09-0716 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 .
Application Number: 09-00000716__
Property Address:
9-00000716-
PropertyAddress: 179294 CALLE PALMETO
APN: 604-381-019-27 -'25953 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
-Application valuation: 28000
Applica t: Architect or Engineer:
4
BUILDING & SAFETY` DEPARTMENT
BUILDING PERMIT
Owner:"
GODFREY EDWARD B
79294 CALLE PALMETO
LA QUINTA, CA 92253
----------------------------------------------
• LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with,
Section 70001 of Division 3 of.the Business and Professionals Code, and my License is in full force and effect.
License^Class: D35-053 License No.: 534494
Date:' I�•Contractor:!
- t 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 1$500).:
(_ 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, prodided 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.). -
(_) 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.). "
( 1 -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:
r
LQPERMIT
Contractor:
STONE CANYON POOLS INC
P.O. BOX 13788
PALM DESERT, CA 92255
(760)343-5420
LiC. No.: 534494
VOICE (760) 777-7012
-FAX (760) 777-7011
INSPECTIONS (760) 777-7153
------------------------------------------------
WORKER'S COMPENSATION DECLARATION
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 issued. My workers' compensation
insurance carrier and policy number are: - -
Carrier DELOS INSURANCE Policy Number 02DKRM22003725
I certify that, in the performance of the work for which this permit is issued, l :shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if,1 should becomesubject to he wo-kers' compensation provisions of Section
3700 of the Labor C de, I shall forthwith co I with those provisions. -, r
f Date: —1-1 -01Applicant: -
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 benefitworkis 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construct'�erthorizpresentativesof this county to eter'upon the above-mentioned property or spection-
Date: '-WQ L. Signature (Applicant or Agent):
/-, - .t '
Application Number
. . . 09-00000716
Permit . . . MECH POOL
Additional desc .
Permit Fee . .
26.00 Plan Check Fee
6.50
Issue Date
Valuation . . .
. 0
Expiration Date
1/05/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
Permit
BLDG.POOL PERMIT.
Additional desc .
Permit Fee . . .
271.50 Plan Check Fee
176.48
Issue Date . . . .
Valuation . . .
. 28000
Expiration Date
1/05/10
Qty Unit Charge
Per
Extension
BASE FEE
252.00
3.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,'000
19.50
Permit
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . .
Valuation
0
Expiration Date
1/05/10
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
1/05/10
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
SWIMMING POOL AND SPA
PER APPROVED PLANS
LQPERMIT
. Application Number 09-00000716
--------- ------------------- ------------------------------------------------
Special Notes and. Comments
& S.T./POOL & SPA ALAMS BARRIERS SHALL
BE PLACE AT PRE -PLASTER INSPECTION
EQUIPMENT & ENCLOSEURE NOT INCLUDED.
-------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged. Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 375.50 .00
.00
375.50
Plan Check Total. - 202.48 .00
.00
202.48.
Other Fee Total 1.00 .00
.00
-1.00
Grand Total 578.98 .00
.00
578.98
J
Bin Jq `:
}
arty of La Qu*'to
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 ; (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
/ I
Project Address: { Vi. 4. Ck L LQ
Owner's Name: 0 D5
A. P. Number:
Address: ;211 t{ Cfr64-E PAtrf r- 40
Legal Description:
City, ST, Zip: G 4 N J AJ i A qSZ5`3
Contractor: S 1 O rsr- C i, �p0 5
telephone: 'M .....
Address:
Project Description: '3`, tN e O L
City, ST, Zip:
9hr1 l7 S
Telephone: �[ 'S
9 -(o Y --83rd
•rr,..-.,::...y .. ,,:>.;•:�:;,,. >,...�K -,
;:;.:,:.<4.;.:>;.{ .:>�:
State Lic. # : 5 3 Iq y q' 14
City Lic. #;
Arch., Engr., Designer..
Address:
City., ST, Zip:
Telephone:
State Lic. #: c/Y;
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Sq. Ft.:
#: Stories:
# Units:
Telephone # of Contact Person: C ( [ _ L0 4 _ b3 g Estimated Value of Project: 2 $' 0 o m o
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets:
Req'd
Recd
TRACKING
Plan Check submitted
PERMIT FEES
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
tad Review, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Pluming
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' Reyiew,.ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
of
66
10
13
POOL
SHELF
•.J.;-, ..• I
• MCKIN6 TO
y I GODFREY RESIDENCE REMAIN
II
POOL 24' X a'-1"
340 S.F. 46' PER. I
550 S.F. GONGRETE
SPA 8' X 'i'
52 Sp. 28' PER.
E 15TING ^
I CITY OF LA QUINTA
BUILDING & SAFETY DEP i 51DEN GE
APPS®VED
i FOR CONSTRUCTION L 901A �fICA92Z53
r DAT ` p BY �' `
WED
ITE RE I
` su ject to d. P Ian notes. .
v aron J. wen R.C.E. 5887
• of
C.
Doc No: 43639 " 74!2009 -• � ,, , , . ,� ...
"Name: Godfrey
rri4 Address: 79294 Calle Palmeto
r La Quinta, CA 92253-8558
Cont: Stone Canyon Pools
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII - _ -