09-0312 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000312
Property Address: 43439 BORDEAUX DR
APN: 609-380-997-51 -293233-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 30000
Applicant:
T4ht 4 4a Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MAZZULLA RESIDENCE
43439 BORDEAUX DR
LA QUINTA, CA
LA QUINTA, CA 92253
Contractor:
Architect or Engineer: FAMILY POOLS CONSTR
1 P O BOX 283
LA QUINTA, CA 92247
(760)564-3655
Lic. No.: 658996
KENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perju t t'I am licensed under provisions of Chapter 9 (commencing with
Section 0001 of Division 3 of th and Professionals Code, and my License is in full force and effect.
Licens las C53 License No.: 658996
Date: Contractor:
OWN •BUILDER DECLARATION
I hereby a firm under penalty of perjury he I am exempt from the Contractor's State License Law for the
following reason ISec. 7031 .5, Business an Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair a y 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 70001 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).:
(_) 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.).
( ) I 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:
LQPERA11T
1,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/07/09
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 perforo'Driqe of the work for hich this permit is issued. My workers' compensation
insurance carrier an poli y number
Carrier STATE FUND )icy Number 1344032
1 certify that, in the peAsto
f the work for which this permit is issued, I shall not employ any
person in any mannbecome subject to the workers' compensation laws of California,
and agree that, if Ime subject to the workers' compensation provisions of Section
370of the Labor f hwith comply with those provisions.
Date: Applicant:
WARNIN FAILURE TO SECURE WORK RS' COM NSATION 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 applic io becomes n and void if work isnot commenced
within 180 days from date of issuance o such ermit r cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that he a ve information is correct. I agree to comply with all
city and cou tiy ordnances and state laws relating to b ' construction, and hereby authorize representatives
of thi un�ltlt' to mer upon the above-mentioned prop y ns ction purposes.
Date: I Signature (Applicant or Agent):
Application Number . . . . . 09-00000312
Permit
. . . BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 284.50
Plan Check Fee
184.93
Issue Date
. .
Valuation . . .
. 30000
Expiration
Date . . .10/04/09
PLB
WATER INST/ALT/REP
Qty
Unit Charge Per
3.0000 EA
Extension
GAS PIPE 1-4 OUTLETS
BASE
FEE
252.00
5.00
----------------------------------------------------------------------------
6.5000 THOU BLDG
25,001-50,000
32.50
Permit
MECH POOL
Additional
desc .
Permit Fee
. . . . 26.00
Plan Check Fee
6.50
Issue Date
. . . .
Valuation . . .
. 0
Expiration Date . . 10/04/09
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 . . 10/04/09 '
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 . . .10/04/09
.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
Application Number . . . . . 09-00000312
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary
Charged
----------
Paid
Credited
--------------------
Due
----------------------------
Permit Fee Total
388.50
.00
.00
388.50
Plan Check Total
210.93
.00
.00
210.93
Other Fee Total
2.00
.00
.00
2.00
Grand Total
601.43
.00
.00
601.4.3
J
LQPER1%11T
ll�
,j T y O� LA (QUINTA
BUILDING OF_
DEPT.
F R ONS
(Q A EKY
DATE_ �. C:: �..n
PFPPY IIAZZUL-1-A
4343 POPL)F14 JX PPAIF
TAPiffSTPY/F.SPLANAPE - I -A QUINT -A
J�a/nvd
Construction
Pools Spas Fovrdains
C760r64-3655
t -1c, #658996
O
Q.-
26'
Bin #
Permit
ii
' t
Qty of La QUinia
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
v Owner's Name: /►% /Wa
A. P. Number:
Address: liG
Legal Description:
Contractor: �/�%�
��•
(�L�
City, ST, Zip: J
%,,5,
c—U%i�c� Telephone: ryti<
if.
Address:
Project Description:
City, ST, Zip:
2� . ,
Telephone:
State Lic. # :
Arch., Engr., Designer:
City Lie. #.:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
`"%'`'''"`"'' Construction T e: Occu ane
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
--,Tj3 Estimated Value of Projec . 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"a Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees