05-0659 (RPL)BUILDING & SAFETY DEPARTMET"T
P.O. BOX 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION,REQ.UESTS'.(760) 777.-71`_3
BUILDING PERMIT
lication Number .
. . ,f05-.0-0000659-' Date
2/24/05
Property Address
79381 SIERRA VISTA -
APN:
604-44.0-046-46 -27519 -
Application description..
'. POOL - RESIDENTIAL
Property Zoning . . .
. . . . .LOW DENSITY RESIDENTIAL
Application valuation
22000
R
Owner
Contractor
ANDRADE JOHN
BLUE HAVEN POOLS
*NOT ON FILE
2318-S. VINEYARD AVENUE
(A)
UNKNOWN
CA;99999 ONTARIO
CA 91761
WCC: SPIEGLER
k WC: 07KR0000891
03/10/05
CSLB: •618892
05/3=/05
CCC: C53
----------.------------------------------------------------------------------
Permit . . . . . .
BLDG POOL PERMIT
Additional desc
Permit Fee . . . .
225.00 Plan Check Fee
146.25
Issue Date . . . .
Valuation . . . .
22000
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20.00. 9.0000
----------------------------------------------------------------'------------
THOU BLDG 2,001-25,000
180.00
r.
Permit .. . . . . .
MECH POOL
;
Additional desc
Permit.Fee . . . .
24.00 Plan Check Fee
-. ,_ 6.00
Issue Date . . . .
Valuation
0
Qty. Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
---------------------------------------------------------------------------=-
EA MECH FURNACE <=100K
9.00
Permit
ELEC POOL PERMIT -RES
Additional desc
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date
Valuation
0
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
P.O. BOX 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 1
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0T L96-5-9, I Date: 3- 3— c,,!3 -
Applicant:
Applicant's Mailing Address:
4�(7-iC�,c� G p
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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.
✓Lice3 nse Class C 'S Li nse N5/ 61* Y4 Z
��ate 3-3�5 Contractor [
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
L) I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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
Yof 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
.5
i sued. My workers' compensation insurance carrier,andpolicy number are:
arner �I �L&K— Policy Number r/ 0 )c2 00 oc fns
_ 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, I shall
forthwith comply with those provisions.
ate —3—n5 A,,plicant `
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.
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
7V M
Lender's Address
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 the abo e -mentioned property for inspection purposes.
Signature (Applicant or Agent)-/ ` + _ I
Page 2
Application
Number . . . . . 05-00000659
Date 2/24/05 ,
Issue Date
Valuation . .
0
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.
ALARMS/BARRIERS SHALL BE IN
PLACE PRIOR
TO PRE-PLASTER'INSPECTION_.
�.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary
Charged Paid Credited,
Due
r-----------------
-----------=---------------'---
----------
Permit Fee
Total 327.00 .00 .00
327.00
Plan Check
Total 171.75 .00 :00
171.75
Grand Total
498.75 .00 .00
498.75
n
e
The Most Dependable
Custom Pool Builder in
Southern California
Since 1954.
CUSTOM DESIGN FOR:
NAME: .SLV i\`� �WQW7�F�'{ `JL
ADDRESS:- 1(�� " �T,►.�S E��jF��G,
y }%�
CITY: _. LA ax I 1 A O sJQ'C
HOME TELEPHONE •' �Q 315 A '
^s
AS OFFICE# -
LOT:
TRACT:
APNY
MAP BOOK PAGE
CROSS STREET.
SPECIFICATIONS I I
TYPE: SIZE:ioX
SURFACE AREA POOL
Q �_
PERIMETER: q� DEPTHS: MIN � AX�
SPA SPECIFICATIONS
ELECTRICAL:
SIZE
BY.
DAM WALL MOTH.
TIME CLOCK: SUS PANEL:
NO OF JETS
LIGHTS N POOL• SPA.
SPILLWAYS) SIZE:
POOL PUMP SPA SLOWER.
BLOWER: HP
WATERFEATUREPUMP
BOOSTER PUMP HP
SPA BOOSTER.
FREE STANDING SPA • 6'. 12'
STUBS.
MSC.
It ' -24-
MISC
GUWTE
POPE RINGS GRAB RAILS
6'R88 12, Aa B. IrAes.-
241R
.2t'R 8 B JO' R.B.B.
EXCAVATION
LOVESEAT EXTENDED 2nd STEPS
TYPE
NOTCH RAISED BOND BEAM
DEEP END RAMP
SPA DAM WALL WIDTH:
FENCE REMOVED BY.
NOTCH SPA DAM WALL.
6'REB 12,R8.8 18'R.B.B
MIC.
2PR8B. VRBB
TRASH REMOVAL (LOADS):
CONCERETE REMCI'AL ILJADS).
TILE a COPNG.
TREE REMOVAL By.
STD WHITE BULLNOSE BRICK
STUMP REMOVAL BY
FLAGSTONE. OTHER,
TILE GROW: TILE TPIM
STEEL:
MISC:
t'R.86, 12 R8.8. tB RBB
24*R.BE. 30' R B 8
DECKING
SURCHARGE
LOVESEAT WIDE SWIMOUT
BY: UPTO, SO, FT
SPA WALL WIDTH:
FINISH. COLOR:
STEPS
CANTILEVER.
MASTIC. CURB CORE:
PLUIIMING
DECCO DRAINS.
FILTER SIZE,
AREA DRAINS
POOL PUMP: Hp: SIJ
PATIO FOOTING SIZE.
HEATER. STUS:
SPA BOOSTER PUMP HP.
PLASTER
WATER"EATUR£ PUMP HP
SAW CUT _P -TRAP.
STANDARD -
SMART SPITE, -
GAS UNE. STUBS
SHEER DESCENTS/ RAIN
OTHER
LIGHTS N POOL. N SPA
SPECIAL EQUIPMENT.
MISC
DELUXE MANT KR
POOL COVER
DIVING BOARD -
SLIDE.
SMARTVAC:
OTHER
OWNER RESPONSIBILITIES
OWNE R TO (1) Determine the approximate elevation of pool or spa at layout on day of excavation.
(2) Take notice that pool and equipment location is sIb}ect to acceptance of local building
department at time 01 issuance of permit
(3) Wet down concrete Snell at least twice daily
for seven (7) days atter shell is instated.
(x) Take notice that BLUE HAVEN POOLS IS NOT RESPONSIBLE for: underground conditions
or objects, and any damage to curbs, sidewalks. driveways, lawns or otner items in access area.
(5) See Mat wl tenting, gates, and garage doors meet local codes for a pod enclosure prior to
pre -plaster krspeclson, -
(6) Fill pod immediately after plaster. (Follow
Instructions: do not use rubber hose)
(7) NO VERBAL AGREEMENTS APPLY.
(8) Fencing to meet all local code requirements by buyer prior to pre -plaster Inspection.
Owner approves plan, pool, equipment locatans and understands decking is for Mistration ONLY.
Owner understands they are to recerve sq ft. of decking per contract.
Signed -
bale: