11-0484 (RPL)P.O. BOX 1504 -
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: "11- 000b484
Property Address: 52382 SHINING STAR IN
APN: 767-200-999-47
Application description: description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:. 35000
Applicant: Architect or Engineer:
n
0 1A -
--------------------------------------------------
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.
Licens )lass: C53 •tense No.: 934229
ace: 7_A 7 CoD actor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l.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 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.).
(_ 1 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 this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
BRAD MASCHO
52382 SHINING STAR
LA QUINTA, CA 92253
(760)777-9920
Contractor:
GRAHAM POOLS, DAVID
761 SOUTH" WILLIAMS
PALM SPRINGS, CA 92
(760)898-9909
Lic. No.: 934229
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/16/11
--------------- - -------------------------------
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:
CarrierEX MPT Policy Number EXEMPT
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
r 3x700 of the Labor Cod shall fo/rth/with c pl with those provisions.
i6ate: 1� � �1 Ap ' t: l�sY
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 1$100,0001. 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 county to enter upon the above-mentioned propert inspection purposes
/6 ure (Applicant or Agent):
ate:
Application Number . . . . . 11-00000484
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
317.00 Plan Check
"Fee
206.05.
Issue Date
Valuation
35000
Expiration Date
11/.12/11
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-.
11/12/11
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
10
Expiration Date
11/12/11
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
11/1.2/11
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
Permit •. . . . . ..
WALL/FENCE PERMIT
LQPERMIT
Application Number 11-.00000484
Permit . . .� WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 87
Expiration Date 11/12/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
POOL/SPA, FIREPIT, 4 L.F. 5' SCREEN WALL,
AT BBQ SITE, CITY STANDARD.
ALARMS/BARRIERS-SHALL BE IN PLACE AT
• PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCUDED. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 436.00 .00
.00
436.00
Plan Check Total 232.05 .00
.00
232.05
Other Fee Total .2:00 .00
.00
2.00
Grand Total 670.05 .00
.00
670.05
LQPERMIT
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS S� :3 g 51+1NNI NCr Sf PERMIT NUMBER OWNER IM 45e_ o BUILDER b 4v 1'� G�2�4H� add LS
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job: Any changes to this list must be.approved by the Building Division prior to commencement -of work. Failure to comply will result in a stoppage of work and/or the voidance •
of building permit. For each applicable trade, all intormation•requested below must.be completea Dy applicant. --un riie is not an accepiaDie response.
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Classification
License Number
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Carrier Name
Policy Number
Exp. Date
License Number
Exp. Date
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(e.g. A; B, C-8)
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5--382 SHINING ST -AP LA ISI E
PLAN VIEW POOL: , s
1/-0" SCA LE
POOL: 5 PA
PERIMETER: 142 FT. PERIMETER: 32 FT,
MAXIMUM LENGTH: 44'-6" MAXIMUM LENGTH; 10'
I
MAXIMUM WIDTH: 33'--5" MAXIMUM WIDTH; 10'
AREA (50 FT): 1,070 50 FT. AREA (50 FT): 80 SQ FT,
DEPTH: BEACH TO 5' DEPTH: 45"
NOTE:
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BOULDER SCHEDULE
SYMBOL SIZE '
A A -77Y,4'x2' 11-1 /2 tons
B B 2'xS'x2' 13/4 -Eon
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BOULDER TYPE TO BE
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CITY OF LA QUINTA
BU(LUNG & SAFETY DEPT.APPROVED"
FOR CONSTRUCTION
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PLAN VIEW POOL: , s
1/-0" SCA LE
POOL: 5 PA
PERIMETER: 142 FT. PERIMETER: 32 FT,
MAXIMUM LENGTH: 44'-6" MAXIMUM LENGTH; 10'
I
MAXIMUM WIDTH: 33'--5" MAXIMUM WIDTH; 10'
AREA (50 FT): 1,070 50 FT. AREA (50 FT): 80 SQ FT,
DEPTH: BEACH TO 5' DEPTH: 45"
NOTE:
j
BOULDER SCHEDULE
SYMBOL SIZE '
A A -77Y,4'x2' 11-1 /2 tons
B B 2'xS'x2' 13/4 -Eon
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C. 'x2'1 1 /2 to h ,u -f
ID
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BOULDER TYPE TO BE
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CITY OF LA QUINTA
BU(LUNG & SAFETY DEPT.APPROVED"
FOR CONSTRUCTION
136
DATE ✓� B'�
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Bin #
Qty of La Quinta ,
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�v
Project Address: 5 a 36,�o, 5 14 1 A/Ay I Alb 194%Z L
Owner's Name:
A. P. Number: 70— 61Y0— 6 !;—
Address: 5'9-393), 5t+I V/ N I n16-- s f/y fZ CA
Legal Description:
City, ST, Zip: LA Qu ( t:�A 9 DZ -53
Contractor: bkv Lb G Imo} "m 0
pc)L,)
P "% (o 0 - 835= .3 y 510
Telephone: ':�»r<%>>t;:.wr:::f •:::�:�s::::::::>::
Address:.P.O„,p13 6 N 0 G 5-
Project Description:
City, ST, Zip: P t �-` r\'5PI2—I AJ0 S c '('2-"3
X( ub Q Phi (— d- S PA—
Telephone: %(fl — —
;:<j ??yiiiii:viiiJ u•i:; :: {}:�+{::v' ::{.:ii::
«« :�;:::;:;:;:;•:::.:::.
S
State Lic. #: 93 y 27 -
City Lie. #•:
LV B.L06V- WA -LLL l . P. S ` Li .5
Arch., Engr., Designer: �ILJ 1 USS
Address:
City., ST, Zip: G4
Telephone:
.::<::::<>:::•:.:;<z;«:.>.;:':>�::�>
.<•s:.:.:..:.>:;;»:>::%r:::>%«•::ProJect
Construction Type: Occupancy:
State Lic. #:
tYPa circle one): New Add'n Alter Repair Demo
Name of Contact Person: IINV (,.[) 6- "IIA r M
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person: S —C( q, 0.9
Estimated Value of Project: O Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for corrections/issue
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 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