06-3557 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, 'CALIFORNIA 92253
Application Number:
06-00003557
Property Address:
57750 BLACK DIAMOND
APN:
762-370-032- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
33000
Applicant: Architect or Engineer:
alA
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 lass: C53 License No.: 818149
ate: V mractor: _
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, 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.).
(_) I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERNIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/06/06
Owner:
RUTH WILLIAMS
57750 BLACK DIAMOND
LA QUINTA, CA 92253
Contractor: e
LAGUNA FALL OL S S
81730 HIGH 11, STE #2
I760) CA 0 OCT 11 2006
(760)347-8
Lic. No.: 18
CITY OF LA QUINTA
FINANCE DEPT
------------------
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 CALIF. INS Policy Number 46001785-0101
_ 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, i should become subject to the workers' compensation provisions of Section
3700 of the Lab ode, I shall forthwith comply with those provisions.
ate: �v'- (� plicant:
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 coy ty to enter upon the above-mentioned operty for inspection purposes.
te: Si re (Applicant or Agent).
Application Number . . . . . 06-00003557
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
304.00 Plan Check Fee
197.60.
Issue Date . . . .
Valuation . . .
. 33000
Expiration Date
4/04/07
Qty Unit Charge
Per
Extension
BASE FEE
252.00
8.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
52.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
4/04/07
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 . .
4/04/07
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
4/04/07
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. ALARMS/BARRIERS
SHALL BE IN
LQPERMIT
0
LQPERMIT
Application Number . . . . . 06-00003557
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 408.00 .00 .00 408.00
Plan Check Total 223.60 .00 .00 223.60
Grand Total -631.60 .00 .00 631.60
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sleeves
Existing
drainage
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Existing
deck
Covered patio
r
511 / umbreiia
sleeves
\ 7' Spa
+1811
3
Stacked quartzite 18'11
18'11
spillway 511
2'
Umbrella
J sleeves
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Existing F
O drainage
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?deck
sting 24'1
Existing
deck
Covered patio
Ruth Williams
57750 Black diamond PGA
LaQuinta ca
Covered patio
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'L
FAIRWAYS ASSOCIATION
September 27, 2006
Ms. Ruth wManns
57-750 Black Diamond
La Quina CA 92253
Re: Architectural Submittal - Pool and Spa
T79-7177
At the September 11, 2006, Amhhecarral Committee mm -ting tine coammitoae reviewed and approved tie
submitted plans, As the requiredfication fee has not been rmived, it wM be deducted from your
construction deposit refund check upon completion of the installation.
If you have any questions m regard to this correspondence please contact the AssocWon office at anytime.
Sincemly,
PGA BEST FA.dRWA YS ASSOCM 77QN
77 -IE ARCFMC7MAL CQWM=E
BF Nancy C Parkinson OC Hk CMICA
PGA NEST Fairways Operations Manager
For the Atchitectwral Goy
Cc: Lagtma Falls CWtom Pools/Spas
File
Post Office Box 1.690 • La Quinta, California 92247• Phone (760)176-5100 • Fax (760) 776-5111
09-27-2006 11:15 LACUNA FALLS 7603478975 PAGE1
x
A
Bin #
City of La Quinta
Building al Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit 061
Project Address:7 - �j (7 bj qck D s A rnon Ii
Owner's Name: i1�5 Qu-t w , 1 IiAM 5
A. P. Number:
Address: !� '] _ 15 a G A J4 Z) t ,o vr, o,.,'
Legal Description: lj t r4 q- GA M, DEng-
�Ciry. ST. Zip: LA, U i ki A Cj �a53
Contractor: LA U NA �4' 115 c �S�J�t �6}S jy �j S
;Telephone: -)
Address:
'Project Description: s~il lq
City. ST, Zip: a) O 64 !t a0 I
Telephone::-)40 - 3Lll-4q�-%-
State Lic. # : \
City Lic. N: 00
Arch., Engr., Designer:
Address:
City. ST. Zip:
Telephone:,
..,.
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: ')Gm' �Z-
Sq. Ft.:
# Stories:
p Units:
Telephone* of Contact Person: —)4.0-410-1003
stimated Value of Proiect -:;�3 0vZ�,
APPLICANT: DO NOT.WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calm
Plans picked up
Construction
Flood plain plan
Plans resubmitted
11ltc113nic31
Grading plan
P" Review, ready for corrections/issue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Dttd
Plans picked up
S.M.I.
N.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
AA.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees