05-5327 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit� 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: C0.5-7-00005327
Property Address: 53860 AVENIDA--N ARRO
APN: 774-175-006-17 -000000-
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 15000
Applicant: Architect or Engineer:
-----------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
.Section 7000) of Division 3 of the Business and Professionals Cod ,and my License is in full force and effect.
License Class: C53 4 Lic a No.: 602947
ontractor. 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 thatrequires 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 ($5001.:
( 1 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 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 ofsale.). -
(_ 1 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 contractorls) licensed
.pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. I, 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:
LQPERMIT
Owner:
LOWRY CHARLES
53860 AVENIDA
LA QUINTA, CA
Contractor:
LEE CONS TRUCTI
53930 AVENIDA.
LA QUINTA, CA
(760)777-9838
Lic. No.: 6029
VOICE (760) 77777012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/06/05
NAVARRO
92253—
Contractor:
2253-
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the followingdeclarations:
_ 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 EX •MPT Policy Number EXEMPT
I certify that, in the performance of the work for which this permit is issued, 1 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' pensation provisions of Section
3700 of the Labor Code, W forthwith_ comply wit o provisions.
plicar
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 15100,0001. 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 applicationis 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.
I certify that I have read this application and state that the above information is correct I agree to comply with all
city and county ordinances and state laws relating to building nstrucuon, and her authorize representatives
of this county to enter upon the above-mentioned propert inspection purpo
Da S' ture (Applicant or Agents ~� -
Application.Number
05-00005327
Permit
BLDG POOL PERMIT '
Additional desc .
Permit 'Fee
162._00 Plan Check Fee
105.30
Issue Date .. . . .
Valuation
15000
Expiration Date
6./04/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
13.00 9.0000
THOU BLDG. 2.,001-25,00d
].17,00
Permit
MECH POOL
Additional desc .
Permit Fee
26.00 _ Plan Check Fee
6.50
Issue Date . .
Valuation . . .
0.
Expiration Date
6/04/06
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 ..
6/04/06
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 .
6/04/06
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 3..0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00'
---------------------------------------------------------------------------
Special Notes and.Comments
.SPA..ALARMS/BARRIERS
SHALL BE IN PLACE
LQPERMIT
City of La Quinta
Building u Safety Division
P.0 Box 1504, 78-495. Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Peirnit Application and Tracking Sheet'
Permit #
Project Address: 5 3 /-0 A^V4 r to
Owner's Name: CIA A4- I &A
A. P. Number:
Address:
Legal Description:
City,ST,Zip: 44
Contractor:
Telephone:
Address: 1;- 4 94.+;--) ts 0
Project Description:
Telephon
Arch., Engr., Designer:
Telephone:
State Lic. #:
Name of Contact Person: Le-
Constru ion Type:
Pt 0ocupancy:
Project type (circle.one): New Add'n- Alter Repair Demo
Sq. Ft.:
es:
Telephone # of Contact Person:
Estimated -Valu� of Project.
APPLICANT: DO NOT WRITE BELOW THIS LINE
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections'
Plan Check Deposit
Energy Calcs.
Plans �ickcd up
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan*
2" Review, ready . for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
II.O.A. Approval
Plans resubmitted
Grading
IN. ftOUSE:-
3'� Review, ready for corrections/issue
Developer Im
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit -7ces
i
CITY OF LA QUANTA
BUILDING
®&pSAFEfY DEPT.
APPROVED
FOR CONSTRUCTION
DATE, /a? • to •D�BY
Install vac line
.epair
uto fill
"BACKYARD RESORTS"
By Michael Lee Construction
Office (760)777-9838 1
fax(760)771-9676
Licensed since 1990
C53-602947
Name: Charle & Tracey
Street: 53-860 Av Navarro
City: La Quinta
r
Phone Office: Res.
Lot Tract Page Book
Scale 1/8"=1' Date
Spa spec.
Size 616" x 616" Area 39' Per. 25'
Spa dam wall width 6'6"
No. Jets 5 No. Lights 1
Spa raised 18" Spillway Type
Special notes
{
l
Depth Min. 3'6" Max. 5' 316"
R.B.B.
Love seat per plan Extra steps
Tanning Ledge Rock pockets no
Excavation: Type Bobcat
Elev. Deep end ram
Removal: wall. Sod none
Plumbing: Hayward Equipment
Size: -Filter 3020 c . Heater Electric
Install vac line
.epair
uto fill
"BACKYARD RESORTS"
By Michael Lee Construction
Office (760)777-9838 1
fax(760)771-9676
Licensed since 1990
C53-602947
Name: Charle & Tracey
Street: 53-860 Av Navarro
City: La Quinta
Job Address:
Phone Office: Res.
Lot Tract Page Book
Scale 1/8"=1' Date
Spa spec.
Size 616" x 616" Area 39' Per. 25'
Spa dam wall width 6'6"
No. Jets 5 No. Lights 1
Spa raised 18" Spillway Type
Special notes
Pool spec..
Size 11'6"x' 28' Area 288' Per. 76'
Depth Min. 3'6" Max. 5' 316"
R.B.B.
Love seat per plan Extra steps
Tanning Ledge Rock pockets no
Excavation: Type Bobcat
Elev. Deep end ram
Removal: wall. Sod none
Plumbing: Hayward Equipment
Size: -Filter 3020 c . Heater Electric
Pump 1 hp 2nd pump 1 h .3rd pump
Type of controls Aqua lod is
Fountains/s ra heads none
No. of Skimmers 1 Lights I'
Decking: Finish Salt
Color Color Deck drains
Steps 105' Notes
Tile: Type
Step trim None Type
Masonar : Coping type Cantalever
Access wall Equip wall
Fire pit B13Q length no
Pebble TBD Plaster
Color Size
JOB ADDRESS CITY OF LA QUINTA SUB -CONTRACTOR LIST
PERMIT NUMBER OWNER
This form shall be osted on the 'ob with the Buildin Ins ection Card at all times in a cons icuous lace. Only persons a BUILDER
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. persoFailure to appearing on this list or their employees are authorized to work
of building permit For each applicable trade, all information requested below must be completed by applicant. "On File"• is notwill anacceptable a
stoppageof work and/or h d
Trade /Classification Contractor ` e voidance
State.;Contractor s'License.
p response.
Workers Compensation Insurance
Company Name Classification License Number Ex Date City Business License .:.
(e.g. A, B, C_8) p Carrier Name Policy Number Exp. Date License Number Exp. Date
(xxxxxx) (xx/xx/xx) (e.g. State Fund, CalCom )
EARTHWORK (C 12) P (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx)
IV9t/9cJ �x�A� t„� q g05�9� 6=3a -a6 S�A fe t
CONCRETE (C 8) uss [;cf (�� /0-01 -D
23 R Irl M.. �l9 Ll6 � — p — / r
FRAMING (G=5) S*4 �c �. -N00/9/33 cc>6` /00351 x,31 0�
C 12A OA �e c
k
Lee GoNS_(-cAlod'!
C—sr�c��1�13i �,�.3n-�
5�s+
z G 2/
_53._ G02�1-1-7 2- 2 3--v`z
170 <-/o... ..... ....
� lz-l3 os !oo ll �-?Q o6
0yL/30C/—;00L/ 116-0/-0,I i.,/0q8
/so / 17-31-