11-0162 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: �1„OOOOQ162_
Property Address: 79785 SHADWELL CIR
APN: 604-483-005-15 -24197
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
.Application valuation. 32000
Ta�144Q”
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JOLIE LEYDEKKERS
_79785 SHADWELL CIRCLE
LA QUINTA,'CA 92253
Contractor:
VOICE (760) 7774012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/14/11
Applicant: Architect or Enginee FEBn LINDLY' S POOLS OF CALIFORNIA
2011
30805 DESERT PALM DRIVE
G'f�A� THOUSAND PALMS, CA. 92276
j '
t�igl �rtJ)c: �f;t3fVii{ . (760) 343-0600
.�.`,?�j Lic. No.: 833313
-- - - - -- --
. LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty,of perjury that I am licensed under provisions of Chapter 9 (commencing with - I.hereby affirm under penalty of perjury one of the following declarations: '
-Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C53 License No.: 833313 for by Section 3700 of the Labor Code, for the'performance of the work for which this permit is
-1 �A� /r'_� issued.
/ta,a- ontractor: A v ! �` 1 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
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 DELOS 'INS CO Policy Number 0009172010-02
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 the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation 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 Code, I shall forthwith comply with those provisions.
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 ($500).: ate: �'� pplicant:
(_ 1 1,. as owner of the property, or my employees with. wages as their sole compensation, will do the work, and 10
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL 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 ($100,000)• 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.).
(_ 1 1, 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: -
LQPERMIT
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, 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 this permit.
2. Any permit issued as a result of this application becomes null and void ifworkis 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 construction, and hereby authorize representatives
of/this%�,ig�ature
the above-mentioned property for inspection purposes. —.
atm e: (Applicant or Agent):
Application Number ... .. . . 11,700000162
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee
297.50 Plan Check Fee
193.38
Issue Date
Valuation . . .
. 32000
Expiration Date .,
8/13/11
Qty Unit Charge
Per
Extension
BASE FEE
252.00
7.00 6.5000
7 ----------------------------------------------------------------------
THOU BLDG 25,001-50,000
45.50
Permit. MECH POOL
Additional desc..
Permit Fee . . . .
26.00 Plan Check Fee-.
6.50
Issue Date ..
Valuation . . .
. 0
Expiration Date
8/13/11,
Qty Unit Chargee
Per
Extension
BASE FEE
.15.00
1.0.0 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
8/13/11
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
8/13/11
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
POOL/SPA, GAS LINE FOR FUTURE APPROVED
LQPERMIT
Application Number 11-00.000162
Special Notes and Comments
BBQ: ALARMS/BARRIERS SHALL BE IN PLACE
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED. 2010'CODES.
------------------------------------------------------------ ------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
_ Fee summary Charged Paid
------
-
Credited
Due
---------------- ------------
Permit Fee Total 401.50
.00
.00
401.50
Plan Check Total 219.38
.00
.00
219.38
Other Fee Total 2.00
.00
.00
2.00
Grand Total 622.88
00
.00
622.88
LQPERMIT
Bin #
Qty of LA Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
l
Project Address:--�$ j S kF �j.��l,j_
Owner's Name: �fl(�(� L D F— (L5
A. P. Number:
Address: 11q--195
Legal Description:
City, ST, Zip: (A QL)1 NFp4 (A cM53
Contractor: �(NXJ��5 �W 6--CA�'V;V
W.
NN
Telephone 9W `102 36
Address: O -- S; �� S' a. �j/�1
Project Description:
City, ST, Zip: • J-3Mf)CA
SPA GA U-G �2
Telep hon T_]I��
}yii t}ti... f{...n•; .�v: ' •N:{:.;?•'•ivv t:ii: i}
s.i.i::A.,;?: ;:;•->r�;,;;~.. {.,..:
G� /` `,
IV .�I
State Lic. # : �J�,� City Lia #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:.
-#::;:•::�{:; ham::;..: }:{..{:;n.::{i�'t't:�-.}w;C
:i>r„:i; -:,-:: y.;:; :'. ;:;::: f>.>.: c>;;rs>
%zw, ::!.:....::.i„°:».>.-.-..~,'';' {�:>.{.; ;.
x.: }f;f`??::f:��ti?:ivi�ilr iiN:;'{-•:;'"'i;':Lj
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �� ;
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Perso : rl6c 12—
Estimated Value of Project: op. ,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
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.
Title 24 Calcs.
Plans picked up
Construction
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
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''” Review, ready for correctionsliissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. App r
Date of permit issue
School Fees
Total Permit Fees
Lindly's Pools of California Inc
30755 Desert Plam Drive
Thousand Palms CA 92276
Lirpnsp # 833313 _ _ _ ,, ��:c� w�L
r
Length: 35 Ft
Width: 12 Ft
Depth: 3'6"-S'6"-8'
Perimeter: 96 Linear Feet
Square Footage: 382 Sq ft
Capacity: 17.325 Gallons
Material: Pebble price group 1-2
Water Features: 2 -Stacked k Stone
Sp
Spillwayss
Length: 4 Ft
Width:' f Ft _
Depth 3'6"
Perimeter, 26 Linear fleet
Square Footage: 36 Sq Ft
Capacity: 1.155 Gallons
Material; Pebble Price Groups 1-2
Water Features: Stacked Stone
Spillways
Filter Pump: 2hp 2 -Speed Pump
Filter Type: 420 Sq Ft Glean Clear
Other Pumps: 2hp pump and motor
Heater: 400k Btu Master Temp
Sanitation: IC40 Easy Touch Salt
System
IT 1 ., �
BUILDING 8,_S �FE-TY DEPT.
=Deck srecirG—tio—nsm
�OVED
FOR CO�iS�i�FRUaFION
DAT -All -511-1 Square Footage: 843 Sq tt,
Material 1: Pavers To be Selected
Ice
IN
towner �ilitiLeydekkers State: CA
Address: 79-785 Shadvweil Zip: 92253
City': La uii�ta
Phone: 769-702-6731