07-2328 (RPL)r
P.O. BOX 1504 - VOICE (760) 777-7012
_ol78-495 CALLE TAMPICO FAX (760).777-701-1
LA Q.UINTA, CALIFORNIA 92253 BUILDING & SAFETY'DEPARTMENT, INSPECTIONS. (760) 777-7153
BUILDING PERMIT
Date: 8/17/07
Application Number: 07-00002328 Owner:
Property A-ddress:- 79470 CALLE PALMETO HATRAK KARL JOHN
APN: 604-381-008-16 -25953 79-470 CALLE PALMETO
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
-Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
Contractor:
Applicant: Architect or Engineer: Owner
�. /Ilk -----------AUG 31 2007
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMP
�"'vC
{- I hereby affirm under penalty of perjury. that I am licensed under provisions of Chapter 9 (comrimencing with I hereby affirm under penalty of perjury one of the following declarations: -•v0 `�6�r
Section 7000) of Division 3 of the Business and PrZaEc
my License is in full force and effect. - _ I have and will maintain a certificate of consent to self -insure for workers ation, as provided
License CI ss: - for by Section 3700 of the Labor Code, for the performance of the work for which t permit is
issued.I Date: .7 A Contractor:- - _ 7 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 �s issued. My workers' compensation
OWNER -BUILDER DECLARATION' insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number
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 theperson in any manner so as to become subject to the workers' compensation laws of California,
permit to file aligned statement that he or she is licensed pursuant to the provisions of the Contractor's State nd agree that, if I should become to the work rscompensation provisions of Section
License Law (Chapter 9.(commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor e` I sh I orthwi corp ose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by r— -�`( -- --- - --- /
an plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date. (J Applicant:
as owner of the property, or my employees with wages as their sole compensation, will do the work,and
thestructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WAR N FAILURE TO SE E WORKERS' C ImPbMATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJEC AN EMPLOYER TO C IMINAL 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 ($100,0001. 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, gas 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,
I—) I am exempt 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
of La Quinta, its officers, agents and employees for any act or omission related to the work being
,y�i performed under or following issuance of this permit.
. Date: v ® Owner: 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 sub'1ect
' / 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.I.
Lender's Name:
Lender's Address:
I,QPFRA1IT
•
permit to cancellation.
I certify that I have read this application and state that the above information is correct. .agree to comply with all'
city•and county ordinances and state laws relating to building cons ction esentatives
of this co ty o enter upon the above-mentioned pro a for ions
ectio r es.
Date:Signature (Applicant or Agen
Application Number
07-00002328_
Permit . . ...
BLDG POOL PERMIT
Additional desc'.
Permit:•Fee
15.,00 '•.. Plan Check
Fee
9'.75
Issue: Date
Valuation
500
Expiration Date
2/13/08
Qty .-Unit Charge
Per
Extension
BASE` FEE
15.00"
L�erm t
MECH PUUL
Additional desc
�-
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date- : ...
Date
Valuation
2/13/08
0
Expiration
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
2/13/08
_- 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 . . .
27.00 Plan Check
Fee
6.75 .,
,..
Issue .Date
Valuation.
. ..
0
Expiration Date
2,/13/08
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
1.00. 3.0000
EA_ PLB GAS PIPE ,1-4 OUTLETS
3.00
-_--- ---------
Special Notes and'Comments
.6:' ROUND.FIBERGLASS
SPA INSTALLED PER .
APPROVED SPECS" (CODE
CASE)
. Application Number:
07-00002328
..::.Fee summary +::
Charged
Paid
Credited
Due
.
Permit Fee Total
113.00
.00
..00
113'_ 00
Plan Check Total.
34.25
.00
.00
34.25:
- Grand Total
147.25
.00
.00
147.25 ..
r
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as t1L builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit.. Building permits are not required to be signed by property owners unless they are personally performing their
own work.. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and t::) have a business license
from the City or County. They are also required by law to put their license number on aill permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to sibcontract, you should be
aware of the following information for your benefit and protection.
If you employ or otherwise engage any persons other than your immediate family, andthe work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not li•--ensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internai Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are .allowed to perform. their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons profess`Owner/Builder" to be contractors is to secure an " wner/Builder" building.
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are pedforming their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' St.-te License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY a
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760) 777-7011
O ER'S SIGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(S)
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08/17/2007
11:05 9096293890
CAL SPAS
PAGE 02/02
IAPMO RESEARCH AND TESTING, INC.
5001 East Ailadelphia Street, Ontario, California 917614816 • (909)472-4100 Fax (909) 472.4244 • wwwJapmo org
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CERTIFICATE OF LISTING
IA60 R"*rch nntlTesUng, Inc. Is n product certification t * Witch taste and inspaets•urnplostaken from to suppliWe stock or from the market or e
cahwnation of bath to verify comprienca to the ra Manaln of applicable codes end standards. This oc" Is 46upiad vft patladle snavaillance of the
su�pftr`Bfectory and worehamos eswall oaths owassmemdtthe suppfarr's (luelity Assurancs Dfstem This fisft is su*dtto the conditions Sat fotth M
th4charecteristks below and Isnot to ba co nmictod as any rocommondetion, asaurancn or guarentao by IAPMD Research mulTeating, Inc. of thopvduct
so:6ptence by Authotilies Having Jurisdiction.
Effective.Date: February 2007 void After: February 2008
Product: Spas/Spa Shells (Acrylic).
Issued To: California Acrylic Inds, Inc. Fila No. SP -1137
1462 E. .9th Street '
Pomona, CA 91766
IDENTIFICATION: Manufacturer's name and/or trademark, model designation and
i USPC® certification mark shall be permanently *affixed to the
i outside of each unit. Those models listed as shel.l,only
shall be marked with ^SHELL ONLY". Units shall be
permanently identified on finished visible su:.face with at
least the company name or trademark.
CHARACTERIS'ICS: Polyester resin reinforced fiberglass'spas in various
colors, sizes and configurations. All support equipment
must be listed.. May or may not* be provided with insulation.
All units, whether -factory or field assembled- are required
l to have suction fittings installed which are listed to ASME
A112.19'..8M-1987 fol -anti-hair and body entrapment per
sedtion 308(d) and je) of the USPC- All units are listed
for above or below g::ound installation and may be portable
or permanent. "
Products comply with the applicable sections of the latest
edition of the Uniform Swimming.Pool, Spa and Hot Tub Code®.
Manufactured in compliance with ANSI Z124.1-1997.
Chalitttan, Product Certlfieatbn Committee Executive -Director / • . �,•.k` .
This listing is for the period iltd c" herein em! is void after the date &S" obove. Any changn in material, mamdactoog procm maning or. \ u , .;Vo:q', y; g , .•
design wirtwat having first obtsinhd the approval of the Product Certification Committee, or oral evidence of iron-complianco with appgcabliacodes ; . v .• err,:..
and standards crofinferiorworb6nahip,meybedoemedsufficient ceuseforrovace6orattdsiMnp.Reproduationofot.mbtencetatNaftrmlot ..; "
oduartwng pum— am be, "Wdo o" by spea le written permission of IAPMC Rosaarrh and Tasting, Inc. Any aftemadon of tMe cardfh;ste could am..
be grooms for rMcatimn of eta ruUng
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08/17/2007 11:05 9096293890 CAL SPAS PAGE 01/02
a 56
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9
Bin # .
' � t)( of La Quints
..
`
f' Building 'U Safety Division
' P.O. Box 1504; 78-495 Calle Tampico * ' "
Permit #
f ^
_La"Quinta, CA 92253•- (760).777-7012
'
Buildin Permit A llcation and Track.In Sheet ,
Project Address: l�1Oi`e ����I�v •
Owner's Name: G
A. P. Number:
c,
Address: �,,�
Legal Description:
City,' ST, Zip: ✓! I ., . la Z2cf
Contractor: 7Dk/��li�
Telephone:,ao Zop 3 •�
Address: ;;
Project Description:
City, ST, Zip:
Telephone:am's
State,Lic..#
City Lic: #: ....
J_
Arch., Engr.; Designer.' .�
Address: `
City, ST, Zip:
,
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Ajd'n Alter Repair Demo
State Lic. #:
Name of Contact Person- `�4�G ����`� }' -
Sq. Ft.: # Stories: # Units: . /v
Telephone #.of Contact Person:7 p�j .�-Co
Estimated Value of Project: 0�
APPLICANT: DO NOT WRITE BELOW THIS LINE '
#
Submittal
Req'd
Recd
- -. • .. ,*
TRACKING ` r
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
Energy Calcs.
Plans picked up '
Construction.
Flood plain plan
+
Plans resubmitted, ..r
Mechanical
Grading, plan -
2"" Review; ready for corrections/issue
Electrical
Subcootacto'r.List
Called Contact Person .
Plumbii:g_
Grant Died.
Plans picked up',,
S.M.I.
H.O.A.-Approval
Plans resubmitted
.Gradin. ^'
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval-,
Called Contact Person
A.LP.P. •.
Pub. Wks. Appr
Date of permit issue, '
'School Fees
,.
' °
Total P'_rmit Fees