05-5465 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application- Number: -i05-00005465
Property Address: 79750 -..-PARKWAY' ESPLANADE N
APN: 609-380-998-67. -293232-
Application description: POOL RESIDENTIAL
Property Zoning: LOW. DENSITY RESIDENTIAL
Application valuation: 36000
T4&t 4 4 Q"
Applicant: Architect or Engineer:
f k,lr�
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JOHNSON
79-750 PARKWAY
n' LA QUINTA, CA
U1 n LA QUINTA, CA
ESPLANADE N
92253
DEC. 2 7 2005 U
Contractor:
LAGUNA FALLS CUSTOM POOL/SPA
ITMOFLAQUINTA 81730 HIGHWAY 111, STE #2
FINANCE DEPT. INDIO, CA 92202
(760)347-8977
Lic. No.: 818149
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. -
License Class: C553 License No.: 818149
Dat l Z 7'�7" Co actor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of per' y 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).:
(_ 1 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 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—) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/15/05
-----------------------------------------------
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 CALIF. INS Policy Number 46001785-0101
_ 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 agreethat, if I shoul�,be me subject to the workers' compensation provisions of Section
^7 3700 of the Labor Co I sha I forthwith co ply with ose provisions.
pyi�•%L0'5Applicant: .
WARNING: FAILURE TO SECURE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN 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. -
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 relatingto building construction, and hereby authorize representatives
of th/is�unty to enter upon the above-mentioned prop j r ins ection purposes.
Date: �� (�� 9lgnature (Applicant or Agentl: //
Application Number
05-00005465
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
323.50
Plan Check Fee
210.28
Issue Date . . . .
Valuation . . .
. 36000
Expiration Date
6/13/06
Qty Unit Charge
Per
Extension
'
BASE
FEE
252.00
_ 11.00 6:5000
THOU BLDG
25;0,01-50,000
71.50'
' Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00
Plan Check Fee
6.50
"Issue Date
Valuation . . .
0
Expiration Date,
6/13/06
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
P1an,Check Fee
11.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
6/13/06
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
6/13/06
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 OUTLETS ..
---------------
3.00
Special Notes.arid Comments
POOL & SPA ONLY. ALARMS/BARRIERS
SHALL'
LQPERMIT
Application Number 05-00005465
---------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE.PRIOR TO'PRE-PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary` Charged Paid Credited Due
Permit Fee Total 427.50 .00. .00 427.50
Plan Check Total 236.2$, •.00 „ .00 236,28
Grand Total 663.78' .00 .00 663.78
. r
EXISTING DECK
7 ft.
EXISTING RESIDENCE.
Homeowner Approval
Date
✓-
+1 8" 7' Spa
Sit & Spin style
15 ft. 1 in.
wd 3'6"
f-
0
Self closing and
Gas & Electricity elf latching gate
.................. _.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.
........................................................................
Property line="_.._.._...
= ,
0
8O�dVB/RM
EAJ3jVS
Nlalli�
Ail`'
4'x 71' Retaining wall,
o be installed by homeowner
28 ft. 8 in.
CD
wd 3'6'
wd 46-
`~
14 ft. 10 in.
34 ft.
14 ft. 0 in.
4
EXISTING DECK
7 ft.
EXISTING RESIDENCE.
Homeowner Approval
Date
✓-
+1 8" 7' Spa
Sit & Spin style
15 ft. 1 in.
wd 3'6"
f-
0
Self closing and
Gas & Electricity elf latching gate
X
A
A
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�s~ 5-V(off
Project Address: 11 •75 a Tar at
0%%-ner's Name: d p� ttSOrt
A. P. Number: N'
Address:—)1-73-0 r�CW
Legal Description:
City. ST. Zip: q 221-3
Contractor: uS d S j 5,9&-]
FTelephone: -112, 2t 3 3
Address: 130 �1� 1 1 Z
Project Description: C a1 eb
City, ST, Zip:y�
Telephone: +%
State Lic. # :
City Lic. #: (
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:"t'.` _
'z
iti
State Lic. #: -':f...
Construction Type: Occupancy:
Project type (circle one): New AJd'n Alter Repair Demo
Name of Contact Person: �I Z
q. Ft.: 5 61
# Stories:
# Units:
Telephone # of Contact Person: 5193-1570
kstimatcdValue of Project: 3 dt7 Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
M
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
�j
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Truss Cales.
Called Contact Person
Energy Cates.
Plans picked up
Construction
Flood plain Plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsrissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SAl.l.
N.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, readv for correctionsrssue
Developer Impact Fee
A.I.P.P_
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees