05-4698 (RPL)I
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Y _ BUILDING PERMIT
Application Number: (05_0000469f8-7
8-7 y
Property Address: 55569 SOUTHERN HILLS
APN: 775 -200 -012 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application Valuation: 20000
Applicant: - Architect or Engineer: .
Owner:
GOELLNER THEODORE C
55569 SOUTHERN HILLS
y LA QUINTA, CA.92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/19/05
Contractor:
6 RYAN INVESTMENTS GROUP, INC.
D CC: GRANITE STATE
` 1 1518726 03/29/06
c�
l►t�� G+ 1 �ou C LEI: 552140 06/30/06
• - LICENSED CONTRACTOR'S DECLARATION -
•- WORKER'S COMPENSATION DECLARATION
' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm •under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: ,License No.: -24
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
1V �{ "✓ G/✓�
te: Contract
issued.
/� I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
,i Code, for the performance of the work for which this permit is issued. My workers' compensation
- - OWNER -BUILDER DECLARATION
insurance carrier and policy number are: -
1 hereby affirm under penalty of perjury h I am exempt from the Contractor's State License Law for the
Carrier B C53 - '- Policy Number - - - - - - - - - - - - - - -
following reason (Sec. 7031:5, Business nd Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance,also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of.the Contractor's State
. and agree that, if I should become subject to the workers' compensation provisions of Section
- License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or -
3700 of the Labor C e, I shall forthwith comply with those provisions.
^ 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):
` APPlica (M" _
(_) 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 -
WARNING: FAILURE TO SECUR RKERS' COMPENSATION COVERAGE IS UNLAWFUL:AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CR AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does theworkhimself or herself through his or her own employees, provided that the
DOLLARS 15100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
-
-• - -improvements are not intended or offered for sale. If; however; the building or improvement is sold within
A
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. P
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.). -
_ APPLICANT ACKNOWLEDGEMENT - -
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT -Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application. r
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed-
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - -
whose benefit- work is performed under or pursuant to any permit issued as a result of this application,
1 1 I am exempt under Sec. , B.&P.C. for this reason
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. '
Date: Owner: -
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
.- CONSTRUCTION LENDING AGENCY - - -
-
- .permit to cancellation:. - A
y-
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to buil ing construction, and hereby authorize representatives
' -
of this county to enter u on the above-mentioned prop for inspection purposes..
Lender's Name: '
- _
D�itj.air Signature (Applicant or Agen : �.-
Lender's Address:
-
LQPERMIT
Application Number
05-00004698.
Permit . . .
BLDG POOL"PERMIT
•, - desc .
-Additional
Permit Fee
207.00 Plan Check Fee ..
134.55
Issue Date . ... .
Valuation_ . . .
. 20000
Expiration Date
4/17/06
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
4/17/06
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
4/17/06
Qty-- Unit Charge
Per_
Extension
BASE FEE,
15.00
1.00 30.0000
-----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
p Permit
PLUMBING
Additional desc
_
Permit Fee
33.00 Plan Check Fee
8.25•
Issue,Date . . . .
.Valuation
0
Expiration Date........:
4/.17/06" -
-
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 OUTLETS3.00
Special Notes.and Comments
r POOL& SPA ONLY. ALARMS/BARRIERS
SHALL
LQMRMIT
-
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28it
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—XGAV TION —
E A
FINISH ELEVATION.
IONS .. REVIS IONS DATE
SPECIFICATIONS AT
ACCESS: SEE PLAN SITE PREPARATION: IoN. WATE R ONLY
GRADING: N/A
- CONC. REMOVAL: N/A
REMOVAL:
DIRT REMO
_
DRY: WELL LOCATION:
N/A
� _6 XIb
5
SHA RECT.
LENGTH: -
SELECTOR VALVE TYPE: -
SIZE / #:
PUMP TYPE: -
SIZE: -
H.P.
612S.F.
PERIMETER: IOq
PER.SURFACE
SQ. FT.
SKIMMER TYPE: -
SIZE/NUMBER:
O
HEATER TYPE: -
U
Q
B.T.U.
HEATER VENT BY:
31_bIIDEPTM MIN.
MAX
SPA RAISED @ 18
JET PUMP TYPE: JANDY
SIZE: - 2
H.P.
EQUIPMENT LOCATION: -
P/C SLAB PIT: -
.-
Q
O
w
PLUMBING MATERIAL: -
r?s
1
SIZE.
SPA X"i
7
/ IN.
BREAK MIN: A
N/
CIRC. DISCHARGE SIZE:
1 11
BACKWASH:
SIZE / LENGTH:
J
RETURNS INSPA #/SIZE: =
RETURN INLET TYPE: -
SPA DEPTH. 3 6
AUTO -FILL LINE (WITH
NO OBSTRUCT): -
J
A/S VALVE LOCATION: -
/
--IMETE
O
i-
U
SIZE/LENGTH: -
SURFACE: S.F.F
SPA aU 4q 5
SPA P 28
CHLORINATOR(S)-
TOTAL GALLONS-- -
m
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28it
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H.P. .slzE: I -PUMP TYPE JANDY SQ.
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SIZE:
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OFILTR TYPE. JANDY
SIZE/*
SKIMMERTYPE. WAWSIZE:
4/
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5HO
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UNT
B U
HEATER TYPE JANDY LAAR5
O HEAT ER VENTWPOOL o- H.P. SIZE: JET PUMP TYPE.,JANDY P/C PIT: SLAB
wUEQUPMENT LOCATION: SEE PLAN
TANNINCE € PLUMBINGMATER AL PVC 50HD 40SHEL=WITH
3_611 2.511
ION SIZE
UBRELLA Q CIRC: SUCI
...
SLEEVE= w m CIRC DISCHARGE SIZE. 2.511 E SIZE: N/A
RY _B MASH. WA
RETURNS ..., #/sIzE. RETURN INLET TYPE. Fz AUTO FILL (WITH
OBSTRUCT) YES
4A/SVALVELOCATION TBD -
LQ
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_
I 30.
LENGTH:
SIZE /
LENG
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,I
4
; I
, � I BY. FIG
; LINE .AGI
: As P
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! a
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4 , I DED.
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v�CHLORINATOR(S) AQUA PILIRE
: l
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I WATER FEATURES: SIZE: PLAN -
—XGAV TION —
E A
FINISH ELEVATION.
-5.5 @WEEP SCREEDMETHOD: BOBCAT
ACCESS: SEE PLAN SITE PREPARATION: IoN. WATE R ONLY
GRADING: N/A
- CONC. REMOVAL: N/A
REMOVAL:
DIRT REMO
YES SO D REMOVAL: WA
DRY: WELL LOCATION:
N/A
c�
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t
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—POOL LU
M
BING
H.P. .slzE: I -PUMP TYPE JANDY SQ.
FT:
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SIZE:
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OFILTR TYPE. JANDY
SIZE/*
SKIMMERTYPE. WAWSIZE:
4/
0L
O
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5HO
OM
O
UNT
B U
HEATER TYPE JANDY LAAR5
O HEAT ER VENTWPOOL o- H.P. SIZE: JET PUMP TYPE.,JANDY P/C PIT: SLAB
wUEQUPMENT LOCATION: SEE PLAN
TANNINCE € PLUMBINGMATER AL PVC 50HD 40SHEL=WITH
3_611 2.511
ION SIZE
UBRELLA Q CIRC: SUCI
...
SLEEVE= w m CIRC DISCHARGE SIZE. 2.511 E SIZE: N/A
RY _B MASH. WA
RETURNS ..., #/sIzE. RETURN INLET TYPE. Fz AUTO FILL (WITH
OBSTRUCT) YES
4A/SVALVELOCATION TBD -
LQ
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r E /
_
I 30.
LENGTH:
SIZE /
LENG
S 2
,I
4
; I
, � I BY. FIG
; LINE .AGI
: As P
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! a
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0
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4 , I DED.
I LEANER
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VAC
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v�CHLORINATOR(S) AQUA PILIRE
: l
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I WATER FEATURES: SIZE: PLAN -
O
O
— SPA PLUM5ING `-
1--
JET SUCTION SIZE: 3"
JI=T DISCHARGE SIZE: 5"
JETTYPE: LASGO
# "8
JET AIR LINE SIZE: 211
LENGTH: -
SELECTOR VALVE TYPE: -
SIZE / #:
PUMP TYPE: -
SIZE: -
H.P.
FILTER TYPE: -
SIZE: -
SQ. FT.
SKIMMER TYPE: -
SIZE/NUMBER:
O
HEATER TYPE: -
SIZE: ` -
B.T.U.
HEATER VENT BY:
JET PUMP TYPE: JANDY
SIZE: - 2
H.P.
EQUIPMENT LOCATION: -
P/C SLAB PIT: -
PLUMBING MATERIAL: -
r?s
CIRC. SUCTION SIZE: ` -
CIRC. DISCHARGE SIZE:
BACKWASH:
SIZE / LENGTH:
RETURNS INSPA #/SIZE: =
RETURN INLET TYPE: -
AUTO -FILL LINE (WITH
NO OBSTRUCT): -
J
A/S VALVE LOCATION: -
/
GAS LINE BY: -
SIZE/LENGTH: -
AUTOMATIC CLEANING: -
CHLORINATOR(S)-
WATER FEATURES:
—STEEL ®°
STANDARD/SPECIAL: ` STANDARD SPA DAM WALL LENGTH: SEE PLAN
RAISED BOND BEAM: +6" -
+12" - +18" ; 63' OTHER -
6" OIV CENTER N/A
EXTRA DEPTH: WA
z
A
•.
&UNITE —
Q
CORNER RADIUS: -
# INLETS: q # JETS: 8
STEPS: SEE PLAN
AUTO -FILL LOCATION: 5EE PLAN '<
POOL BENCH DEPTH: -24"
TAN LEDGE DEPTH: - '
SPADEPTH: -3'-q" @ BOND BEAM SPABENCH: -2411 BOND BEAM
GRAB RAIL: N/A
HANDRAIL: N/A CUP ANCHORS:
N/A
0
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�
MASONRY —
FENCH REMOVAL BY: -
REPLACED BY: -
SIZE OF OPENING: -
MATERIAL: -
W
V
i W
EQUIP. WALL BY: -
SIZE/MATERIAL: -
BBQ: SEE PLAN
FIREPIT: > SEE PLAN
Q
to
- DECKING —
BY1VHOM: GAL PACIFIC
FINISH: SAND/,��0001 SQ. FT. 546/1-754
COLOR: T5D
CANTILEVER: YES BRICK: . -
STEPS: -
EXPANSION: YES RAIL ANCHORS: ` -
FIBER MESH: -
SAND & PLASTIC: YES
TILE AND STONE —
TILE: ARIZONA TILE
' COLOR: PORTO GAFFEGROUT COLOR: TBD
COPING/OTHER: -
CANTILEVER: YES BRICK: -
STE,° TRIM: -
NUMBERED TILE: -
O
ELECTRICAL —
BY WHOM: GAL PACIFIC
FJ -BOX LOC.: @ EQUIPMENT SWITCH LOC,: -
LIGHTS - WATTS/CORD: -
I - / - _ /_
SWITCH RUN: -
PANEL CHANGE: ' N/A LIGHT RUN: '-
REMOTE SWITCH: YES
TYPE: DANDY ONE TOUGH
SPA SWITCH LOC.: SPA
HEATER SWITCH LOC.: -
- INTERIOR FIN! —
PLASTERCOLOR:
IPEBBLE COLOR: WHITE PEARL'
LIGHTS: -400W 1=100W
NAMEPLATE: - I I A-V COVERS: ' -
CUP ANCHORS: -
RAIL ANCHORS: '- RECESSED STEPS: p
�-4-�
COVER AND FITTING COLOR:
-
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