11-0528 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
' 1
Application Number: e, 11-00 0 00528
Property Address: L" 53549 VIA BELLAGIO
APN: 777-170-005- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 35000
TUV/
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
------------------------------------------------.--
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.
Licen a Class: C8, 10, 27, 2 License No.: 656128
Date: �>� ntractor:
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 .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).:
(_ 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.).
(_ 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.).
I—) 1 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: I{�
Lender's Address:
L&ERMIT
Owner:
MIGLIORINO ROBERT/MARY
81 ELEVEN LEVELS ROAD
RIDGEFIELD, CT 06877
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/23/11
►D A
—L-7
Contractor:
TESERRA Ad 1
P.O. BOX 1280 r MAY 2 G 2011
COACHELLA, CA 92236.
(760) 398-9222 . i 67Y0,FLACJU1N7R
Lic. No.: 656128 — r1r1e?.,C 3. es+ 1
------------------
WORKER'S 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.
V� 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 EVEREST NATL IN Policy Number 7600006481111
_ 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 su ' theworkers' compensation provisions of Section
3700 of the Labor Code, I sha114eK ' h comply wi os isions.
/D�t ¢/�] AW
cant:
W/ ARNI G: FAILU T URE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 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 co
/pntyy toenterupon t above-mentioned prop! inspection purposes.
uS' azure (Applicant or Agent):
Application Number' . . . 11-00000528
Permit ..
BLDG POOL PERMIT
Additional desc
Permit Fee . . . .
317.00 Plan Check
Fee
206.05
Issue Date . . . .
Valuation
. . . .
35000
Expiration Date
11/19/11
Qty 'Unit Charge
Per
Extension
BASE FEE
252.00
10.00 6.5000
-----------------------------------------------------------
THOU BLDG 25,001-50,000
----------------
65.00
Permit
OOL
MECH POOL,-
Additional
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . . .
0
Expiration Date
11/19/11
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
11/19/11
Qty Unit Charge.
Per
Extension
BASE FEE
15.00
1.00 30.0000
------------------------------------------------7---------------------------
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
11/19/11
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, INCLUDED 96
L.F. 1 1/2" GAS
LQPERMIT
Application Number 11-00000528
Special Notes and Comments
LINE. 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 421.00 .00 .00 421.00
Plan Check Total 232.05 .00 .00 232.05
.'Other Fee Total 2.00 .00 .00 2.00
.Grand Total 655.05 .00 .00 655.05
LQPMI IT
0 EXISTING LANDSCAPE LIGHTING IN REAR YARD RAISED PLINTH AT 44' WITH LT.BROOM CONCRETE COPING.
0 EXISTING OVERHEAD UTILITY LINES IN REAR YARD ONE RANTER BOWL AND RANDOM STONE VENEER FACE • .
POOL SPLIT MAIN DRAIN SUCTION MINIMUM Y APART.
ANTI -COVERS i0"AWE IANSI APPROVED
FIREI PIT AT O'�WITH LIGHT BROOM FINISH COLORED
ICONCRETE
I
STEPPING PADS
POOL I SPA LIGHT JUNCTION BOX
POOL I SPA LIGHT ON GROUND FAULT CIRCUIT INTERRUPTER
POOL EQUIPMENT 50 AMP SLIBPANEL
WITH 30' CLEARANCE AT FRONT AND SIDE
POOL EQUIPMENT: 400,000 BTU HEATER
•ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
POOL EQUIPMENT: 400,000 BTU HEATER
'ALL EQUIPMENT SHALL. BE SEISMICALLY ANCHORED
TAs -,1}'Po[yPRoPYLeHE cis
11• ELECTRIC CONDUIT
DATION OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH
)H 114 - MANDATORY REQUIREMENTS
I ARMLS TO RE INSTALLEn ON ALL Dfk-M WITH DIRECT ACCESS
TANNING SHELF AT 12'WATER DEPTH
WITH ONE UMBRELLA SLEEVE
RAISED PLINTH AT+24' MRH LT.M;k M CONCRETE COPING
ONE PLANTER BOWL AND RANDOM STONE VENEER FACE
RAISED BOND BEAM AT +16' WITH LT.BROOM FINISH
COLORED CONCRETE CAP AND RANDOM STONE
VENEER FACE
RAISED PLINTH AT +24* WITH LTAROOM FINISH CONCRETE CAP,
ONE PLANTER BOWL AND RANDOM STONE VENEER FACE
TILE DECIONG BY OTHERS
mSIX Fr. LKHTDRoOYWICFMCAN
trnsQ ne1113rgIlBYanam
M M FT. SIB CPRS
am m
MAIN HOUSE'ZOO A1� HEC1Ti1CAC PMEL,`
SAFETY FEATURES:
'NLAND6RP/PIBROOL91 MTNUTAN IH7MOl1AEBlf BfNdllq OF7IEAIBICAN
Bot>En:a TBINI Alm M790YD J>R TIE A16pM OOOkIY R JLi7I01GTl ETaa®9 µ9Q
ELECTRICAL'
EOIAOIBRWBONM RMMIDA RHOLE NTA W TO EJAMATEVRTAM
QgKMM N RE POR AFA AB 19(CEC MT. IAA
201 O CALIFORNIA BUILDING CODE (SAMON3m6C)
201 O CALIFORNIA MECHANICAL CODE (&MWoNMXUC)
20113 CALIFORNIA PLUMBING CODE 160MOIIMUO)MUF
201O CALIFORNIA ELECTRICAL CODE (9A1OOMEMNEC)
201 O CALIFORNIA ENERGY EFFICIENCY STANDARI
SPECIFICATIONS
TYPE Df►erc
Sim SDe. x
SLWACE MEA OF POOL ONLY M SQ FT.
PSMETER 122LAFT
D®MB YN. Sd
POOL 8 WKIY EDGE COIBFm SQFi.
/ tIt lAF'T. .
SPA SPECIFICATIONS
TILE
MASONRY
WPBATYFE
RLL R M _
GFLMYrME—
ILE ME TAD.
BTif 17A04 TAR lR Fl. 1115 --mg. ��
ePAOA9IEYLININ —
RETI91
9JATI9 WJND
140.0F" I
I191T 1-1mM
RaR ILE
ROAMSMAT —
.3m 1.1,
fwL.,
WLLMYTM
EYE9EU
STEEL
TTIHRBIOMLBfffrEPR
R AroaNFETAIKef ID
mmTmmm
•Rea FTImeolE
IT FrIqA�
E_A
RE91R
60AARO
trRea —
DrRAe —
Ir RBa N7
TM SBF HEPTA
P=FOMZM NO
ND
MASONRY
WPBATYFE
RLL R M _
GFLMYrME—
PLUMBING
q„O ANN E SSOSQFI.
PODLFUW JIIDY am 2P2SPBDQC
BDDBIBiPIBi UIdY 6QE 2A W
AOOI ROF LYIOY qE 2A IP
_
MaPUIV am
MUM AVE � ffru .
So A
A�
MIDP. OO. TBIIe_
RAMwu—
JETI99 INSUB
FFa
ii�lT
IJb►AA6 Amoy
AxAounETe —
n9Be11 n ouALPaar
RLLAE MIMSBL�¢
OABL/E 1 ur $I=
.3m 1.1,
fwL.,
FOWTAB 111PIUYIFADA —
m" "mm —
UWMMMM 0-01W NWA 1-Iww
BTIBOETolwam YES
WC. — -
EYE9EU
FENCING
FLUMMXM 2tft611CTANa2Vr IETIRI
R310E1Y1E—
xmrt
GATE
OU N ITE
aVERNAiFA
JRIYMYTYIE fv
cAoxm YES
OpOA RECASTBYa1166 OTHER
RB8-SE M
OWNER RESPONSIBILITIES
Dw761T0
MTAIE MU ME�LOOCA7MMEMS&M TOTO�MICEOF IPl
LOCA BUIDRA D B VJ"WD AT TIE TOE OF SP W CE OF FO W.
q TET 00"CO MM 98LMLEAffT TOLE DALY FOR WANDAY11AF1019ELL SEVAIM
AUMTMTTBBEWAM DNIIOEE MOA IIDBEOIA ONV> T%LA A0"ImmillmR pf A[Lmme
M QLnT0 a16�5,M 9YM9c DD991MLWAWOGFQIAPOOL9 OMM
MFKLMMMM4VAMYAFMRFAMM(FOJMB IRJ=W-DOWTIAERIAii10E)
(>) lffTTTMP80W=0 �p*PRMW= OF IE>HitANOnwTAlf/l/>E1MDAlR
IffUK
0MMMf R01FARAL FOR AM EaNUM LownsAo 1MIFm TRE fwwa;eiIEO®A010RHATOLE
F— MICLIORINO RESIDENCE
l� 1 . I (I BATE 2011 I DESIGNED BY I PROJECT MGR JT. PAM I C EC1ED BY I
'mF I REVISIONS
BY THE OCRAUMNA F RMDTBA• TIE OCA MTOR 91ALL09NFATENITN AREPIWF W ORBI
affARE M401IM TE ME M BEEIRAYATED
CONSTRUCTION AUTHORIZATION STONE
SALES FIELD nLE
n1r, BOULDERS
SELECTIONS
L.IJ
U
z
W
'Q
V I
W
nE
O
Z
Qf
O
J
U
Bin #
City of La Quinta
Building & Safety Division. '
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760)- 777-7012
Building Permit Application and Tracking Sheet
Permit #
11-
Project Address: S� S
Owner's Name: I 1 O(zW/t0,
A. P. Number:
Address: 5 3 Sy 9 i//A
Legal Description:
Contractor:ES -
City, ST, Zip: LA Q11AIT-,1, Z S�
w.4:; •:.i v :<,>.c •v.':,+F:;-: y
Telephone: .� -.>���-•,r,,:.�:av�.s; -.,s.,t.
Description: AJ -!- S 4,
Address: C� 6 /O O • -- sProject
City, ST, Zip: ^CA
�x 6
TelephonZ Z ;:<z:<>;.:;.;
O :t:.,�..•,�f,'y,\424::::: %i.:iV;'fSccY+'.tF2yrf .4:
State Lic. # :Al S C / 2 19 City Lic. #;
Arch., Engr., Designer:
L- v
Address:
City, ST, Zip:
Telephone:
:%. yrsh<•> �: •.
•.. ..:::c�^:^~.�vi:::v; .:�;>.-ice:-..Project
AM:•'Ftii.:
Construction Type: YP Occupancy:
type (circle one): ew Add'n Alter Repair Demo
State Lic. #:a
Name of Contact Person: o
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ZSO /A
Estimated Value of Project: 3 $ _O vn
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
S
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan .
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionstissue
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 correctionstIue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr .
Date of permit issue
School Fees
Total Permit Fees