05-1618 (RPL)0
Ot
u1cv
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760)1777-7012
-495 CALLS TAMPICO FAX (760) 777-7011
ALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
APR 9 9 2nQ5 BUILDING PERMIT
ciryo�
App F' o r . . . . .
Property ,.ess . . . . .
APN:
Application description
Property Zoning
Application valuation . . . .
05-00001618 1 Date 4/28/05
80415 CAMARILLO WY
772-250-997-118 -31349 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
Owner Contractor
--------------------------------- ---------------------------------
TOLL CA V CALIFORNIA POOLS & SPAS
C/O KEVIN D DUERMIT WCC: SEABRIGHT INS
8901 E MOUNTAIN VIEW 200 WC: BB1050510 01/01/06
SCOTTSDALE, AZ 85258 CSLB: 656128 10/31/06
CCC: C8 C27 C29 C53
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P.O. BOX 1504�� VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:�� 5' Date: Z� OX
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licens un provisions f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and ss License is i ull force and effect. �j
License Clas%s�=/."j��' Lice e No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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 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 Contractors' 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).):
U 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 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
i/ of the work for which this permit is issued.
)t
Ave a d will maintai orkers' compensation insurance, as required by Section 3700 of the L bor Code, for the performance of the work for which this permit is
orke 'compensation insurance carier and o{i Vy7nber ar
amer. Policy Number
_ I certify that, in the performance of the work this permi is issue , I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and a ee hat, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
�Jorthw�ith comply with those pro ' ionss..
Datev�G Applicant
WARNING: FAILURE TO SECURE WOR ERS' 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.
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 � `
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 Ouihta, 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 andFvrks 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 igree to comply with all city and county ordinances and state laws relating to building
construct" ,d hereby authorize representatives of this count �t nter upomentioned property for inspection purposes.
Date �G ( �� Signature (Applicant or Agent):
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Application Number . . . . . 05-00001618
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Permit . . . .. .
Additional desc
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
BLDG POOL PERMIT
189.00
10/25/05
Plan Check Fee 122.85
Valuation . . . . 17920
Qty
Unit
Charge
Per
Extension
BASE
FEE
45.00
16.00
-----------------=----------------------------------------------------------
9.0000
THOU BLDG
2,001-25,000
144.00
Permit .
.
MECH POOL
Additional
desc
Permit Fee
. .
. .
26.00
Plan Check Fee
6.50
Issue Date
. .
. .
Valuation . . .
. 0
Expiration
Date
10/25/05
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
10/25/05
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
10/25/05
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
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3.0000
EA PLB
GAS PIPE 1-4 OUTLETS
3.00
Permit . . . . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
WALL/FENCE PERMIT
15.00
10/25/05
Plan Check Fee . . .00
Valuation . . . . 80
Qty Unit Charge Per Extension
BASE FEE 15.00
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Special Notes.and Comments
POOL & SPA ONLY. 5 L.F. 4' BLOCK WALL,
CITY STANDARD..ALARMS/BARRIERS SHALL BE
IN PLACE PRIOR TO PRE -PLASTER
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Application Number . . . . . 05-00001618
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Special Notes and Comments
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 308.00 .00 .00 308.00
Plan Check Total 148.85 .00 .00 148.85
Grand Total 456.85 .00 .00 456.85
g;n # '
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
05 -/W
Project Address: t�—Cwko Lo
Owner's Name: '-()1,t D
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: COLLI,ro M Iq POOLSTelephone:
Address: t7 e0x zw
Project Description:
City, ST, Zip: 6�,�
Iot A -
Tele hone:
State Lie,. #
City Lie.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
:>::z?;:>s
onstruction Type: Occupancy:
State Lie. #:
type t Project a circle one : Ne Add'n Alter Repair Demo
J ) P
Nalne of Contact Person:NAN S4Ej�
Sq. Ft.:
# Stories:
#Units:•
Telephone # of Contact Person:.2-,,�5'-f l�& f `
Estimated Value of Project: Jg067--k�::)
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 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 correctionsliissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
.INHOUSE:-
''" 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
7 H .. .. F.. I A�1. h_
A
1
----- - - - - --
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SPECIFI; AT ONS
tA INS ISIZ1
TYPE
SURFACE. AREA Or PODL ' :> ; _� i. I
�`.r
r''Jp_ E'erAi( f
PfRlhitTER DEPTHS MYk,
SPA SPECIFICATIONS TILE
91TE x M FT. tSK—
_ �1L>: TYPE F
r
SPA CAN WALL AD WATER LINE � -
Np, OF JETS { TILE TRIM — _--'
LIGHT i - a s+� ULIARfER ROUND --
RAISED SPA p.T---
SPIL,LWAY rfK a 1
'
S --
SP€C:AL NOTES
DECKINC
EXCAVATI h! STEEL Sa El;
FINISH
TAT€ _
A�rcESSy/,ROM ��- �E.XPA{�NnON+EOWTS
' WOKMEWFR Y
r, �rA-l QN
DECK DRAINS ' �
DEEP ENO RAMP
LOVE SEAT DEOX DRAIN
GQNCREI: "OVAL Lms OURS DONE
SW RE1+I0VAL LOADS STEPS
,REE REMOVAL 3T STEP FACE - -
41.IRIGATION RE144YAL TILE 8A5E
�
IRNUAAllDN REMR WI) AND YIS+-"
6' FLEJ3. RIBBANS $$ 4 tL Ia J�*L' �
12' R_a2. WOW s7fu
18' R,a.B.
Z4' R.B.B. — - —
TAN 5HE!F UFT4i sf "'� _ — I
Oy
MASONRY
ROCK POCK
CCPING TYPE
CENTERS R.BJB. FAojgr.
SPILLWAY TYPE SEE 1
PLUMBING sTE�
EtLTER s?Z l PROP. M. WALLS-"
POOL PUMP CfS 51ZE PLAN70 WALL
�iETAINING WALLS
90051TR PUMP51TE EQUIP. WALLS
ADO'L PlUQP SITE i Pl"T
ACC T PUMP 97C '- L �A � P tF-_
HEATER SIDE r
TTNE CLOCK
n J
SUB PANEL -
A19ft OU
SXIMMER TYPE
FILL LIT PEBBLE PLASTE -
�- j f 1+ti LIGHTS
CAS UNE 5PJ95
110FIT'S SPA
FOUNTARI5J5PRAYHEAM- -� ROLLED 110NO DCA9 -
VffR OESC WHIND EPA r`
A f r " EYEBAISS _.
LIQi18 IN POOL SPA
STUB SET EOiAPMENT FENCING
misc.
FE7VGE TYPE
Fl_uveING SLM
HEIGHT
GATE
GUNITE GATE REVERSAL
DEP END RAMP � JiF_MGW & RpHANO
E TENIIEG end STEP
r, LOSkSEAT
SFlLiWAY nP
EST. START
EST- COr�rr'LET10N
CAlfTELE44R
U.% - SEE STm
� '�a +•.9---
OWIER TV: (1) DETERMINE the JIPPRUAWATE ELEVATION OF PDOL OR SPA AT LAYOUT N CAY OF EXCAYATICN
(2)- TAKE NCMCE THAT POOL AND LUUIPNENT LJ}C A-11DNS ARE %3,EDr'0 ACCEPTANCE CF
LOCAL SUILDItcG dEJ'ARTLII'j•IT !1� Ti+IE OF Tlli•Ire OF PJiRUIT
(3) WET T} M COWORETE SHELL AT LEAST T✓dCE OAELY FOR SEVEN DAYS AFTER 5X L IS INSTALLM
(4) AGREE THAT CAUFORNIA PODS IS NOT RESPONSI9LE FOR UNDER�WNO CON1311"S 4R OBJECTS,
ANb ANY i)IWIVCF 1V CUk9Sl SIt7EnAU45, ORIYE4VhYS, LAth}iS. OR OhiElt fID15 IN TH1= AC{.'ESS ARFA
(5) SEE; THAT ALL FFNNONC, CAIE5, AND OAHAGE DIDDRS MEET LOCAL DUDES FOR A POOL ENCLOSURE
PRiCR'0 PRFFLKSTER INSPEGTIDN
(6) FlLL, POOL IMQFDIATrLy AFTVt PLASTER. (l'DLLUK INSTRUCTIONS DO NOT USE RU88ER HOSE)
{T) TAXE NOTICE tKAT THIS OAWNG IS THE SOLE PRLWEM OF GAUFOWIIA POOLS AND THAT ANY
USE MTHOUT WRITTEN PERL{4SSON #F CAI.JFONNIA P,7C+LSF WC. 15 P344SLT BY LAVE,
OWNER APPROVES PL W, POOL AND EOUIPWEHT LOCA71flNS AND HAS RUD THE RMPO S1R1uT1ES AND t1UT'1GE5 ABOVE.
I
SIGNATURE(S) LJAIE
SWIMMING POOL PLAN FOR:
0267 PA SN `1 E ! 11 SCE
S71REET 'b0- Li IS
VJ y
J09 ADDRESS
ICITY
PHONE OFFICE
RE
LOT TRACT
WAGE BOOK f
MAP BOOK PACE NO.
CITY
MAIL ADDRESS
CONSTRUCTION OrRCE
PHONE NC,
SCALE;
1/8"=zl`
DATE
- D o '
DRAWN BY
;:v�) qg;l
SOLD BY
1�11H
CHECKED SY
,SOB#
REVISIONSDATE
w. ■Tw e S
1
I
1 1l r 9 ■ •
BUILDING & _SAFM DEPT.
MIS '-ONS1€ U rrON
1
SELECTIONSI
CONSTRUCTION UTH I, TI STONE- �
TILE
sit
111 S liI G,LIi) �
BOULDERS
Ne PR G UNITl ~ DECK COLOR 14A l�l�
L
UNDE-1ZGRUI_ ND JANDY 4-6
trOr'R PEBB.%PLAS i
SIGNATURE
I'#kl�-I'r1313L�: DRAINAGE NOTE: DrainJ�ge e7d irriga}ion for plgnters -and pots, by
others, unless otherwise noted.
0
F)
to CN
ry 0
N
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SC
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