04-7769 (RPL)BUILDING & SAFETY DEPARTMENT
P.O.'Box 1504 (760),777-7012
78-49.5 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7133
BUILDING PERMIT
Application Number . . . . 04-0000776.9 Date 12/14/04.
Property Address 80330 TORREON WY
APN: 772-250-997-100 -31349 -
Application description POOL -•RESIDENTIAL
Property Zoning . . . . . LOW DENSITY RESIDENTIAL
Application valuation 1500-0
Owner
----------=---
MR . MYRL NOFZ I1aLE
-80-330 TORREON VD GEC 14 2004
LA QUINTA CA 92253
CITY AF 1.A QUINTA
Contractor
PICASSO POOLS, INC
78078 COUNTRY CLUB DR, #206 -
PALM DESERT CA 92211
(760) 345-4600
ruarosv�rc v`r, e-
i WCC: STATE FUND
WC: 1709395
12/0-/05
CSLB: 810111
07-/3-/06
CCC: B -C27-053
Permit .
. . . . .. BLDG POOL PERMIT
Additional
desc
Permit Fee
162.00
Plan Check Fee
105.30
Issue Date
Valuation . . . .
15000
- -Qty
Unit Charge Per
Extens=on
BASE
FEE
45 00
13.00
9.0000 THOU BLDG
2,001-25,000
117 00
Permit .
. . MECH POOL
Additional
desc
Permit Fee
24.00
Plan Check Fee
6 00
Issue Date
Valuation
0
Qty
Unit Charge Per
Extens=on
BASE
FEE-
15 00
1.00
9.0000 EA MECH
FURNACE <=100K
9 00
---------------------------
Permit .
.---------- =----------------- --------------------
. . . . . ELEC POOL PERMIT -RES
Additional
desc
Permit Fee
45..00
Plan Check Fee
11.25
Issue Date
Valuation.
0`
Qty
Unit Charge Per
Extens---on
BASE
FEE
15.00
1..00
30.0000 EA. ELEC
PRIVATE SWIMMING POOL
30.00
Permit
. . . PLUMBING''
Additional
desc
P.O. BOX 1504 -V
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or Engineer's Address:
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
Cod , and my Li nse is in fu force nd effect. �j/
cense Class (-L�� rcense No. O b / /
ate trractor
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 for a 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.).
U 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.).
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:
1 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
N of the work for which this permit is issued.
-A 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
issue�d.. �My - �workers' compensation ' rance carrier and policy number are:
amer er'�pe�olicv Number /7a e? wry T
_ I certify that, in the rfortnan 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisi s.
e-,Vate y A� nt ,
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
APPLICANT
ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Buildingand Safety 1. Each
person u Y Apermit subject to the conditions and restrictions set forth on this application.
pe 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 Ouinta, 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
construction, and hereby authorize representatives of this caz:�
above-mentioned propert r inspection purposes.
Date / '/�ature (Applicant or Agent) '^'
Page 2
Application
Number . . . . . 04-.00007769
Date 12/14/04
Permit Fee
33.00
Plan Check Fee
8.25
.Issue Date
Valuation .
. . 0
Qty Unit
Charge Per
Extens-on
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 ONLY..ALARMS/BARRIERS
SHALL
BE IN PLACE
PRIOR TO PREPLASTER
INSPECTION.
EQUIPMENT ENCLOSURE
NOT.
" INCLUDED 'IN
PERMIT.
Fee summary
Charged
Paid Credited"
Due
Permit Fee
Total 264.00
.00 .00
264.00
Plan Check
Total 130.80,
00 00
130.80
Grand Total
394.80
00 .00
394.80
1„u h n
PICASS 0 POOLS
LIC #810111
POOL SPECS
SIZE: QX271
AREA: 327 SF
PERIMETER: 84 F
SPA y'E 3' TO 5'
H
SIZE: 6XI
LL
AREA: 32 6P
DAMWALL: a
RAISED @; +I " a 7 -
SPILL
SPILL TYPE=
#OF JETS:
LIGHTS: H
FACE FINISH: 060
DIG/STEEL 0
TYPE,�
ACCESS: Q
ELEVATION: cn
DEEP RAMP:
BENCH/TAN-LEDGE; I z
`'
CONC/SOD REMOVAL: `
TREE REMOVAL;
IRRIGATION REPAIR:
RBB LENGTHS:,
ROCK POCKETS:
PLUMBING N
FILTER: 320 ti
POOL PUMP;
BOOSTER PUMP: z
HEATER: 400 000 BTU
TIME CLOCK: AQUA RITE fj
SUB PANEL:
RETURN INLETS: 2 g
z 0 p
SKIMMER:'
AUT6—FILL: nz Q ~
GAS LINE: w D
CJ U m fJ CJ
STUB OUTS: z
CASCADES:
SPRAY HEADS:
POOL LIGHTS: M U L L * z
SPA LIGHTS: _ Q
PLUMBING SIZE:
STUB SET EQ:
GUNITE
DEEP END RAMP- Q
I 2nd STEP:
LOVE SEAT: 4- Q
SPILLWAY TYPE: z
CANTILEVER: p Q
COPING;
RBB:SEE STEEL Q
TILE 0
TILE TYPE U
WATERLINE: TBpz
TILE TRIM: H
RBB TILE;
I-- U w
DECKING
COLOR: a
SQ FT: 577 SF
FINISH: ` z
SMOOTH BROOM
o z
WALK WAY: w �z
CANTILEVER:
DECK DRAINS:
DECCO DRAIN:
CURB CORE;
STEPS:'
STEPS FACE: Q
SUB BASE: `
VISQUEEN:
BANDING: w A
STAMPED:
RELEASE H
MOW STRIP;
MASONRY
COPING TYPE: Z
RBB FACE; w
SPILLWAY:
a
STEPS: z
P/L EXT WALLS: z
CLi
NTER WALLS: Lu w
TNG WALLS: z
Ql
EQ WALLS: __4}-
uj I
A&R GATE:
Bim.
SIZE: <
F� MODEL:
TOP FINISH: w a
SIDE BURNER:
LL cn
pP FACE FINISH; � w
FLEXI LIGHT:
POWER OUTLETS:
LIGHTS SWITCH: __
PLASTER
PLASTER COLOR: Z
PEBBLE COLOR: w
POOL LIGHTS: 1
SPA LIGHTS: w
ROLLED BOND BEAM;
EYEBALLS:
zQ
OTHER PLAN FOR _
NOFZIGER RESIDENCE
ADDRESS: 80-330 TORREON WAY
LA QUINTA
LOT# 100 MTV
REVISIONS:
(1---- -- — DATE:
{ (2)� DATE:
j (3) DATE --
'Date Printed 1/8 Scca�
11:56 PM 12/09/2004 1 1 -1- 1FT_