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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 �rI- 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) V �7 f?e 4 ol 1-4 711 v ROOM sift .o. AtAm MOW .. GRW ROOM 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 MAW 1.4 1 ft,.. npooeotitleigpoA :� a........� � 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 Z. r 08/17/2007 11:05 9096293890 CAL SPAS PAGE 01/02 a 56 %tj,, LO 7)H9 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