10-0978 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINT& CALIFORNIA 92253
Application Number: 10 -00000978 -
Property Addressc_ 52530 DEL ,GAT& DR
APN: 770 -290 -003 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 10000
c&14t 4 4 409.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
-------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 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 Win full,force and effect:
u eclass: C53 Lkenae;No.: 930999
Date��• u��actor:.- �Cb t C.��i fJOCI`.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that) am'exempt.from the Contractdr's-State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county thatrequires a permit to
construct. atter, improve, demolish, or repair any structure, prior toits issuance, also;requires Me;epplicant for the
permit -to flle-a signed•statement that he or;aheis licensed pursuam;to the provisions'of ihe' Contracter's'State
License Law (Chapter 9 (commencing with Section 7000),of Division '3 of the Busmese'and,Professions Code) or
that he or she I'axempt 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 titan five hundred doilars 05001::
1 _ ) 1, as owner of the property, or my employees witK wagea'as their sole compensation, will do the work, and
the structure:is not(ntended ct or offered for sale (Sec. 7044, Business and Professions Code: The
contractors' State License Law does napply to amowneroUproperty who build's or Improves thereon,
and who does'the work�himseif or herself through his or her own employees, provided that'the
improvements are not Intended or offered for sale: If, however, the.buildirg 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.):
as owner of the property, am exclusively,contracting"with licensedcontractors to construct the project'(Sec:
7044„Business and Professlons'Code The Contractors' State:License Law does not'apply to an owner of
property who builds or Improves thereon, and who contracts for the projectswitha contractor(s) licensed
pursuant to the Contractors' State License Law.).
T _ 1 I am exempt under Sec. ,.B.&P..C. for this reason
Date:
CONSTRUCTION LENDINd AGENCY
I hereby affirm under penalty of perjury that there'la a construction lending agency for the performance of the
work for which this. permit Is !awed (Sec. 3097, Civ: C.),
Lender's'Name:.
Lender's.Address• i4 Ilk
L,QPSRMIT
VOICE (760) 7774012.
FAX (760)177-7011
INSPECTIONS (760) 777-7153
Date; 9/23/10
Owner:
TONY ROBBINS
52530 DEL GATO
LA QUINTA, CA
Contractor: u c” 7 2010
LEFT COAST POOR C INC.
74478 HIGHWAY *1
PALM DESERT, Ck-
(760)567�9007
LiC. No.: 930999
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 to seM{nsurefor workers, compensation, as provided
focby"Section 3700 of theLebor Code, for.the performance of the work for which this permit is
Issued.
I have and will maintain.workers' compensation Insurance, as;requlred 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'poileynumberare:
Carrier EXEMPT Policy Number EXEMPT _
I certify that, in the performance of the work.for which this permit is'iswed, I shall not'employ arty
personyn any manner so as to become subject to the workers' compensation laws of California,
and agree that, it I should: become subject,to the workers' compensation provisions of: Section
/ 40P
3700 of the Labor Code, 'shall forthwith comply with'/ those, provisions.
Gate: • � • plicant; g i cwt wz.. � (L�/[ 4b 5
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGEiIS.UNLAWFUI, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL' PENALTIES AND CIVIL FINES UP TO`ONE HUNDRED THOUSAND
DOLLARS18100,000). IN_ADDITION TO THE COST'OF COMPENSATION, DAMAGES ASPROVIDED FOR IN
SECTIOM370&OF THE LABOR CODE, INTEREST,.AND ATTORNEY'S FEES.
APPLI CANT 'ACKNOWLEDGEMENT
IMPORTANT Applicatjon'is nerebyrriade to -the Director of Building and Safety,fora permirsubject: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 pursuapt to any permit Issued as a; result of this`application,
the owner, and the; applicent, each agrees to, and shall defend, indemnity 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 thi&permit:
2. Any permit issued as asesult of this "application becomes null and voldif work is not commenced
within TOO days from date of issuance of such permit, or cessation of work for 180 days will subject
permit,to cancellation.
1 certify that l.have read this application and state that the,above Information Woorrect. I agree to "comply with. all
city and'county ordinances'and state laws relating to building construction, hereby authorize representatives
Of is county to enter upon th abave-mentioned property i i rp
DDaate: L' �+re (Applicant or Agent):
.. a
Application Number . . . . . 10-00000978
Permit. . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . .
117.00
Plan Check Fee
76.05
Issue Date . . .
Valuation . .
10000
Expiration Date
3/22/11
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
8-.00 9.0.000
THOU BLDG
2,,001-25,000
72.00
Permit. . . .
MECHANICAL
Additional desc . .
Permit Fee
24.00
Plan Check Fee
6.00
Issue Date
Valuation
0
Expiration.Date..
3/22/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9:000.0
EA MECH
APPL.REP/ALT/ADD
9.00
Permit. . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00
Plan Check Fee
11.25
Issue Date
Valuation . . .
. 0
Expiration Date . .
3/22/11.
Qty Unit Charge
Per
Extension
BASE
FEE.
15.00
1.100 30.0000
EA ELEC
PRIVATE SWIMMING POOL
30.0.0
PermitPLUMBING:
Additional desc .
Permit Fee . .
27.00
Plan Check.Fee
6:.75
Issue Date
Valuation . . .
. 0
Expiration Date
3/22/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.0.0
1.00 6.0000
EA PLB
FIXTURE
6.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 1.00:00
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Permit . . . . . . WALL/FENCE PERMIT
LQMRMIT
•- i
Application Number . . . . 10-0000.0.978
Permit. . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee .00
Issue Date Valuation . . . . 175
Expiration.Date 3/22/11
Qty Unit Charge Per Extension
BASE FEE 15.00
Special Notes and Comments
4' X 4' PLUNGE POOL, INCLUDES CHILLER,
PUMP & FILTER, 7 L.F. 61 PRIVACY WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE:AT PRE -PLASTER INSPECTION. 2'007' -
CODES.
----------------- ------ ----------------------------------
Other Fees _ . . . . . .. . BLDG S.TDS ADMIN (SB1473) 1.00
Fee summary Charged Paid Credited Due
----------- ---------- -- -----------
Permit.F.ee Total 228..00 ,00 .00 228.00
Plan Check Total .1,00.05 .00 .00 im.05
Other Fee Total 1.0.0 .00 :00 1:.0.0.
Grand Total 32.9..05 AD .00 329.05
LQMRMIT
&n
City Of La Quinta
BAUng ar Safety Div ,
pmt g
P.O. Box 1504, 78495 Calve Tamplou
C0
la Qldnta, CA 92253 -•(760) 777-7012 �.
Building Permit Appticat[on and Tracking Sheet
Project Address:
v Ownexs Name:
A. P. Number:
Ad&vis:S LEGQ AFL C-4 "
D
ct,, ST, zap:
Contractor.
g " S 9bl
addt : -1
l # P *xt Description: #--
City'. ST. Zip; 7 CA IiZ16 a
Suft Pa. C; . uCity lit: #:
Arch., Bagr,, DwiBaa:
Ad":
CitX, ST, Zip: o&Q A
1— CA 915� D -7
Tdephom-
:l Qty Construction Type: Oocvpancy:
State Int:. # 's
. hoject type (ch de ooe): New Add-n Aloe Repair Demo
Name of Contid Pasoh
QLQ ATS Sq. Ft : # Stories: # Units:
Tdcphono * of CoaW,Pwm: rsetimsbed Value of Project {� "
APPLICANT,: DO NOT WRITE BELOW THIS LRE
it Submittal
Req'd Ree'.d TRACING PEBbIIT FEES
Pian Seb
Plan Me& submitted Item Amount
SbvdoM Calm
Reviewed, ready for corrections PtasCbe* DcpWt
Trm Cwcs,
Called ContactPernaPhu Cho& fthaee .
TMe U Cales.
ttlaen picked up Coswh=fta
Flood plain oft
ukd
Gmdltts plan
r! Renew, ready for eorreellonallme Electrical
Subcontaexw LJst
Called Contact Pelson Plumbing
Grant'Deed
Plans picked pp S:MJL
ICOJL Approval
Plan resubmitted Grading
EN HOUSE;-
'Re radyaor eorreegonwissue Dcvdoper Impact Fee
Planning Approval
Called Contact Perm A,LP.P:
Pub. WkL Appr
Date of per alt Issue
School Fen
Total Permit Fees
Im
CITY OF LA QUINT -A SUB -CONTRACTOR LIST'
JOB ADDRESS PERMIT NUMBER OWNER BUILDER------,—
This form shalt be posted on the job with the Building Inspection Card at all times 1q;a coondmous 11lace. Only persons appearing on this list or their' employees are buthoriz.ed to work
on this job. Any changes to this list must, be approved by the Building Division prior to commencement of work. Failure to 'comply will result in `a stoppage -of work an.d/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. O -On File' is not can acceptable response.
Trade I Clawificttion
`."Cdintractt.
t're c" t" LJ Cie
ce 8
S e
anse::
Company Name
-Clatsiftation
(e.g. A. B,, C-81
License Number
OXXXXXI
Exp. Date
Carrier Name
e.g. State n1pd, CalComp)
Policy Number
16-1-,j
6717
4
MASONRY
PLUMBiNd IC -161"
146"Jars 04-4w&ktr
r_* A
rv-,
KASM (P-45)
DRYWALL (C-9)
ELI (c -lot
NIS
A
6-1�0 CE
5-PLr=,_ Sj�-
67 11
QqF1 G j"_ 9)
.:S"w METAL (6-43)
FLOORING 5
,GLAZING (C_-71 :.--'-`
(NS6LATION,(C. 21
MMAWt PIV,*4-(0-42)
PAINTING (0431'
CERAMIC ME (I C.rA)
CABINETS (C-6)
FENCING (C43)
LANDSCAPING 10-27).-;.",
POOL IC -531.
r
P'MAP _►.��
gedroovv::Door
gedrom&
F
�AC
61 ❑
MVt(ow
Mo'd'owAaC Bacle�jard
pl,uw
-
cm
pooLegkpwew
pluv,,ge w/. aa
4x4
mSdeck i av'd
ode and
0
JIM
Propertld Lim s' WALL
Tx & matching privacy wall
emptd Lot
N
CITY OF LA QUINTA
BUILDING & SAFEIY DEPT.
APPROVED
FOR CONSTRUCTION
Robbiks R-escdekwe
DATE Q-2z-X'BY
52530 Del Gato Drive.
La Quinta, Ca 92253
_ Left Coast Pool Concepts, Inc.
ewe
1 Lic. 930999 -Tel. 760.567.9007
,
www.LeftCoa.stroolconcept5.com
Tire Fusion of Art, Design and Water
�'/? PAGE DEPT: DESIGNER REV
Mario M Horvath
r
scnLE 1/8"=.1' SHEET 1 OF 1