09-0859 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253,
Application Number:
09-00000859
Property Address:
54230 AVENIDA VELASCO
APN:
774-215-025-12 -000000-
Application description:
POOL - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
20000
c& -14t
44aQ rw
Applicant: Architect or Engineer: 4*
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: C53 Lice No.: 614611
Date: Contractor:� "
OWNER -BUILDER DECLARATION '
1 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).:
(_) 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.).
1 ) I am exempt under Sec. B.&P.C. for this reason
Date: 9Z �� a�7 Owner: _
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty ofperjurythat 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
Owner:
OLMSTEAD
54230 AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS &
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612.
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/10/09
SPAS,
-----------------------------------------------
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 DELOS INS CO Policy Number 02DKRM120001870
_ 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
3700 of the Labor Code, IyIssfhall forthwi comply—with those provisions.
Date:�Applicant: � �/
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 certify that I have read this application and state that the above information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of thise7county t enter upon the above-mentioned property for inspection
D. ignature (Applicant or Agent):
Application Number . . . . . 09-00000859
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.00
Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. .
20000
Expiration Date
2/06/10
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
•18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
162.00
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
2/06/10
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
2/06/10
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
27.00
Plan Check
Fee
6.75
Issue Date
Valuation
. . .
. 0
Expiration Date
2/06/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 6.0000
EA PLB
FIXTURE
6.00
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 REMODEL.
CHANGE OUT
LQPERMIT
Application Number
. . . .
09-00000859
----.------------------------------------------------------------------------
Special Notes and
Comments
PLUMBING, ELECTRICAL, RE -PLASTER AND
RE -TILE.
-------------------------------
Fees . . .
------
. . . .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
Paid
Credited _
Due
Permit Fee Total
305.00
.00
.00
305.00
Plan Check Total
159.05
.00
.00
159.05
Other Fee Total
1.00
.00
.00
1.00
Grand Total
465.05
.00
.00
465.05
LQPERMIT - ..
• Bin
Qty of La Quinta
Building &r Safety Division
P.O. Box 1564, 78-495-Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit iv
Da
Project Address: C -d
Name:
o7m T,
A. P. Number:
Address: 230 Oif
Legal Description:
City, ST, Zip: 4
Contractor: &C
Telephone:
T
Address: �3— cs—5 �Y
Project Description: sat
City, ST, Zip:
M2A rrnnd lRao i
Telephone:
Im VkA
State Lic.
City Lic. C.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
........
.
.. . . . . . . . . . . . . . . . . . . . .
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #-
Name of Contact. Person:
Sq. Ft.: —T#
—Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: Ro. ow
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIUNG
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, read . y for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
V Grant Deed
Plans picked up.
S.. .1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3r4
Review,ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
i
a 3'
W ooO C is NWA
POO I SAG
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PeP�+n�t�ers �' 2 �F �v1 11
Iia 4-h—
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Equipment specifications
VS 3050 Pump
gq( o2.30 400,000 BTU Heater
,ICA 612 7-:5:3 420 CCP Filter.
Easy Touch 4,w/spa side remote
400 watt light
100 watt light
MP auto -fill
Skimmer —
EZ Touch 4 w/indoor controller
Spa -side remote:
f (2) Handrails
Concre a equipment pad
Intellichlor salt cell