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04-3895 (RPL)BUILDING & SAFETY DEPARTMENT O. Box 1504 (760),777-7012 495 CALLE TAMPICO FAX (760) 777-7011 QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 Number . . ress . . . APN : Application description Property Zoning Application valuation . BUILDING PERMIT . . . 04-00,003895 Date 5/05/04 . . . 79420 CANTERBURY 775-032-009- . . . POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 13000 Owner .Contractor KOZUH MATTHEW G CALIFORNIA POOLS & SPAS 79420 CANTERBURY. P.O. BOX 1280 LA. QUINTA CA 92253 'COACHELLA CA 92236• (760) 398-9222 WCC: STATE FUND WC: 04600061168 01/01/05 CSLB: 656128 10/31/04 CCC: C8 -C27 -C29-053 ---------------------------------------------------------------------------- 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. Permit. ... BLDG POOL PERMIT Additional desc Permit Fee 144.00 Plan Check Fee 93.60 Issue Date . . . . Valuation 13000 Qty Unit Charge Per. Extension BASE FEE 45.00 11.00 9.0000 THOU BLDG 2,001-25,000 99..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 Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 P.O. BOX 1504�� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 7 5 Applicant: Applicant's Mailing Address: Date: Architect or Architect or Elhoihee(fs Address: 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, andmr - Li y Ucenssggis in full force and effect. `' �� �2 Ucense Cl M - 53 cense No. 6 13 Date J I 1 q 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 fife 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 I, as owner of the property, or my employees with wages as their sole compensation, will do the worts, 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 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sea 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 contractors) licensed pursuant to the Contractors' State License Law.). U 1 am exempt under Sec. , BA PA. 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 self4nsure 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. yI 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 i�sueQ. My worjwrs' compensation. insurance carrier and policy�ymber are: Cartier 4-f-Q-f'P a-tAA� Policy Number 0 5/(0/9//lo B _ 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 Code, I shall forthwith comply with those provi ns. Data `� / Applicant —i&tek 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. 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.). Lendees Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a perdu 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 penia 2. Any permit issued as a result of this application becomes null and void [two* 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 inforu4n 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 countyto ter upon ft above -mention property for inspection purposes. Date i " Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00003895 Date 5/05/04 -----------------------7-----------=---------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA. PLB FIXTURE 6.00 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 SPA ONLY. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary ----------------- Charged ---------- Paid Credited --------------------- Due Permit Fee Total 240.00 .00 .00 ---------- 240.00 Plan Check Total 117.60 .00 .00 117.60 Grand Total 357.60 .00 ..00 357.60 12 04 09259a N;Rt` kCr 05,22/2004 IG i3 ' 7607746145 Pdiay l2, 2004 Mi. & Mrs. Matt Kozuh 79-420 Caritebury La Quinta, CA 922.53 Dear Mr. & ibirs- Kozuh: PGA -WEST PAAE 0'1 i el The Architectural Committee bas aeviewed and appr®ved your request to install a spa and concrete decking at your 79-420 Cantebury residenee, We reserve the right to make a final inspection of this change to make sure IIIA it matches the onSinal request. lett appaoval is bid oily on the aesthetics of your proposed plan and should not be tatter* as .any ceitification as to the construction :worthiness or structural integrity of the proposed change. We want to reiterate that the maintmace of the spa and conemle decking being installed is solely the responsibility of the homeowner and will not be the responsibility of the Association. Tliis provision is mcorded with. the County of Riverside and runs with the land. We appreciate your cooperation in submitting this request for approval. If you have any questions, please contact me at (760) 771-1234, ext. 15. Sincerely, felly ,cc alliard Operations Manager, I the Architectural CosmY;ittee cc* Architectural Caiamittee 54320 Southern Hills, La Quinta, California 92253-5665, Telephone 760771=1234 FAX 760-771-3.125 .5PECIFI.CATiON-S SIZE- SURFA0E AREA OF PNX PERIMETER f)P'TH8 VK VAX. -SPA 5PECIFIGATIONS.-': TILE' SPA VAM WALL O ER IJ4 --NC:.'CF JETS— LW,HT QUARTER ROUND -OLL— RfiJS0 SPA AT R.ls.lk VkiWAY TYK SPIZOAL NOTES EXCAVATION ./ STEEL. TYPE ACCESS FROM ELZVAT ON S. C. tap END - RA40 LOVE SEAT PWAEFE REYOVAt Sm NWOVAL A75 G VM 0 NOVAL BY IRRIGATION. . REMOVAL AX CAn IRRIGATION REPAIR is' ir 18' P.R. EL 24' R.B.B. R.11D. TAN SHELF DVYTH 9= Foc9m cm lul�. 11 PLUMBINO 4A& FBI -TER St2E POOL pvmp 51 z E Mr,STER kMFP !97E: A001. PUPP 517E WE TWF. ELM RUB PAwn ADIV[, FILL UK .�kS - IlgiE 51185 MTS IN-P06LIN !PA. mus. SET' DAqIPMM GUN.IT.E - DEEP END RAMP EXTENE10 2fid ErEPI e LOVESEAT SPILLWAY TYPL____L� CA'HTILEIW iR.B.S. SEE STM DECKING FMK COMM 0 f i 401FM DECK DRAINS'' 01D= DRAJU LWS CURB CORE Lms, sxp� .. TILE e[ASE SAND " M$tWEN lt6. MOW_STFqP- MASONRY C!Dplw TYPE R.R.B. FAQ.N0 SIP"ALY TYPE lf, s3zi PROP. EXT.- WALLS EAUP, WALLS FIREFIT "­ u[;r175_ PCB UGHTS SPA Rcurw gow DEHI?1P SPA f)E5ALL!S FENCE ri?E GATE'PMRSAL RFWVt & G PAT_START RIM t0fAFPLEnlaR OTHER OWNER TO: (l) OVERWNE THE AP1'Rb6ATE ELEVA-RCN OF POOL OR SPA AT-LAYdA ON 0AY'0F EXUVAV6� (2) TAKE NOTLQE THAi-PPUL ANIT EWIP4AENt LWA-RDNS ARE 5U . MT TO . ACCEPTANCE 0 . F .. LOCAL au joiNr. v4vimDii A-rTwr or oowt Qr Pow IIET 40IAT4 QSN-CRM � A-LFA:$t. PMCE VAFLY FOR SF�.o OAYS AFTER SEED IS: IWAULm (4) AGR2E-THAT 666MIA;FODL9 IS NOlr ROP.ONj]ELE FOR GJWEJ 44l7dp C4Nl19TfCR15 6R OE3,ECTS. AND ANYTA MAGE. TO CURBS, 51DEWA V% DRIYEAYS. Lk'6W.: 00`0!}Hpfi ITE W S: LN 7K ACOFSS AREA (5) SEE IRAi ALL FEYQr4G,.GATM ANFD'OARA�G DOUR$ MEE� LI)a, CODES FOR A P06. EN'c'L=RE- MDR M ?RkPU,57M INSP!�m FILL -ROM ANEDIATELY AMQ� LASM. (FOLLOW IRST ' MZYMS —:M MOT -USE - RUBBER �GM* TAKE. 90CE . T)i . 41 . THIS D�'AiMG - ig-. NE 'SOLE MMV'V mr.."A .6ms AV:'HAT 'Aly IJSE'WTHrj.LFT'W.RlTTEN PE*t8i� 6CA.LlF0RNlA:F0QLS,-:lNCi IG q.WRib EI LAW, QVMi3t APPROVES P"N. PIOCL,, AMU MWIJJrj LOCAL-nMIS ANP MA5 RE4{) TEIE.RESPflN51RILfREs lwflfl 140ums OqNE QA7L ..81NImVNG POOL -PLAN FOR: NAME -H KOZU R-ESIDENCE: - JAB AD DRESS CITY OFFICE. REY7--­ 7 PHONE': LOT - TRACT PACE .,BOOK MAP BOOK PAGE' NO. JCITY MAIL ADDRESS �qNSTRUCTCN ORFICE PH&NE NO. SCALE OATE DRAWN BY SOLD BY CHECKEU BY: i C) B-11 RE V1 S] 0 N.S. DATE lr�q 2 A wt:BE CHARGED IF lhL AFMOVED lkpn RE ON -A �4 112,4A r% hAn -FUR 7F q 5 . S F L rCTI ON S' STONt /A N TILE & BOULDERS li 141 APPRO-YED FOR DECK COLOR JANDY PEBB.'/PLAS . -AxeA4�+... _SfQNATIU'RE -ohd irri L Dro nage qcfm�or.- for'c>lor'l;ers orc pops,b y: .6RAINAGE NOTE:' y6l =� n GO]