12-1294 (RPL)P:J.'BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA-
92253
Application Number:X12-9
00612:9 —
Property Address:
61264—SAPPHIRE LN
APN:
764-280-999-93 -300236-
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
21500
Ta�/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JACOBSON
61294 SAPHIRE LANE
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: CLASSIC POOLS & SPAS
79461 40TH AVENUE
BERMUDA DUNES, CA 9220
r
VOICE (760) 7 —7(
FAX (760) 77 — I
a
INSPECTIONS (760) 777-7:.,J
Date: 10/31/12
D°
OCT 31 2012
CITY OF LA QUINTA
FINANCE DEPT.
k760)345-8302
Lic. No.: 634338
yr
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Profess n s Code, 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
License Class: C10 C53 icense No.: 634338 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�r issued.
Date: J 2 ontractor: K• I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
or
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 perjur/that I am exempt from the Contractor's State License Law for the Carrier CASTLEPOINT INS Policy Number WCPBC1252212
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work 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 to beco ubject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I sh d ecom bjec to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of Labor d sh o hwit comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by '7
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: (J . > pplicant:
(_ 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 RS' 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 T RIM L 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 DDITION 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.).
(_ 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—) I am exempt under Sec. , BAP.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
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 sation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab a infor tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building cons c ' n, and hereby authorize representatives
ofhhis county to enter upon a above-mentioned prope/rty for i ec ' n purposes.
Date:) L nature (Applicant or Agent):
Application Number
12-00001294
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . .
225.00 Plan Check
Fee
146.25
Issue Date . . . .
Valuation
. . .
. 21500
Expiration Date
4/29/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
180.00.
Permit . . . MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
4/29/13
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 . .
4/29/13
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 . .
4/29/13
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 . . . . . 12-00001294
Permit -WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date _ Valuation . . .
. 192
Expiration Date 4/29/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
--- ------
Special Notesand Comments
----
POOL/SPA, 12_ L.F. 4' EQUIPMENT
ENCLOSURE, CITY STANDARD, REMODEL
EXISTING FIREPIT. INCLUDES - 60 L.F. -
GASLINE. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION. 2010
CODES.
-----------------_----------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 344.00 .00 .00
344.00
Plan Check Total 172.25 .00 .00
172.25
Other Fee Total 1.00 .00 .00
1.00
Grand Total 517.25 .00 .00
517.25
LQPERMIT
7'
/ EXISTING PATIO
O /
/ SYNTHETIC
/ PUTTING
/ GREEN
3"
DRAIN
LINE
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE Zy
EXISTING
RESIDENCE
AREA SCHEDULE
POOL
310 5q. Ft.
POOL PERIMETER
7q Ln. Ft.
POOL GOPING
l5 5q. Ft.
5PA
3q 5q. Ft.
5PA PERIMETER
22 Ln. Ft.
5PA SPILLWAY
10 Ln. Ft.
5PA GOPING
25 5q. Ft.
COLOR STAMPED CONCRETE
1,625 5q. Ft.
6A5 LINE -
50 Ln. Ft.
+IS" RA15ED BOND BEAM
30 5q. Ft.
4' HIGH BLOGK WALL
13.5 Ln. Ft.
- - - - ------
FOOL $ SIVA MATERIAL 5(f.,HEOULE
I. POOL DECK COLOR STAMPED CONCRETE, COLOR TO BE SELECTED
2. SPA STACK STONE 5PILL WAY
3. 5PA RA15ED +18", WITH A LIGHT BROOM FINISH ON COLORED CONCRETE COPING
4. SPA WATERLINE TILE TO BE SELECTED (GATAI)
5. POOL COPING: TO BE 16" WIDE, WITH A LIGHT BROOM FIN15H
6. POOL WATER LINE TILE TO BE SELECTED (GATAI)
-1. RA15ED BOND BEAM +12" WITH A LIGHT BROOM FIN15H ON COLORED CONCRETE GOPING
8. THREE, 18" WIDE SHEER DESCENTS ON RAISED BOND BEAM
q. RA15ED BOND BEAM TO HAVE STONE ON POOL SIDE, STONE TO BE SELECTED
10. RAISED BOND BEAM TO HAVE STUCCO VENEER FIN15H ON THE BACK 51DE
11. POOL AND SPA TO HAVE PLASTER, COLOR TO BE SELECTED
12. TANNING LEDGE TO BE q" DEEP
13. TANNING LEDGE UMBRELLA SLEEVE .
14. POOL LIGHT
15. 5PA LIGHT
16. STEP 51ZE TO BE SELECTED
THESE PLANS, DRAWINGS AND SPECIFICATIONS ARE NOT TO BE REPRODUCED,
CHANGED OR COPIED IN ANY FORM OR MANNER WHATSOEVER WITHOUT THE
EXPRESSED WRITTEN CONSENT OF CLASSIC POOLS/SPAS SCALE: 1'=10'-O'
rll;
GAS
ELEC.
PANE:
GATE i
3"
DRAIN
LINE
?Cassic,
�-. p00b / spa
cv,f-xm
(160)=345=8302
LIC# CIO C53 #634338
NAME, JAC❑BSS❑N RESIDENCE
ADDRESS, 61-264 SAPHIRE DR,
CITY, LA QUINTA, CA
PHASE: — TRACT, — L❑T# —
i3in.#
Citjr of La Quinta
Building &r Safety Division
P.O. Box 1SO4,78-49S Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I
Project Address: - P kh Re- gi,
Owner's Name:. fh G. Q -d b s 16
A. P. Number.
Address: _ So, JD h.`
Legal Description:
Contractor. � b S" /J 1
City, ST, Zip: t
Telephone:
Address: 7? _ Y((Le) U
Project Description:
City, ST, Zip: 10 t
Telephone. CJ - 3 Y 3:C7 " p `` £�00"IM
State Lic. #: (0 3 3 City Lic. #; 10 % "0
2 u c_s•
Arch., Engr., Designer:
a
t
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:,+
f Qt
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft; #Stories:
#Units:
Telephone # of Contact Person: -
Estimated Value of Project: S Cj U
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACIMG
PERMITFEES
Plan Sets
Plan Check submitted
G
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Catcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mecbarilcal
Grading plan
r" Review, ready for correctioustissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'^' Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Sckodl Fees
Total Permit Fees