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08-0481 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 "`&ttt 4 4 Q" Application Number: _06_-_0_T0_6_0_4_81— Property Address: '81846 RANCHO SANTANA DR' APN: 767-200-999-5 -312023- Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 24500 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury tha am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Busines a d io Code, and my License is in full force and effect. LicenseClass: C5 Lic a No.: 802919 at C ractor: 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 Is 500).: (_ 1 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 fSec. 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.). (_ 1 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 fSec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: GREG TERLECKY 81846 RANCHO LA QUINTA, CA (760)777-9920 SANTANA DRIVE 92253 Contractor: AZURE POOLS AND SPAS P.O. BOX 10641 PALM DESERT, CA 92255 (760)322-7665 Lic. No.: 802919 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/21/08 .. O � MAR 27 2000 CITY OF LA ALIINTA 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 DELOS . INS CO Policy Number 01DKPM12002794 I certify that, in the performance of the work for which this permit is issued,-] shall not employ any 'person in any manner so as to become jest to the workers' compensation laws of California, an agree that, if I sfol bj ct t th workers' compensation provisions of Section 0 of the Labor Cfort i co ply 'th those provisions. a scant: 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. ' certify that I have read this application and state that the above information is correct. I agree to comply with all, city oclourdinan es and state lawsrelating to buil ruction, and hereby authorize representatives of tha pon the above-mentioned prope or spa ' n oses. DateSi n e (Applicant or Agent): Application Number . . . . . 08-00000481 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee .252.00 Plan Check Fee 163.80 Issue Date` Valuation . . . 24276 Expiration•Date 9/17/08 Qty Unit Charge Per Extension BASE FEE 45.00 23.00 9.0000 ------------------------=--------------------- THOU BLDG 2,001-25,000 ------------------------------ 207.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/17/08 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 9/17/08 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 9/17/08 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 Permit . . . . . WALL/FENCE PERMIT LQPERMIT Application Number . . . . . 08-00000481 Permit . . . WALL/FENCE PERMIT Additional desc— . Permit Fee . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 224 Expiration Date 9/17/08 Qty Unit Charge Per. Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, 14 L.F. 4' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION.. Fee summary Charged Paid Credited ----------------------------------------------- ---------- Due Permit Fee Total 371.00 .00 .00 371.00 Plan Check Total 189.80 .00 .00 189.80 Grand Total 560.80 .00 .00 560.80 LQPERAUT .- Bin # City of La Quinta Building 4 Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # \ Project Address:DWI A. P. Number: Legal Description: Contractor: H-W(�� c) Owner's Name: Address: I ffi City, ST, Zip: Telephone: Address: �! a�� D �' 11 Project Desc ipt' n: City, ST, Zip:AfIVW t Telephone: City Lic. #: State Lie. # : Arch., Engr., finer: Desi ` Address: N City, ST, Zip: Gr'L Telephone: I ,97 fl) State Lie. #: r Name of Contact Person: / / q— Construction Type: Occupancy: Project type (circle one) ewAdd'n Alter Repair Demo Sq. Ft.:tories: #Units: Telephone # of Contact Person: �— Q Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan 2"d 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: -.3rd 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 024Q� a 41 ;?Ieo �= tip ' i u i. 'wC�++ P; L LV: s ''-`3. 80-2919 POOL SPECS POOL SIZE: 15' X 30' POOL AREA: 397 SF. POOL PER: 99 FT. POOL DEPTH: SPA SPECS SPA SIZE: 7 SPA AREA: 49 SF. SPA PER: 28 FT. EQUIPMENT PUMP: FILTER: HEATER: POOL LIGHT: SPA LIGHT: FINISHES DECK AREA: 813 SF PLASTER: TILE: 1 "=S' SCALE GREG T ERLEC KY Terlecky Residence 81846 Rancho Santana Drive La Quinta, Ca LOT tt : 3 RA NCI -IO SANTA NA Azure Pools & Spas PO Box 10641 ' Palm Desert, CA 92255 ALL PROPERTY LINES 760.322.7665 HAVE EXISTING 5'