05-1799 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tihf
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
-------------------------------------------------
LICENS TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I amlic4nsed1under provisions of Chapter 9 (commencing with
/ Section 7000) of *i=ion the Busin and P essi a Code, and my};eye� ul o and effect.
V/
License Class: License No.: (�7� ��
yate: 4&P Contractor:
`7 w11
0"R -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 ($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 .l, 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(sl licensed
pursuant to the Contractors' State License Law.).
( 1 1 am exempt under Sec. , B.&P.C. for this! ason
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: IV
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510
CSLB: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
01/&moi
10/31/0
Date: 5/10/05
D 4
MAY 13140
,ti_ 5
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
X 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 C8 C27 C29 C53 Policy Number - - - - - -.- - - - - - - - -
I certify that, in the performance of t e work for which this permit is issued, I shall not employ any
person in any manner so as to be bject to the workers' compensation laws of California,
and agree that, if I sho d beco sub!e to the workers' compensation provisions of Section
�j 31000 of the Labor C , 1 shall f hw' comply with those provisions.
DDate: A;i Applicant.
WARNING: FAILURE TO SECURE W RKERS' C M SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 becPion,
oid if work is not commenced
within 180 days from date of issuance of such perwork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the s vco act. 1 agree to comply with all
city and county ordinances and state laws relating to build' g oreby authorize representatives
of this cou y tto ynttee_rupon the above-mentioned prope fo in
ate: % �1.�✓S'gnature (Applicant or Agent)
27
Application Number:05-0000179
Property Address:
81-1-36^RED ROCK RD
APN:.
764-270-999-154 -300233-
Application description:
POOL - RESIDENTIAL'
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
17000
Tihf
s(P
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
-------------------------------------------------
LICENS TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I amlic4nsed1under provisions of Chapter 9 (commencing with
/ Section 7000) of *i=ion the Busin and P essi a Code, and my};eye� ul o and effect.
V/
License Class: License No.: (�7� ��
yate: 4&P Contractor:
`7 w11
0"R -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 ($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 .l, 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(sl licensed
pursuant to the Contractors' State License Law.).
( 1 1 am exempt under Sec. , B.&P.C. for this! ason
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: IV
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510
CSLB: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
01/&moi
10/31/0
Date: 5/10/05
D 4
MAY 13140
,ti_ 5
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
X 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 C8 C27 C29 C53 Policy Number - - - - - -.- - - - - - - - -
I certify that, in the performance of t e work for which this permit is issued, I shall not employ any
person in any manner so as to be bject to the workers' compensation laws of California,
and agree that, if I sho d beco sub!e to the workers' compensation provisions of Section
�j 31000 of the Labor C , 1 shall f hw' comply with those provisions.
DDate: A;i Applicant.
WARNING: FAILURE TO SECURE W RKERS' C M SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 becPion,
oid if work is not commenced
within 180 days from date of issuance of such perwork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the s vco act. 1 agree to comply with all
city and county ordinances and state laws relating to build' g oreby authorize representatives
of this cou y tto ynttee_rupon the above-mentioned prope fo in
ate: % �1.�✓S'gnature (Applicant or Agent)
27
Application Number .
. . . . 05-00001799-
5-00001799Permit
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
180.0.0 Plan Check
Fee
117.00
Issue Date . . . .
Valuation
16567
.
` Expiration -Date
11/06/05
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
-------------------------------------------
THOU BLDG 2,001725,000
---------------------------------
135.00
Permit . .
MECH POOL
Additional desc'.
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
11/06/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
------"-----I-----------------------------------------------------------------
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
11/06/05
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
11/06/05
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 3.0000
---------- -----------------------------------------------------------------
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . .
15.00 Plan Check
Fee
.00
Issue Date
Valuation
433.
Expiration Date
11/06/05
Qty Unit Charge
Per
Extension
---=------------------------------------------------------------------------
BASE FEE
15.00
LQPERMIT
Application
Number . . . . .
05-00001799
-------------------=------------------------
Special Notes and Comments
--------------------------------
INSPECTION.
EQUIPMENT ENCLOSURE
NOT
INCLUDED IN
PERMIT.
Fee summary
Charged
Paid
Credited
Due
Permit Fee
Total 299.00
.00
.00
299.00
Plan Check
Total 143.00
.00
.00
143.00
Grand Total
442.00
.00
.00
442.00
LQPERMIT
Bin #
City of La Q uln tQ
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 #
vs /
Project Address: !� _ >7� �� n>
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: D
C L POOLS �
City, ST, Zip:
Telephone:
h one:
Address: c) Box I.z%o
Project
City, ST, Zip: LIA 1;t5Ilipd3 0
Description: lj� �� n�
ooL — S
Telephone: G
e P O
State Lic. # : /old) 2'
City Lic. #,
Arch., Engr., Designer:
-- - - °
Address:
City., ST, Zip:
Telephone: P
a 'c.
State Lt #. f
Name of Contact Person: DAA
Construction cuPancY:
Type: Occupancy:
P
one): Add
DemoJect
type (circle 'n Alter Repair r
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: ? "-/4'
Estimated Value of Project: 1
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
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2a' 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:-
3" 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
5PA Ar+(.Pil WI1"I-I col-JGr<
51"otilE `i' -D i.�lArC -LIti� ,51
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JOI- E. 0 R20L_ At -JD 6ISA i - e WA-re" L -id
I
CONSTRUCTION AUTHORIZATION
11 SALES 11 FIELD
DIG
PRF-GUNITE
UNDERGROL
I,tASONRY
DECK
PRE -PEBBLE
SPECIFICATIONS
TYPE f
� t * I i SIZE Z -LV c X � _ 1L- � "C
SURFACE AREA OF POOL c
PERIMETER ��" ( DEPTHS MIN. =>I _ c) ' MAX. - 0
PA SPECIFICATIONS TILE
SIZE & X �iL SQ. FT.TILE TYPE
"e Ceh�c v"'\ LC
r� I
SPA DAM WALL WIDTH WATER LINE a
NO. OF JETS TILE TRIM
LIGHT QUARTER ROUND
j f I R.B,9. TILE
RAISED SPA AT ��,.G'
SPILLWAY TYPE O 1- A -R
SPECIAL NOTES
SIGNATURE(S) DATE
SWIMMING POOL PLAN FOR:
NAME ROMITI RESID.; INCE
STREET&1-15f*_
JOB ADDRESS -j"FLG7(a ICITY LA j 1 'IA
PHONE OFFICE RES-
LOT 3154 TRACT PAGE BOOK
MAP BOOK PAGE NO. CITY
MAIL ADDRESS
CONSTRUCTION OFFICE PHONE NO.
SCALEPATE IDRAWN BY SOLD BY CHECKED BY
1/8 44.2.8` C 6-11 c, J E F r:
DATE'REVISIONS
3
DATES ' BY
5
SELECTIONS
STONE
)(Xs --s9t-�:e6
TI LE
Ao r( c,
BOULDERS
DECK COLOR'-
JANDY
PEBB,/PLAS
SIGNATURE
DRAINAGE NOTE: Drainage and irrigation for planters and pots, by
others, unless otherwise noted.
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