12-1260 (RPL)t
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00001260 ">
Property Address:
53728 VIA BELLAGIO
APN:
772-510-060- -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
35000
Tay/ 4 4 Q"
Architect or Engineer:
P/A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
---------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thatI am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pr fessionals Code, and my License is in full force and effect.
License Class: C53 License No.: 833313
2Y' 6— ntractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perithat I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Busi ss 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)•:
(_) 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.).
I—) I am exempt under Sec. , BAP.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
I
Owner:
COASTAL REAL ESTATE
53728 VIA BELLAGIO
LA QUINTA, CA 92253
Contractor:
LINDLY'S POOLS OF
30755 DESERT PALM
THOUSAND PALMS, CA
(760)343-0600
Lic. No.: 833313
r
VOICE (760) 7(-7FAX (760) 7.
INSPECTIONS (760) 777- i
D Q 0
I ° 08T 2
D
22 5 2011
CITY OF LA QUINTA
FINANCE DEK
Date: 10/23/12
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.
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 9014035
1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any mishould
to beco a subject to the workers' compensation laws of California,
and agree that, iecome su ject to the workers' compensation provisions ofSection
3700 of the Labhall forth ith comply with those provisions.
/te:11ant:
WARNING: FAILURE TO SECURS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CNALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDIHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR EREST, 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 inform tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building construct n, and hereby authorize representatives
;of thi ounty to enter upon the above-mentioned property f r inspecti purposete:la`ZS'I'Z Si ature (Applicant or Agent):
Application Number . . . . . 12-00001260
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 3.17.00 Plan Check Fee 206.05
Issue Date . . . . Valuation . . . . 35000
Expiration Date 4/21/13
Qty Unit Charge Per Extension
BASE FEE 252.00
10:00 6.5000 THOU BLDG 25,001-50,000 65.00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 4/21/13
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 4/21/13
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 4/21/13
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, COURTYARD WATER FEATURE, 2
LQPERMIT
Application Number . . . . . 12-00001260
----------------------------------------------------------------------------
Special Notes and
Comments
FIREPITS. INCLUDES
173 L.F. 1 1/2" GAS
LINE FOR FIREPITS
& 20 L.F. GAS LINE
FROM METER TO HEATER. 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
LQPERMIT
Bin #:
City Of %a. Quinta
Building 8r Safety Division .
P.O.-Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# ��p
1
Project Address: 1PI �7� L �P O •
Ownea'sName.�p�S j PSL M- n zS%X
A. P. Number.
Address: 53 — �111 % \,(P
Legal Description:
City. ST, Zip: �, P Q� �(`R CA _ 1115
Contractor. LW MA 1 S Pm L5 4 � . L ' JG"
Telephone:
Address: , D cse(L, Q 'Q (.J d It,
Project Description:
City, ST, Zip: 50,.)o CA.
(��o.� M-41Co�fL(`�. � �rlLf✓
Telephone0o A1j'�p0�
State Lic. # : �•` J CityLie. #; p0 .
Arch.,Engr..,Designer- . D 1i5e 90, t,U 1M :.
iii LAft O Iz 'CA5 UNE -FOq;
Address: 9 1 141 �w ven 1�
�.�L�i �1 T : �✓ UFT . Q r 6 11-16
city, sT, zip:nQa Un G?�, 0221►
on neroL ehtr ox NAL
Telephone: Y�o� �� _
Construction Type: Occupancy:
State Lic. #: �3 s. ' ; , .
Name of Contact Person: TO 6 . (&V ry A) 6� �
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft :
# Stories:
# Units:
Telephone # of Contact Pelson p� 1 I (oq 1
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKDcIG
PERMIT FEES
Plan Sets
Plan Beck submitted
Amount
Structural CaleS.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
2'' Review, ready for correctionsrusae
Eleetrieal
Subcontactor Inst
Called Contact Person
Plumbing
Grant Deed
Plans picked ap "
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for coriectionsrissae
Developer Impact Fee
Planning Approval
Called Coutf ct Person
A.I.P.P.
Pub. Wks. Appr .
Date of permit Issue
School Fees
Total Permit Fees
a
P/L
P/L INFINITY EDGE BASIN
SPA AT GRADE LEVEL
,1
.......-------------------------------------- - -
R: 3' 6°'19' 5" i
TANNING i
SHELF
w
FIRE PIT AT
O GRADE
-------------- io -
FIRE FAIT AT GRADE
LEVEL SWIM UP BAR
Q
r �
r
r
COVERED PATIO
COASTAL REAL ESTATE
INVESTMENT
POOL
EQUIPMENT 53-728 VIA BELLAGIO
---
5 LA QUINTA CA 9225)
ti
COURTYARD
FEATURE
EQUIPMENT COURTYARD
WATER
FEATURE 181"
DEEP.
E p
O
PlL
,
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