09-0067 (RPL)P.O/. BOX 1504. �� VOICE (760)'777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/28/09
Application Number: z-0 . Owner:
Property Address: 86420 TORREON WY PAUL BROWN
APN: 777-330-025- - - 80420 TORREON WAY
Application description: • POOL - RESIDENTIAL LA QUINTA, CA 92253 �• `U
,Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 152'00 8
Contractor:
Applicant: Architect or Engineer: PICASSO POOLS INC 6
78078 COUNTRY CLUB DR,. .#
BERMUDA DUNES, CA 92203 QFi-il►Qu�N��`
(760)345-4600 G1I pN�EOEPT•
Lid. No.: 810111
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 is in full force and effect.
License Class: 13 C27 C53 I= License No.: '810111
Dat `�' C R, 2ntractar-
/s
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 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 Contractor's State
License Law (Chapter 9 (commencing with Section 70001 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 (5500).:
(._ 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 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 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
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:
LQPERM[T
WORKER'S COMPENSATION DECLARATION
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.
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 STATE FUND Policy Number 290-0001790
_ 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
37700 of the Lab de, I shall forthwith comply with those provisions.,45''
atef�'1 � •�' 0 l plicant:
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.
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.
I certifythat 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 thi ouno2ty to enter upon the above-mentioned ro-Perty for-, nspection purposes.
ate'01 • �//S�'p"tu/re (Applicant or Agent)-
V r(a
Application Number .
. . . . 09'-00000067
Permit . . ..
BLDG POOL PERMIT
Additional desc
Permit. -Fee . . . .
171.00 Plan Check
Fee
111.15
Issue Date . . .
Valuation
15136
Expiration Date..
7/27/09
Qty Unit.Charge
Per
Extension
BASE FEE
45.00
-14.00 9.0000
THOU BLDG 2,.001-25,000
126.00.
Permit . . .
MECH POOL
Additional desc..
Permit Fee . . . .
26.00 , Plan Check
Fee
6.50
Issue Date . .
Valuation
0
Expiration Date
7/27/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
EA MECH FURNACE 5100K
11.00
Permit . . .
ELEC POOL PERMIT -RES "
Additional desc .
Permit Fee
45.00 Plan Check
Fee
11.25
Issue Date
Valuation
. .
0
Expiration Date
7/27/09
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
7/27/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 3.000.0
EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Permit . . . . . .
WALL/FENCE PERMIT
f
LQPERMIT ..
Application Number 09-00000067 .
.-.'Permit WALL/FENCE_PERMIT
Additional desc ..
Permit Fee,. 15.00 Plan Check"Fee
.00
Issue Date., Valuation
64
Expiration Date 7/27/09
Qty Unit Charge Per
Extension -
BASE FEE
15.00
---- Special -Notes and Comments
POOL/SPA, 4 L.F. 4' EQUIPMENT WALL,, CITY
STANDARD. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged' Paid Credited
Due
Permit Fee Total 290..00 .00
.00
290.00
Plan Check Total 137.15 .00
.00
137.15`
Grand Total 427.15 .00
.00
427.15
J
LQPERMIT
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- BROWN- MTV 258 �k
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01/12/09 POOL SPACONCRETE
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11 47 SF 1 355 SF
,.. AREA: • 423 SF -
` `
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1 PERIMETER: 87 LF 27 LF' 1/9' 1 SCALE
131 LF
11 Iis
80-420 TORREON WAY
2" GAS LINE
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LA QUINTA'IL
P�
` 140 LF
ELECTRIC LINE
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BUILDING-& SAFETY DEPT. '
APPROVED''
FOR CONSTRUCTION`
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01/12/09 POOL SPACONCRETE
f
11 47 SF 1 355 SF
,.. AREA: • 423 SF -
` `
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1 PERIMETER: 87 LF 27 LF' 1/9' 1 SCALE
131 LF
11 Iis
80-420 TORREON WAY
2" GAS LINE
I I �d
LA QUINTA'IL
` 140 LF
ELECTRIC LINE
I .,CITY OF_L A o UINTA f
-
t
BUILDING-& SAFETY DEPT. '
APPROVED''
FOR CONSTRUCTION`
' I } -DATE BY
GAS METER
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Via:
I ELECTRIC
EXISTING METER
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TREE
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_ 15a 0p .
135/3&
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Cjlr of Quin ta
BcuJdtrl .E Saferryy Dhision '
P.O. Box 1.50 , 76-1 Y'D - Calle Tampico .
a Quinn, CA ?=; (7 50) 7-77-70f-1 '
B-0, dingy Permit Application and Tracking Sh'
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AFtr L•1CANT: -DO NOT WRi i t Sa_OW i FUS LINE
Ssibrait�i (
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IL'd (
TRaCI:JNCFEES
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RcaieK-ed, rade for corrections
Plan Chert Dcpas
t Caps
Called Contact Pr -son. I
Plan Check- E —net
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Plans picked up •
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Construction
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71,00d main plan I
Plans mmubmincd
?Mechanical
j.Grading pian.
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El=trical
Subeomc. for List
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Called Coalact Person
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Plans picked up
H J A .Appro.al
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Called Contact Person
°ab. WkL Appr
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7 _7
Date o(permit issue
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Permit .i =
_ 15a 0p .
135/3&