43AtiAt3E
C�
O
(F)
*14TRY
10
FITC ieN
(N) MA50NRY BLOCK
WALL~ TO BE N57ALL
Q
51_0ff
5ET5ACK
+ .
10 RtMAtN
VK SYlllf4MNS POM AMA
ICK irm STANK CowftTE
_... (E) MAIN ELEC
-METER PANEL
To REMAIIN
ul
R(,,; ZONE
,�y c;
F,,,,E5l1)E,N6E
%7-- (E) -MASONRY POKEY WALL
and WOOD 1=ENGEiN0
N1 OATE AND AUTO LATCH
TO -REMAIN
(E) WALKKAY
TO REMAJN
(E) SOD
TO REMX'N
(E) 2 TREES
TO REMX)N
®m
EX6TINO SITE PLAN �GP�..E: �/8"=!'-D" 2
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