04-6157 (RPL)i
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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 . . . /04-000 0 615'7— _Date 9/03/04
Property Address . . . . X79865 BARCELONA DR M-23
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APN: 609-380-998-6 -29M3232-
Application description . . . POOL - RESIDENTIAL ff'
Property Zoning ... . . . . . LOW DENSITY RESIDEN+I�I L SEP G 7 ZOOM
Application valuation 19800
CITY OF LA QUINTA
Owner Contractor FINANCE DEPT
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CAMILE COX - TOPMAN BUILDERS
79865 BARCELONA P.O. BOX 10202
LA QUINTA, CA PALM DESERT CA 92255
LA QUINTA CA 92253 (760) 772-7296
Qty Unit Charge Per
BASE FEE
ti
Extension
15.00
WCC: VIRGINIA SURETY
WC: 00500019402
01/01/05
CSLB: 455121
11/30/05
CCC: B -C29
------------------------------------------------=
Permit .
. . .
. . MECH POOL
---------------------------
Additional
desc
Permit Fee
. .
. . 24.00
Plan Check Fee
6.00
Issue Date
. .
. .
Valuation . . . .
0
Qty
Unit
Charge Per
Extension
BASE
FEE
15.00
1.00
9.0000 EA - "' ' MECH'
FURNACE <=100K '^"
9. 00
----7-----------------------------------------------------------------------
Permit .
. . .
. . BLDG POOL PERMIT
Additional
desc
Permit Fee
207:00-
- -Plan Check Fee
134.55
Issue Date
. .
. .
Valuation . . . .
19800
Qty
Unit
Charge Per
Extension
BASE
FEE
45.'00
18.00
9.0000 THOU BLDG
2,001-25,000
162.00
----------------------------------------------------------------------------
Permit
. . .
. . ELEC POOL PERMIT=RES
Additional
desc
Permit Fee
. .
. . 45.00
Plan Check Fee
11.25
Issue Date
Valuation
0
Qty Unit Charge Per
BASE FEE
ti
Extension
15.00
P.O. Box 1504�� VOICE (760) 777-7012
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78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0 7 — 6/,S- % Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Ad ress-
Lic. No.:
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 ispmn.fuUIL4orce and effec �5 Z
License Class�l�r�i Lihse No. 1
Data
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of palQemplos
empt 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 a er, 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 licensedth 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 orp 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 noti hundred dollars ($500).):
U I, as owner of the property, or mwith 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
Date Owner
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
ued. wo ers' corn ensation insurance carrier_anddpolicy number are:
Cartier 1� IIJI �-Q� Policy Number C�[h5si- ' � I -4%z2
I certify that, in the performance of t ork 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 ree the if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pro cions. /
Dat O Applicant
WARNING: FAILURE TO SECURE ORKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRE THOUSAN DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO E, INTERE T, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury tha here i 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 cancellaf
I certify that I have read this application and state that the above inform ion i 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 up o the ove-mentioned property for inspection purposes.
Date Signature (Applicant or Agent):
Page 2
Application Number . . . . . 04-00006157
Date . 9/03/04
Qty Unit Charge Per
Extension
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL
30.00
--------------------------------------------7-------------------------------
Permit . . . . . . PLUMBING
Additional desc
Permit Fee . . . . 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation . .
. . 0
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
----------------------------------------------------------------------------
Special Notes and Comments
POOL & SPA 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 309.00 .00 .00
----------
309.00
Plan Check Total 160.05 00 .00
160.05
Grand Total 469.05 .00 .00
469.05
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Certificate of Insulation N
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Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
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Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated o
with fire -retardant chemicals that will likely lose their effectiveness over time. It has not been treated N
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it a
settle over time as may other insulation materials. o
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This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home
to provide the following thermal performance:
Job Name: Tapestry at Esplanade Tract: 29323-2 Phase: 4
Lot #f.: 6
CeWng Area: R-38 Blown
Overhangs:
Witb Living Above
Pian: I Address: 79-865 Barcelona Dr., La Quanta, CA
Garage Ceiling:
Exterior Walls
Ceiling: Garage WaU:
Inaccessible to Blow
Signed
Interior Walls:
R-13 Unfaced Batts
Cantilevered :
Floors WlLiving Above
bcontractor.. OJ Insulation Co., Inc.
1 S. Vincent4Ada Ce 9,1702 (6241112-6070 License #465709
Conchita Ortiz, Secretary/Treasurer --dd- R. Scott Jenkins, President--or--
Lou Merola, Director of Operations Officer
R- means resistance to heat {low. The higher the R- value, the greater the insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the buyer.
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SWIMMING POOL PLAN FOR.
X RE51DENGE
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1, --fir ?— 16-04 JOHN CHARLENE
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