04-7151 (RPL)19
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
04-_00007151,
57825 SANTA ROS_A TR
762-240-013-6 -30487
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIA
20000
Architect or
4-
4�VOICE 760 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
------------------
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, and my License is in full force and effect.
license Class C-27 LicenseNo.: 624647
ate: 0:� ContractorZ V
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 ($500).:
(_ 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
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 _ 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.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
Lhereby 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
Date: 5/25/05
Owner:
SANTA ROSA DEV _
40847 SANDPIPER CT
PALM DESERT, CA 92260
Contractor:
CASA VERDE LANDSCAPE MAINT COR
78341 DARBY ROAD
INDIO, CA 92203
(909)590-2425
LiC. No.: 624647
------------------
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 td 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 GRANITE Policy Number 9549987 -
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
/ 0 of the Labor/Code, I shall forthwith comply with those provisions.
r/
D" ate:'0 d Applicant;/ C '
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. -
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and,4eOebrauthorize representatives `
of this n t/�./jenter upon the above-mentioned property for it peection p ses. f `
Date' A5 Signature (Applicant or Agent):/ "��- ' _ • .
7—
LQPERMIT
Application Number
04-00007151
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.00 Plan Check Fee
134.55
Issue Date
11/19/04 Valuation . . .
. 20000
Expiration Date
5/19/05
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00. 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit
MECH POOL
Additional desc
Permit.Fee . . . .
24.00 Plan Check Fee
6.00
Issue Date
11/19/04 Valuation . . .
0
Expiration Date
5/19/05 .
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
------------------------------------
EA MECH FURNACE <=100K
----------------------------------------
9.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit. Fee . .
45.00 Plan Check Fee
11.25
Issue Date . . . .'
11/19/04 Valuation
0
Expiration.Date
5/19/05
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'
11/19/04 Valuation
0
Expiration Date
5/19/05
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
Special Notes and Comments
POOL & SPA. ALARMS/BARRIERS SHALL BE
dti
Application Number
. . . . . 04-00007151.
--------------------------------------------------
Special Notes and
Comments
--------------------------
IN PLACE PRIOR TO
PREPLASTER INSPECTION.
EQUIPMENT ENCLOSURE
NOT INCLUDED IN
PERMIT.
**PERMIT REPRINTED
TO REFLECT CHANGE OF
CONTRACTOR. $4.50
SUPPLEMENTAL FEE
CHARGED.
------------------------------------
Other Fees . . .
----------------------------------------
. . . . CHANGE OF CONTRACTOR
4.50
Fee summary
Charged Paid
Credited
Due
Permit Fee Total
309.00 309.00
.00
.00
Plan Check Total
160.05 160.05
.00
.00
Other Fee -Total
4.50 .00
.00
4.50
Grand Total
473.55 469.05
.00
4.50
l .
LQPERMIT
P.O. Box 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760),777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number'° . . .
. .
04-00007151 _-_ -- ''Date
11/09/04
Property Address . . . .
. . '57825
_\
SANTA ROS_A TR___ -
BASE
APN:
15.00
762-240--013=6 -30487 -
9.0000
Application description .
.
POOL - RESIDENTIAL
------------------------------------+,-,
Property Zoning
-�==- ; :---------------
LOW DENSITY RESIDENTIAL
Permit .
Application valuation..
BLDG POOL PERMIT ,
20000
Additional
Owner"�'`
_. Contractor
--------------------------------------
SANTA
SANTA ROSA DEV
r
`''
_ __
'� x. 'I"' DIAm6ND GREEK 'POOLS
_,
40847 SANDPIPER CT
Issue Date
78341 DARBY ROAD
PALM DESERT --.CA-92260
Ur�r/ '20000
INDIO CA 92203
(909) 590-2425
�'
Qty
Unit Charge
WCC: STATE FUND
2n
WC:_ 1776208
02/10/05
'°"d
45.00
CSLB: 585287
01/31/06
- - - - - - - - - - - - - - - -, '`_+ •.1UL,,, v!M
-
u
i -
CCC: B1. -C53 -C27
- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - -
Permit
.Additional desc
Permit Fee . . .
Issue Date . . .
24.00
Plan Check Fee 6.00
Valuation 0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
r_ _ 9.00
------------------------------------+,-,
-�==- ; :---------------
-
'---- : ----------
Permit .
. . . .
BLDG POOL PERMIT ,
Additional
desc
Permit Fee
207.00
Plan,Chec,k Fee134.55
Issue Date
. . .
�Valuationa
Ur�r/ '20000
�'
Qty
Unit Charge
Per.
Extension
BASE
FEE
45.00
18.00
----------------------------------------------------------------------------
9.0000
THOU BLDG
2,001-25,000
162.00
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
------------------------------------------------------------
30.000.0
EA ELEC
PRIVATE SWIMMING POOL
30.00
Permit
PLUMBING,,
----------------
1
Additional
desc
Permit Fee
33>.00.
Plan Check Fee
8.25
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: O 71V
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or Engine 's ddress:
/V/
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, and my License tin ITI,,(rce and effect. C (j
_.License Class l.��j License No. S�
Date (�\� 1��1 Contractor �) G_✓t u1.8
OWNER43UILDER 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 file 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 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 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 (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.).
U I am exempt under Sec. , B.8 P.C. for this reason
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 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
iss� d. h� :orker�' compensation insurance carrier and RoI'�cy r�y(�ber
Carrier $lA-1 C'�h r Policy Number 1
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California, and agree that, if u ecome subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date , `� �"I Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($ 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.).
Lender's Name
Lender's Address
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.
I certify that 1 have read this application and state that the above information is correct. 1 to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the ve-ment ned property for inspection purposes.
Date ` 1 Signature (Applicant or Agent):
1
0
V
Page 2
Application Number 04-00007151
Date 11/09/04
Issue Date. Valuation
0
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 3.000.0 EA PLB GAS PIPE 1-4 OUTLETS
------------------------------------
3.00
---------------------------------------
Special Notes and Comments
POOL & SPA. ALARMS/BARRIERS SHALL BE
IN PLACE PRIOR -TO PREPLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary Charged Paid Credited
Due
Permit Fee Total 309.00 .00 .00
309.00
Plan Check Total 160.05 .00 .00
16.0.05
Grand Total 469.05 .00 .00
469.05
70.00'
ACL
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A DIVISION OF CASA VERDE LANDSCAPE
78-341 DARBY RD BERMUDA DUNES,CA,92203 SHEET
Bus, (760) 880-2203 Fax, (760) 360-6725 License# 624647
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880-2203
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(760) 360-6725 FAX P O O www,dlo.mondcreekpools,com
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TYPE SPECIFICA�TTIIONS
I
U 00 ° °
SURFACE AREA OF POOL
PERIMETER DEPTHS MIN. 13 MAX,
In
C:)
SPA SP- CIFICATIQNS
ELECTRICAL
SIZE X SQ. FT. '
BY LENGTH
ft
v
w
SPA DAM WALL WIDTH :4
TIME CLOCK - SUB PANEL
LIJ
Q
NO. OF JETS
NO. OF LIGHTS IN POOL
LJJ
z
J
LIGHT _� BOOSTER PUMP
OUTSIDE G.F.I. LIGHTS G.F.I. OUTLET
ry
Q 0
CA. AQUA AIR—BAR AND BLOWER
EXTRA SWITCH FOR SPA LIGHT
U
ry H
F—
BLOWER ONLY
BLANK OUTLETS
Z Q
RAISED SPA SPILLWAYS
MOTOR BOOSTER
Q
V (_.)
SPECIAL NOTES
BLOWER CLEANER
z
0
EXCAVATION
misc.
N
TYPE
ACCESS FROM
COPING AND TILE
ELEVATION
COPING WHITE
H
Q
DEEP END RAMP
COPING SPECIAL
FENCE REMOVED BY
TILE TYPE
FENCE TYPE
TILE TRIM MAS71C
TRASH REMOVAL LOADS
6" R.B.B. f L 12' R.B.B. Ift, 18' R.B.B.
ft
CONCRETE REMOVAL LOADS
MISC.
TREE REMOVAL BY
STUMP REMOVAL BY
117 ;r
DIRT PAD
DECKI G
6" R.B.B. eft, 12" R.B.B. _ft, 18' R.B.B. ft.
BY UP TO
ft
WALKOUT/MISC.
FINISH COLOR
ROCK PAC(
EXPANSION JOINTS
MASTIC FOOTING
STEEL
STEPS TYPE
EXPANSIVE SOIL
CANTILEVER
6" R.B.B. —ft 12' R.B.S.tL18" R.B.B. ft
DECK DRAINS CURB CORE
SURCHARGE - DEEP END RAMP
OECCO DRAIN DIVING BOARD JIG
LONESEAT INSIDE ft, OUTSIDE
PATIO STRAPS AND FOOTING NO.
SPA WALL WIDTH in. OTHER In
WALL DOWEL/MISC.
SLIDE INSTALLTION
MASONRY
T—BARS DECK DOWELS
COPING TYPE
PLANTER WALL _
PLUMBING
TYPE ft. X
ft
FILTER SIZE
CAP BACK UP WALL
POOL PUMP SIZE
FOOTINGS R.B.B. FACING
HEATER • SIZE
nREPIT TYPE SIZE
m
BOOSTER PUMP SIZE
EQUIP. WALL TYPE ft X
ft
qq
v
SKIMMER TYPE
CARETAKER OF HEADS
FENCING
OTHER CLEANER STUB ONLY
MISC'
FILL UNE SLIDE LINE
PLASTER'
P—TRAP BACK WASH TO
LIGHTS POOL SPA
GAS UNE STUBS
FOUNTAINS/SPRAYMEADS
ROPE RINGS EYEBALLS REQUIRED
COLOR NAME TILE
l0
LIGHTS IN POOL IN SPA
HYDROSTATIC VALVE
CARETAKER AQUA AIR BAR
STUB SET EQUIPMENT
SPECIAL EQUIPMENT
m
SOLAR RUN
DIVING BOARD SIZE
SAWCUT AUGER
MODEL COLOR
MISC
SLIDE SIZE
4
GUNITE
MODEL COLOR
a
GUNITE INSPECTION REQUIRED: YESNO
POOL COVER SOLAR HTG.: YES — NO
ROPE RINGS GRAB RAILS
FENCING
DEEP END RAMP
OWNER SHALL MEET ALL LOCAL CODE REQUIREMENTS
PRIOR TO PREPLASTER INSPECTION
6" R.B.B. ft, 12" R.B.B. ft. 18" R.B.B. fL
OTHER
LOVESEAT EXTENDED 2nd STEP
NOTCHED BOND BEAM
COPING CANTILEVER
J
NOTCHED SPA DAM WALL
SAP DAM WALL WIDTH
OWNER RESPONSIBILITIES
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
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
a
€
USE WITHOUT WRITTEN PERMISSION OF CALIFORNIA POOLS, INC. IS PROHIBITED BY LAW.
8
a
o
OWNER APPROVES PLAN, POOL, AND EQUIPMENT LOCATIONS AND HAS READ THE RESPONSIBILITIES AND NOTICES ABOVE,
m
in
zl
SIGNATURE(S) DATE
FINISH SCHEDULE
NO. QUANTITY MATERIAL DESCRIPTION
1
I
2 I
3
4 _....,
5
f
6
II
7 .� >A R
8 ..+SNI %df ti.l'L"1 LA
a
10 V1i 1V V 1 � %...:.ry
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i5
O
11
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REVISIONS
I
r
Odto Date By Description of Change
n
Q
O
CL
n s !—r�
I LViu++L- L_U+f
R 1 Ar a.i
I
,.•
THE SITE Ul A V,HEEUJU
�3
INSPECTION.
r? T r, A l r,
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ACL
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A DIVISION OF CASA VERDE LANDSCAPE
78-341 DARBY RD BERMUDA DUNES,CA,92203 SHEET
Bus, (760) 880-2203 Fax, (760) 360-6725 License# 624647
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