04-6218 (RPL)-1•
i
P.O. Box 1504 ,
78-49 -� CALLE TAMPICO
1 .
LA QUINTA, CALIFORNIA 92253
y
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Nu,�tber . . . 04-00006218
Property Address . . . . . 78780 CITRUS
APN: { 772 -080 -006 -
Application description POOL - RESIDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENT
Application valuation . . . . 20000
ID
rl SEP 102004
I
OF LA QUINTA
IL 1-11,1noIN.-P4
Owner !
Contractor
-------------- -
SCHUBERT
---------
------------------------
MCINTYRE POOLS & SPAS,
INC.
78-780 CITRUS I
P.O. BOX 1791
LA QUINTA ,
CA 92253
LA QUINTA CA 92253
(760)e342-3612
WCC: HRH INS
WC: 176911104
01/01/05
CSLB: 614611
09/30/05
CCC: C53
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Permit .. . .
. . BLDG POOL PERMIT
Additional desc
Permit Fee
. . 207.00
Plan Check Fee
134.55
Issue Date
Valuation . . . .
20000
is
Qty Unit
Charge Per
Extension
BASE
FEE
45.00
18.00 (9.0000
THOU .BLDG
2,001-25,000
162.00
-----------------------------------------------------
Permit . . .
. . MECH POOL
-----------------------
Additional desk
Permit Fee
24.00
Plan Check Fee
6.00
Issue Date `.
Valuation . . . .
0
Qty UnittCharge
Per
Extension
BASE
FEE
15.00
1.00
t-----------------------------=---------------------------
9.0000 EA MECH
FURNACE <=100K
9.00
-------------------
Permit . . I
ELEC POOL PERMIT -RES
Additional des
Permit Fee
45.00
Plan Check Fee
11.25
Issue Date.
Valuation . . . .
0
i
Qty Unit -Charge
Per.
Extension
BASE
FEE
15.00
1.00 30.0000
EA ELEC
PRIVATE SWIMMING POOL
30.00
P.O. Box 1504�� VOICE (760) 777-7012
T-Vf
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: od - t 71 1W I Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Ib /fit
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I 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 is in full force and effect.
License Class / License No.
��_LT/_ 41
Date ontractorZ/�i�4� e 4Z r ('✓�.sa
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 fora permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 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 or through his or her own employees, provided 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I 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.
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' compensatio rance carrier and policy number are:
Tier Policy Number
r _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name •� /�
Lender's Address Q✓ r
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
1 certify that I have read this application and state that the above information is correct. 1 agree to q9mply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above -mento prop$rty for inspection purposes.
gnature (Applicant or Agent .l-�! . ' '�
Page 2
Application Number . . . . . 04-00006218
Date 9/09/04
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Permit . . . . . . PLUMBING
Additional desc
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date
Valuation . .
. . 0
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
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Special Notes and Comments
POOL/SPA.'ALARMS/BARRIERS SHALL
BE IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
-------------------------------------
Paid Credited
Due
Permit Fee Total 309.00
----------
.00 .00
----------
309.00
Plan Check Total 160.05
.00 .00
160.05
Grand Total 469.05
.00 .00-
469.05
i
P/L �-
7' Dia Spate
+1 � - •mss
PLASTER
DAM WALL
EQ WALL
/
/ a \
N Rock boulde
+6, t
RESIDENCE
N�:�E.
78-780 �-1-FRUS AVE_
LA QUIN i A, CA, a
. c
A RE—INSPECTION FEE OF $30
\ WILL BE CHARGED IF THE APPROVED
f _ \ PLANS AND JOB CARD ARE NOT ON
' \ P/L THE SITE FOR A SCHEDULED
_ \\ INSPECTION.
BBQ'- • • .� -. .
\ NO EXCEPTIONS!
\\
� . SCHUBER ]
POOLS A SPAS
942-3812
o� y 7
Pool EQ
DEPTHS 3'-6'
POOL PUMP 1.`
HEALER 400,
FlLTER CCE
1-100 N
UGHTS 2 -400 -
CONTROLLER
SPA SIZE 7' 1?
SPA PER. 22
SPA S.A. 38
SPA DEPTH
.JETS 5
JET PUMP
DECK AREA
PATIO AREA
W.F.
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020
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