05-2872 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: [05-00002872'1
Property Address: 057.758—SANTA'ROSA TR
APN: 762-240-013-27 -30487 -
Application description: POOL - RESIDENTIAL a
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 17000
'� 14 2005
Applicant: Architect or Engi r: JUL
CIry OF: PINANCEDE� �
Lo/\/ i lCA cTuC �/�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am Iic sed u er provisions of Chapter 9 (commencing with
Section 7000) of Di ' 'on 3 of th4,Busin and Pr siona Code, and my 'c�g is in ful rce and effect.
License Cla icense No.: �//
f)ateiJX Contraa -.
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 (5500).:
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 (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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) 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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/11/05
Owner:
SANTA ROSA DEV
40847 SANDPIPER CT
PALM DESERT, CA 92260
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT,INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
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.
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 027 029 053 Policy Number
I certify that, in the performance of thento
ich this permit is issued, 1 shall not employ any
person in any manner so as to becomthe workers' compensation laws of California,
and agree that, if I shouJ�►become suworkers' compensation provisions of Section
37p0 of the Labor C eJ,� shall forth with those provisions.
WARNING: FAILURE'TO SECURE WORKERS' COITi1PE ATIO OVERAGE 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 a void i rk is not commenced
within 180 days from date of issuance of such permit, or ces ion of wor for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above informati is rect I agree to comply with all
city and cou ty ordinances and state laws relating to building struction, nd her authorize representatives
of this c n y%t�o ter upon the above-mentioned property i i pection p rpo
Date: 17 ignature (Applicant or Agent):
LQPERn4TT .
Application Number
05-00002872
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee.
180.00 Plan Check Fee_.
117.00
Issue Date.
Valuation
17000
Expiration Date
1/07/06.
Qty Unit Charge
Per
Extension
BASE'FEE
45.00
15.00 9.0000
---------------------------------------
THOU BLDG 2,001-25,000
---------------------------------
------------------------------PermitMECH
135.00
Permit. . . .
MECHPOOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
` Issue Date . . . .
! Valuation
0
Expiration Date
1/07/06
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
1/07/06
QtyUnit 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
1/07/06
_ 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
--------------------------------------------------------------=----
Special Notes and Comments
---------
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERn4TT .
0
LQPERMTT
#
.
Bin #
Rectd
Cit} ®f La Lima
PERMIT FEES
Building 8r Safety Division
Permit #
Plan Check submitted
P.O. Box 1504,78-495 Calle Tampico
s J 2 8 rf2
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: C6LL,Fb rpi i q ®®L.S:}:}•}::::>:},>;•<•.>::<.:;:}}•:;::.;;;;:.::..}}.;
� � Telephone: >><':::;z:?::::?€� :;:»#<>; >...•:<:>»:
..............
Address: (j Sox I Z?®
Project Description:
City, ST, Zip;.6cathed L4
CA 9.1A 3 0
Telephoner
99 2 �e
Ix :' x:•. Y
»s•':^ >>`<? . :v>....
.V
•'•r:•}::::::{j�.}i..•::i`+':!:•:ir}:4:'C}}:::i::Y 'f'}$F:i
State Lie. # 9)
City Lie. #;
Arch., Engr., Designer:
Address:
LK L
City, ST, Zip:
Mechanical
Telephone:
},f.::<•:.,,..::::..,rf;}:zat:iK ; K. zf • •:Construction Type: Occupancy:
'
State Lie. #:
j.. �vn±:
::::• ,,.•.. Project type (circle one): Ne Add'n Alter Repair Demo
Name of Contact Person: MAJ
Sq. Ft.:
# Stories:
# Units:.
Telephone # of Contact Person: , Estimated Value of Project:- Q(�
APPLICANT' DO NOT WRITE RFI nW T141Q i IKIM
#
Submittal
Req'd
Rectd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Mt/4j
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 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:-
'"' 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
OWNER TO: (1) DETERMINE THE APPROXIMATE ELEVATION OF POOL OR SPA AT LAYOUT ON DAY OF EXCAVATION
(2) TAKE NOTICE THAT POOL AND EQUIPMENT LOCATIONS ARE SUBJECT TO ACCEPTANCE OF
LOCAL BUILDING DEPARTMENT AT TIME OF ISSUANCE OF PERMIT
(3) WET DOWN CONCRETE SHELL AT LEAST TWICE DAILY FOR SEVEN DAYS AFTER SHELL IS INSTALLED
(4) AGREE THAT CALIFORNIA POOLS IS NOT RESPONSIBLE FOR UNDERGROUND CONDITIONS OR OBJECTS,
AND ANY DAMAGE TO CURBS, SIDEWALKS, DRIVEWAYS, LAWNS, OR OTHER ITEMS IN THE ACCESS AREA
(5) SEE THAT ALL FENCING, GATES, AND GARAGE DOORS MEET LOCAL CODES FOR A POOL ENCLOSURE
PRIOR TO PREPLASTER INSPECTION
(6) FILL POOL IMMEDIATELY AFTER PLASTER. (FOLLOW INSTRUCTIONS -- DO NOT USE RUBBER HOSE)
(7) TAKE NOTICE THAT THIS DRAWING IS THE SOLE PROPERTY OF CALIFORNIA POOLS AND THAT ANY
USE WITHOUT WRITTEN PERMISSION OF CALIFORNIA POOLS, INC. IS PROHIBITED BY LAW.
OWNER APPROVES PLN, POOL, AND EQUIPMENT LOCATIONS AND HAS READ THE RESPONSIBILITIES AND NOTICES ABOVE.
SIGNATURE(S) uAlt
SWIMMING POOL PLAN FOR:
NAME ALLEN RESIDENCE/LOT27
STREET �77f56 SRT
JOB ADDRESS S�rN�"A ��a tt- CITY L JI
PHONE OFFICE `76p'�0d41S9- RES /
LOT -2'`7 . '_.:... TRACT PAGE BOOK
MAP BOOK PAGE N0. CITYi- 0 J)yU-iA
MAIL ADDRESS /403 -Ik4 - 'b -
CONSTRUCTION OFFICE PHONE NO. -7 ,
SCALE DATE DRAWN BY SOLD BY CHECKED BY
1/8"=1' . 0Ca/E 7/0-;) v ,..I c,,CK
JOB# REVISIONS DATE
1l -i , 0'7- c u I NTA
2 BUILC,.NG & SAFETY DEPT.
3 FOR CONSTRUCTION
4 DATE 7 I tr BY
SELECTIONS
CONSTRUCTION AUTHORIZATION STONE
SALES FIELD TILE
DIG BOULDERS
PRE-GUNITE DECK COLOR
UNDERGROUND JANDY
MASONRY PEBB. /PLAS
DECK SIGNATURE
PRE -PEBBLE DRAINAGE NOTE: Drainage and irrigation for planters and pots, by
others, unless otherwise noted.
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