08-1578 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant: Architect or Engineer:
P"
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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: C53 A License No.: 897835
ate: 2 ractor: Ad
OWNER-BUILA 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, 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 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 ownei 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.).
1 _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
Ihereby 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
Owner:
LANGWELL OAT
44415 CA
LA QUINT
Contractor:
SHARK PO
82253 HI
BERMUDA
(760)275
Lic. No.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/17/08
-
-------------- - - -
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.
g 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 STATE FUND Policy Number 1890440-2008 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 Cod. `ee, I shall forthwith comply with those provisions.
ate:?�(� 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 15100,0001. 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 ou1AAAnttyy�tto(1�enter upon the above-mentioned property r ins ec oses. ��--
a1 t�M ► fws Sig re (Applicant or Agentl:
It -
Application Number:
08=00001578, .
Property Address:
44415 CAMINO LAVANDA
APN:
604-193-029-25'.-25290
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
35550 ,
Applicant: Architect or Engineer:
P"
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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: C53 A License No.: 897835
ate: 2 ractor: Ad
OWNER-BUILA 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, 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 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 ownei 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.).
1 _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
Ihereby 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
Owner:
LANGWELL OAT
44415 CA
LA QUINT
Contractor:
SHARK PO
82253 HI
BERMUDA
(760)275
Lic. No.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/17/08
-
-------------- - - -
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.
g 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 STATE FUND Policy Number 1890440-2008 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 Cod. `ee, I shall forthwith comply with those provisions.
ate:?�(� 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 15100,0001. 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 ou1AAAnttyy�tto(1�enter upon the above-mentioned property r ins ec oses. ��--
a1 t�M ► fws Sig re (Applicant or Agentl:
Application Number . . . . . 08-00001578
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 323.50 Plan Check Fee 210.28
Issue Date . . . . Valuation . . . . 35550
Expiration Date 3/16/09
Qty Unit Charge Per Extension
BASE FEE 252.00
11.00 6.5000 THOU BLDG 25,001-50,000 71.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/16/09
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 3/16/09
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 . . 3/16/09
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
LQPERAIIT
Application Number . . . . . 08-00001578
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 427.50 .00 .00 427.50
Plan Check Total 236.28 .00 .00 236.28
Grand Total 663.78 .00 .00 663.78
LQPERAIIT
Bin # City of La Quinta
Building & Safety Division
Permit # ^ P.O. Box 1504, 78-495 Calle Tampico
`� 1 v La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: L°�� . 41 S (./� I ( A SL�4 Owner's Name: (�'
A. P. Number:
Address: 9 _ t L t, 25 L
Legal Description:
City, ST, Zip: � ,� Z2
Contractor: A� C
Telephone: '
Address: �� J
_
Project Description:
City, ST, Zip: IJ
3
/ 3(r-
Telephone: l
_ co�
0
State Lie. # : 835
City Lie. #:IQ S Q
5 ? 4, V`
Arch., Engr., Designer:
Address: 8 2 • IE3 tVt
City, ST, Zip: M D >-L-C) 7
Telephoner .
State Lic. 9:8:�q g35
Construction Ty -Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: J Sl o lev I
Sq. Ft_: +q I
I # Stories: #Units:
Telephone # of Contact Person: 'L� . '} 5 6 Estimated Value of Project: 3�
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
r" Review, ready for correctionsfissue Electrical
Subcoutactor 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
Pool & SP
Clark & Sally Lanov...
41 ms
HH t CA'
b .-amlnO L01 i n
9225 0 6 0 MW j C.:: 4a C)
- - - - - - - - - - - -
Ipmeru
10R>
71
16" Wide Snnda-v-,
CL
71
+24" High Nei4 Spa
.... .... .... .. ................ .... ... ... .. ...... ......... . ....... . ........ . ............ . ... . .......... . .. . . ... . ........ . ..... . ............. .. ....... ..... . ............... . ... . ..... . ... . .... .. ..........
ti
ms
1
Property Un,
II
------------
z -10 1041811
Wood- Service Gate
to be Removed Acces
%zkqrV1Tj1Vr
P.
PROPERTY LINF-
1�
1 - 1L
00 ti
r�A-C-A
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36
16 R. fit D.
New Pod
361--
36t
Ai-itoNll
. ..... . .....
�:teps to the P('01
760-347-2079
760-578-E15-667
Toll Free 366-97-
Shark
Lic
# 897835 C5
CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVED
FOFJ CONSTRUCI"
QN
0 ;6, 4 1-sew C*1K
ill 61f . ... ...........
j
umli-x-,113 1a'Ieve I
Underground Service Alert
,C�C]Rf—..
Call: TOLL FREE
1-800
422-4133
TWO WORI(ING DAYS BEFORE YOU DIG
Is Bandini
GENERAL SPECIFICATIONS:
If any ERRORS, DISCREPANCIES or OMISSIONS appear in -he drawings,
speciikofons or other contract documaft, the GENEPAL CONTRACTOR
shall notifythe designer in writing of such error or omission.
In the evert Thai the GENERAL CO-14TRACTOR 4ails to give such notice
before cons [rud c n and/or fabrication of the worTHE GENERAL C 0 N -
�Scale 7/32" 1 Ft
------------------------ ---------
TRACTOR WILL BE HELD U-90NSIBLE to the result of any errs-s, d1s.
c re pa in ces oromissions and the cost of red i rig the same.
POOL SPECS
SIZE,
SOFT:
DEPTH:
PERIMETER:
EST TOTAL GALLONS:
SKIMMER&
RETURNS,
INTERTOR MATERIAL:
5PFCIAU
TILE:
NOTES.
SPA SPECS
SIZE:
5w:
DEPTH:
PERIMETER:
F5T TOTAL GALLONS i
SPILLWAY:
RAISED HEIGHT.
%1MMFRS-,
RETURNS;
TILE:
INTERIOR MATERIAL:
SPECIAL'
NOTES:
PLUMBING
PMRNS.,
SKIMMERS:
POOL MAIN I)RAINS,
SPA MAIM DRAINS.,
CLEANING SYSTEM:
HEADS-.
VAC LINES:
ROBOT VAr--,
I WATER FEATURES,
SPA SPILLWAY:
LIGHTS IN POOL
LIGHTS IN 5PA;
TOTAL PIPE:
-SPECIAL:
NOTLS:
DECK
DECK TYPE,.
ELEVAT104:
TOTAL DECK 5,QFF:
PERIMETER:
RA5E1) BEAM:
UP STYLE.
MATERIAL 1:
MATERIAL is
SPECIAL:
—
NOTES:
EQUIPMENT
POOL PUMP:
ZNI) PUMP:
FILTRATION:
FILTER SIZE:
HEATER:
INLINE:
TIMER'
GAS:
r------------�W ----------------- --�:,--------- -- ---------
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ii0l 211 PROPERTY LINE
Existing Planter c6z�,
I
71 ,
6 Ft. � W, .
IN Pool
71
i Aelps to tllwl Pool
+ '` High New Spa
.................__... _.... _.... .... .... ..... _....... ......... - ... _.... - ... .........
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1041 8"{
Wood Service Gate E
to be,,kernoved
351-
36
Autn R
-347-2 7 60-57 -.5 6
Toll Fr - 7- Shark Lic # 897835 C5
V'
_' h �-Lpp a
cmr of LA QuirvrA
sutojNa & snow oeaT
APPROVED
Fow con4sTmcm9q
fl Pel.A 6fFF dQGf'
Scale 7/32"' _ 1 Ft
I
I
k
1
I
I
Ln
I�
Underground Service Alert
aI : TOLL FREE
_ 1.800
-4 1 3
TWO WORMISIG DAYS BEFORE YOU DIG
GENERAL SPECIFICATIONS:
If any EI RJR , DISCREPANCIES or 0MISSIDNS appear its the drawings,
speciGcatons or 4teoract doCum nts, the GENERAL ��N
TRACrO R
shall natil the designer inwang of such error or ormssion.
In the event chat the GENERAL CONTRACTOR fails'o give such notice
before construction andlar fabficaiian of the work; THE GENERAL C0N-
TRACTOR WILL BE HELD RESPONSIBLE to the result of any errors, dis-
creponces or ominorts and the cosy of rectifying tie same,
POOL SPECS
ST1E:
SQFr
DEM:
PERIMETER:
F-sT TOTAL GALLOW:
SKIMMERS:
RETURNS:
INTERIOR MATERIAL:
SPECIAL:
TILE:
NODS:
_
SPA SPECS
DEPTH:
PERIM ETLR
EST TOTAL GALLONS:
5PILLWAY.
RAISED HEIGHT:
SKIMMERS; _
RETURNS:
TILE:
INTERIOR MATERIAL:
SPECIAL:
NOTES:
PLUMBING
RETURNS:
SKIMMERS:
POOL MAIN DRAINS:
SPA MATH DRAINS:
i CLEAN-ING SYSTEM:
HEADS:
YAC LINES,
ROBOT VAC:
I WATER FEATUPFS:
SPA SPILLWAY:
LIGHTS IN POOL:
LIGHTS IN SPA:
TOTAL PIPE:
SPECIAL:
NOTES:
_
DECK
QECK TYPE
ELEVATION:
TOTAL DECK SQF7
_ PERIMETER:
RAISED BEAM:
LIP STYLE:
MATERIAL 1:
MATERIAL. 2:
SPECIAL;
NOTES:
EQUIPMENT
POOL PUMP:
ZND PUMP: _
FILTRATION:
FILTER SIZE:
HEATER:
IN LIN E
TIMER:
GAS:
SPECIAL:
NOTES: