12-0679 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12'_0.06066.7-9
Property Address: 78730 ROCKBERRY CT
APN: 604-431-021-29 -23995--
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL•
Application. valuation: 22 000
(F -4,4t 4 e(4ry Q"
BUILDING & SAFETY DEPARTMENT
.BUILDING PERMIT
Owner:
KONTRA ALAN
78730 ROCKBERRY COURT
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/25/12
IF1
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERMIT
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 nul void if work is not commenced
within 180 days from date of issuance of such permit, or essa ion of w Fk
for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ave in rmatio is cor ct. I agree to comply with all
city and county ordinances and state laws relating to build' g con ruction and reby uthorize representatives
of tDisfuounty to enter upo he above-mentioned prope for pectin Pur
f `��r
ate: �t e� S' nature (Applicant or Agent):
Contractor: ' _
Applicant: Architect or Engineer:
_,,,�
VACATION POOLS INC cIiY(0 SMk0UItN(A
PO BOX 10940
INDIO, CA 92202
(760) 775-0468
Lic. No.: 856835
-------------------------------------------------------------------------------------------------
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury 'h.21m kctled under provisions of Chapter 9 (commencing with
'i
I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division I the Busine a d Profe sional -ode, and my License is in full force and effect. •
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
L' en lass: C53 ense 856835
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�_4,s��
r��// ontractor:1
issued.
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of ' ry that I am exempt from the Contractor's State License Law for the
, Carrier STATE FUND Polic mber 194 8584-2012
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performa a of t wor for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so sp b ome subject fo the workers' compensation laws of California,
permit to filea signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if 1 sho d beco a subjec a workers' compensation provisions of Section
' License Law.(Chapter 9 (commencing with Section 700011 of Division 3 of the Business and Professions Code) or
_3700 of the Labor C e, I/sh I fort wit 'c mply wit se provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
ref
' any applicant for a permit'subjects the applicant to a civil penalty of not more than five hundred dollars'($ 500).:.
ate. /� plicant: /
1 _ 1 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
WARNING: FAILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TE RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
` 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)..
- whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I amiexempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERMIT
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 nul void if work is not commenced
within 180 days from date of issuance of such permit, or essa ion of w Fk
for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ave in rmatio is cor ct. I agree to comply with all
city and county ordinances and state laws relating to build' g con ruction and reby uthorize representatives
of tDisfuounty to enter upo he above-mentioned prope for pectin Pur
f `��r
ate: �t e� S' nature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 12-00000679
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 225.00 Plan Check Fee
146.25
Issue Date Valuation
22000
Expiration Date 12/22/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
20:00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
180.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee 45.00 Plan Check Fee
11.25
.Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/22/12
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 . . . . 24.00 Plan Check Fee
6.00
Issue DateValuation
0
Expiration Date'. 12/22/12'
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
Special Notes and Comments
POOL - NO HEATER. ALARMS/BARRIERS SHALL
BE IN PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED. 2010
CODES.
- -- -
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
Other
1.00
Fee summary Charged Paid Credited
-----------=---------------------------------------------
Due
Permit Fee Total 294.00 .00 .00
294.00
Plan Check Total 163.50 .00 .00
163.50
Other Fee Total 1.00 .00 .00
.1.00
Grand Total 458.50 .00 .00
458.50
VACATION POOLS, INC..
' P.O. Box 10940
a Indio, CA 92202
Ph. (760) 775-0468, Fax(760) 775-0469
License # C-53-856835
PA
(4) Deck Jets,
Tanning Shelf with , r
' Umbrella Sleeve -
Pool
-3 12' x 50'
Lawn . Lawn.. -
j Pool Bench'
.17
New
Concrete Decking
(550 sc{,. ft.)
Poo 1/spa
Equipment
CC Existing Alumawoocl Cover
O `J and Concrete below to NOTE:
H remain Landscape elements (Trees,
Q _ Shrubs, Vines and Lawn) and Patio
PA PA F=urniture shown for illustration only.
Unless by separate bid.
18" PA
Existing KONTRA Existing
Concrete RESIDENCE _ Concrete
1
CITY LA QU'NTA .
BUILDING 8� SAFETY DEPT.-_..\
APPROVE
FOR CONSTRUC-TION
18" PA
DA
Scale: 145"=l' -o"
DATE REVISED
KONTRA RESIDENCE
05/29/12 06/14/12
i;ln.#
City 0 LCA Quinta
Building a Safety Division
Box 1304,78-495 Calle Tampico
6..Qulnta, CA 92233 - (760) 777-7012
Building Permit' Application and Tracking Sheet
Permit #P.O.
Project Addtrss: /. OG ext
Owner's Name:.0 /�-
A P. Number.
Address:
Legal Description:
City, ST, Zip: , 4
Contractor. I/QG�i 0A, �� J
Telephone: n
Address: 2
ProjectDescriptionh z; 0G
City. $T, Zip:� J
d
EA E hG,-
'7�
Telephone.7�0- / 7S Oyshl '
State Lic. #: ?.3-�- 14City Lic. #;
Arch., Engr.. Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: el W O /�
Coro action Type:. Occupancy:
Project type (circle one) New Add'r Alter Repair Demo
Sq. Ft.: es: #Unit$
Telephone # of Contact Person: CJ "'a 7 �ys-�
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd .'
TRACKING
PERMfPFEES
Pine Sets •
Pian Cheek submitted
tole
Itan Amount
Structural Cases.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calve.
Called Contact Person
Plan Chc& Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Pians resubmitted..
Mecharilca!
Giading plan
r, Review, ready for correctionsPrssue
Electrical
Subcontactor ISst
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
H.O.A. Approval
Plans resubmitted
Grading
IM HOUSE:-
'^' Review; ready for eorrectionslissae
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees