09-0645 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO-
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000645 _
Property Address: 79190 SHADOW TR
APN: 649-030-069-36 -31310 -
Application description: PLUMBING
Property Zoning:_-- • ' HIGH DENSITY RESIDENTIAL
Application valuation: 1000
Applicant:
Ti4t
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
KEITH GIBSON
79190 SHADOW TRAIL
LA QUINTA, CA 92253
(760)771-3345
rchi D or ngin _
'JUN 2 5 2099
CITY OIF hA QUINTA
FINA00E f)EPT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions f Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines nd P ofessionals Code, a r -License is in full force and effect. '
Licensee C.1asss:` C27 C53 License I 65900
Date: aGi1 �p C actor.
OWNER -BJ LDER DECLARATION "
I hereby affirm under, penalty of pe r that I am exern from the Contractor's State License Law for the
following reason (Sec. 7031.5, ess and Professions Code: Any city or county that requires a permit to '
construct, alter; improve, demol , 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 1, 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 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 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 thispermitis issued (Sec. 3097, Civ. C.). - - -
Lender's Name: '
Lender's Address:
LQPERDIIT
,VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
DESERT PARADISE OUTDOOR CNCPTS
40101 MONTEREY AVE 4B1 PMB209
RANCHO MIRAGE, CA 92270"
(760)601-6003
LiC: No.: 365900
------------------
WORKER'S COMPENSATION DECLARATION
Date: 6/25/09
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 E} •MPT Policy Number EXEMPT
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 a ecome subject to the workers' compensation laws of California,
and agree that, if I sho tl beco a subject to the wor r compensation provisions of Section
3700 of the L or C de,l sho forthwith comply - i hose provisions.
Date: N d licant: -
WARNING: FAIL E TO SECU E W KERS' COMP /SATIO COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T RI NAL PENALTIES AND IL.FINES UP TO.ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN D ION 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. -
certify that I have read this application and state that the abov 'nfbrm 'on is correct. I agree to mply with all
city and ounty ordinances and state laws relating to buildin constructio , and hereby authori r resentatives i
of thi ounty to /enter upon the above-mentioned propert for inspection urposes.
ate: / Si ture (Applicant or Agentl: �-
Application Number . . . . .
09-00000645
Permit . . . PLUMBING,
Additional desc .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 12/22/09
Qty Unit Charge Per
Extension
BASE
FEE
15:00
1.00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
178 L.F. 1 1/2" GAS LINE FOR FUTURE
- APPROVED APPLIANCE-2007 CODES
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
Fee-summary Charged
-----------------
Paid Credited
------------------------------
Due
----------
Permit Fee Total 18.00
.00 .00
18.00
Plan Check Total 4.50
.00 .00
4.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total 23.50
.00 .00
23.50
LQPERMIT
w
F- V)
ww
on
zU)
O ¢
� J
zz
J
n
dWzLd _
U) W
Q 7 LLLJ
Ci Ld Q
00 Z
in
M
--�_-•-•.- x
41
f :i,
U: O_
Q
Z
- ?wff__
905
wl ■1... �' ��
login
l l
07%
"m Cn V) ® tai` Lo O F— Z) F_ q Ld � W
T- z F- w M w _+ Q = F- to F- r L, u
+V)YrO F- w: www UZ) ::F _ U4
� � 3a -3w 0 �o 3:: < O�Z¢�ta l- M iTT- O
w U)F- i-- Uji C7 =
Cl a. LU W 2 -- F- J
j cnNON I). -oma=�F-F- J�_r�h- -_j-j QOM
zC;EU')c1l�zz�w0OO= Q �O�
LLJ O � t-- O wt : a. LL
®>'q ,M tnZ® N0UU��w
M
FT. WIDTH 10'-6" FT.
Q Q
Q
0C®
FT. SPA PERIMETER 28 FT.
DEPTH: 3'----'--_--- :--::-:
o
EXCAVATION:
<
0
0_ C)
O
U
lr_O
(n
Q
z
O 0
0 C'l� ow C�
LLJ
O
!- H
zQ Q za
r'
Q
0
^
W
Y
LiJ
O C'1
UU)
e }
00
re
0 Lo
0 to C..) 0
U: O_
Q
Z
- ?wff__
905
wl ■1... �' ��
login
l l
07%
"m Cn V) ® tai` Lo O F— Z) F_ q Ld � W
T- z F- w M w _+ Q = F- to F- r L, u
+V)YrO F- w: www UZ) ::F _ U4
� � 3a -3w 0 �o 3:: < O�Z¢�ta l- M iTT- O
w U)F- i-- Uji C7 =
Cl a. LU W 2 -- F- J
j cnNON I). -oma=�F-F- J�_r�h- -_j-j QOM
zC;EU')c1l�zz�w0OO= Q �O�
LLJ O � t-- O wt : a. LL
®>'q ,M tnZ® N0UU��w
M
TheAls�' n of
Pool & Spa Pro sionals
wJ F a. 0_ i
w /cl .�IFORNIA
mC���- A` LAN PSCAPE
n, COC'ACTORS
Member
ASSOTION
i
�L
t
�,: � Eomlcomo 5 e
swC'oncepts
Serving Coachella
Valley Since1975
Contractors LaG#365900
sF-
0-53 C-27
PMB#205,40-101 M0 NT EREYAVE.,8-7
RANCHO MIRAGE, CA,922-70
WWW, desertparadiseoc. coin
760 601 -6003
LENGTH 36'-6"
FT. WIDTH 10'-6" FT.
Q Q
Q
POOL PERIMETER 94
FT. SPA PERIMETER 28 FT.
DEPTH: 3'----'--_--- :--::-:
TO 5' TO
EXCAVATION:
Li Li
LL
U C)
U
LL-
(n
Q
w !-
L! Li_
0 C'l� ow C�
LLJ
w a,
�
!- H
zQ Q za
r'
Q
Y Cj
W
Q�
Y
w�
��
O C'1
UU)
e }
00
re
0 Lo
0 to C..) 0
0
w�
C! 0)
CL
��
3:
C9
p'tt
cn V)
t� M
p Y Lf) Z cn
to
O
F-
� F- - � M1
n
�
rn
-� CV
!n
J �
O_
'O tti
z Oo
� 00�
z m
� '�!-
z QO' II 0< 11
it
Q_ 11 QL0 zz000i�i<t�
dr
�¢
Qd,
�a
:204
ter-
�a
Ohl
w 11
mc�a_ L_0<
Fireplace
V)(L a- C) a�n�
�a
Stone Waterline
o¢
Special Misc._
0<
TheAls�' n of
Pool & Spa Pro sionals
wJ F a. 0_ i
w /cl .�IFORNIA
mC���- A` LAN PSCAPE
n, COC'ACTORS
Member
ASSOTION
i
�L
t
�,: � Eomlcomo 5 e
swC'oncepts
Serving Coachella
Valley Since1975
Contractors LaG#365900
sF-
0-53 C-27
PMB#205,40-101 M0 NT EREYAVE.,8-7
RANCHO MIRAGE, CA,922-70
WWW, desertparadiseoc. coin
760 601 -6003
LENGTH 36'-6"
FT. WIDTH 10'-6" FT.
POOL SQ. FT. 349
SPA SQ. FT. 38
POOL PERIMETER 94
FT. SPA PERIMETER 28 FT.
DEPTH: 3'----'--_--- :--::-:
TO 5' TO
EXCAVATION:
DECKING:
Special Misc.
Decking by Sq. Ft.
6
Finish Color
%
Cant, Step, Porch Step
Deck Drains: Yes No
Stub: Yes No
STEEL:
Drain to Street: Yes No-
Tie into Owners Ex. Drain Tine:
Special Mise.
Curb Core: Yes No
Deeco Drain: Yes No
Special Misc.
POOL PLUMING'
ELECTRICAL:
Special Misc.
Special Misc.;
MASONRY:
SPA PLUMBING:
Special Misc.
Spillway Type
Property Line Wall
Fire Pit
R13B Facing
Equipment Wall
GUNITE:
Stone Steps
_... ---°—
Fireplace
Special Mise.
Veneer on Outside of Spa
Stone Waterline
Special Misc._
WOOD:
TILE:
Special Misc.
Group 1,2,3: Yes No
Tile Trim: Yes No
❑ Steps ❑ Benches 91 Love Seats'
Special Misc.
IRON:
Special :Mise.
PLASTER / PEBBLE:
Type
Special Misc.
JOB#
ADDENDUMS DATE SELECTIONS
1
STONE
2
BOULDERS
3
DECK COLOR
Q
PEBBLE/PLASTER
5
STUCCO COLOR
6
WATERLINE
%
GROUTCOLOR
SCALE:
SALESMAN JIM L01
MAP BOOK REF. TR)
Prepared Especially For. G I B S a N F
Street 79.190 SHARUTRAIL.
City LA QUINTAL CA. 92253 (DI
Phone KEITH (360) 790-0679 Cell P1.
Office (949) 824-9818 Fax =
Bin # � . •..
Civ of LaQuinia
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # i J
O� , (��
Project Address: ,12 G
Owner's Name:
A. P. Number:�Q,j
Address:
_ G
Legal Description:
City, ST, Zip:
Contractor:
Telephone: � _
•;>.i:••:};.r}..<.::::}....r:•:..
Address: _
Project Description:�y
City, ST, Zip:
:>"#:<»;<:;_}»:>:<%: r: r!. • :-:
Tel �^ A0AIX
State Lic. # City Lic. #•-.
Arch., Engr., Designer:,
Address:
City,, ST, Zip:
Telephone:
>' >?>s::nf€€:>:: s%'a tj
�����`' �'}' • •<�; .. •,�•..,< ,, ,.,.;}. ;
2.}:}r';$it.}.}:::<rir.f/.•}t}vii 'j.•. f J :�t.F:
+ii:•}?::•i:Y.:!•!Y;iiS ilyi:!:<Y4:�i. f};?.}}}:�:<yi*'
Construction Type: Occupancy:
Project type (circle one • New dd'n Alter Repair Demo
State Lic. #:
Name of Contact Person: -.
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:p �/ �C/Q
Estimated Value of Project:
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#,
Submittal
Req'd
RWd
TRACEING
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, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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