05-3492 (RPL)P.O. BOX 1504 4
�uw
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00003492 Owner:
Property Address:51315 CALLE`KALIMA BUFFIN WILLIAM THOMAS
APN: 770-166-015-3 -000000- P O BOX 134
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM DENSITY RES Application valuation: 16800
AUG 12.2005 Contractor:
Applicant: Architect or EngiJP
eer PICAZO POOLS & SPAS
CITY OF LA QUINTA WCC: EXEMPT
FINANCE DEPT. WC: EXEMPT
CSLB: 836900
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Iam 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: Licensee No.:
,__,C15te:0-t- al'oe Contracto . �roo tla C, L,.ha,
OWNER -BUILDER DECLARATION '
I hereby affirm under penalty of perjury 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 _ 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
VOICE (760) 777-7012;
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/08/05
05/31/06
04/30/06
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.
1 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 C53 Policy Number - - - - - - --- - - - - - -
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.
te: �ro� Applica.,--,
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.
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 ouinta, 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 propeertt or in, ection purposes.
D�-6ignature (Applicant or Agent)
: /
Application Number . . . . . 05-00003492
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
180.00 Plan Check Fee
117.00
Issue Date . . . .
Valuation . . .
. 16800
Expiration Date
2/04/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
135.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/04/06
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
2/04/06
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
2/04/06
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
---------------------------2-------------------------------------------=----
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application
Number . . . . . 05-00003492
---------------------------------------------------------------
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 284.00 .00
.00
284.00
Plan Check
Total 143.00 .00
.00
143.00
Grand Total
427.00 .00
.00
427.00
LQPERMIT
' CITY OF .LA QUINTA SUB -CONTRACTOR LIST
5A
JOB ADDRESS51-3115 � PERMIT NUMBER OS— 31/9, OWNER BUILDER s
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,, Fail, to COM131V will result in a stoppage of work and/or the voidance
of building permit.. For each applicable trade, all information reauesteri helnw mllct ho mmr)latocl k6 nnn1;e-nnt 'Irl- MI -11 7,. ....+ .,..♦ L.1 ':=�'�
-
Trade / Classification Contractor
----- — --- — ••r•----- —, •+r+l+...+.•..•• N v , — — •rva u-1 ua, VLCIVIV 1V0PVILI.G.
State Contractor's LicenseVorkers Compensation Insurance
City Business License
Company Name
Classification.
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date Carrier Name
(xx/xx/xx) (e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12)
Pt e,A^..04��t-10A -?Ct9L5
t✓' '�_3
3 QeJ
0
S'! i
CONCRETE (C-8)
FRAMING (C-5)
STRUCT. STEEL (C-51)IVII
(� g ��� S
c•
O D
MASONRY (C-29)
PLUMBING (C-36)
1 I AzoGo —j ®L,b
9-3 e300
`$•i5(a•
(
'�
t•
PTH, PLASTER (C-35)j_rl—cls
� FA.ULL
S
"�
•�®•�,
E�P�Y Cab ep,K�s.
�� 'D
1 • (• m
DRYWALL (C-9)
1
HVAC (C-20)
ELECTRICAL (C-10)
ROOFING (C-39) .
AZo(�c2 LS
• `J
�j� Q�
•B�,
�i (
•
SHEET METAL (C-43)
FLOORING (C-15)
GLAZING (C-17).
i
INSULATION (C-2)
i
•.
SEWAGE DISP. (C-42) --
j
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
i
F
FENCING (C-13).
LANDSCAPING (C-27)
POOL (C-53)
34.L AA A
-4-1761
364 `� ��s tCS�Ab� ���..•®®
1 44•I•®�
sagd tlmjad Icsol
sed 100gaS
aria llnuad jo als(l
jddv -n1.% -qad
d'd'1'r
aosaad PWM:) wn•:
Isaaaddv 3amugd
as j lasdwl jadolanad
aasss)saollaajjoa JGJ .(psaj *A01 as
-:3SQOH W
301ps,7 .
paulwgosu =vld
Issajddv
TITS
do payatd sasld
paaa losj�
3nWwnld
nosjad laaooO palls -3
u.1 jolaslooagnS
Isaula 13
anstysaoso3&u*3jol .(psaj •Aalwalf wz
avid 3otpsj7
lcalucgaalV
palllwgasaa $acid
acid otsld pooh{
natanissuo,
do papld sagd
•0193 M203
338s1s91I3agJ acid
nouad laaao] Pally
ssaj J,
ltsoda(l pay, ocld
1 aaaajoa jol 6psaj •po"aaa
•sals> lajnlaajlS
loseviv
wall
f{
[�
paulmgns �aaq, acid
saaS acid
Z
533A LIC834
JN1Y�V211
P.3alI
P.;1I
igulmgng
s
3NI1 S1H1 M0138 3MUM ION 00 :1NVOrWdV
-- :13210MJO =IRA Pamw!
S S•
:uossd jmuoO }o # auoydzloi
x
:Awn N :sauolg M :'i3 •bS.-
oula0 jtsday J2IIV u.PPV %%af4 :(auo alalia) ad/4 Uafojd
�`L �Gj O�Ij1,3Q
t
Z.1.
:uosjad muo> jo aumm
:K •ari ales$
:auoydalal
Y
%buednaap :adrCl uomnruuoO
:dtZ *.LS %(p)
:CPPV
0 311 Alli
saustsaQ "JIu3 ..ywV
:x'711 a187$
wZ
_
-:;
S . VS ':auoydalal
Y
(' -1:d.Z
0
•� >
'LS '.Ci1J
�{ 5 •7i :=ppV
S1' j0U2jlu0�
7t
�( .
i
: ou3sap laaf
r'�•:iT�.: Z d%�- G :auoydapli
(y I n : Z •LS •,w)
1 O' :ssalPPd
�:auaNs}auwp
iaays 2u1 :)eJl pue uonoliddy liuuad Suipling
Z IOLI LL (09D - iSZZ6 Y: 'nu!nb Cl
wldwel aM S6i-SL US I x09 'O'd
UOMMG AiICS 8 2UMLMg
mu!nZ) el jo AID
:nondu�saQ (eaa
:laquinN •d •V
:MPPV laafold
bb -y'Q
X uuuad
N ,„9
X
M0,
Ojl
f
1
k
C'g ®F LA C�UINTA
.BUILDING & SAFETY DEPT.
.!'Tel F"RO YOED
FOR CONSTRUCTION
DATE o �g!®$ BY
W-
'G.D�GKIt�IC� �`t�OT�d��s
SWIMMING POOL SPECIFICATIONS
POOL SPECIFICATIONS e
MV: vN 1 size:JLML:—:_X
SOrface area: erimeter.•+ i
depths: min.'s t0 max.
PA ECIFIC TI,Q VLS
size:�X�_surf— area rimeter. :
dam wall width: 12•N length J&_2 _spa
spillway type. I &I TI L—F— of jets:
notes:
EXCAVATION/STEEL
type of dig: 8t AT access: 0
elevation:
wanifenec removed by: •—
walUfence type
eonc.removal: sod removal:
trec/stump removal:
6"r. b. b. 12"r. b. b. 18"r. b. b.
Surcharge: bench/loveseat
tanning shelf water depth:
GUNTTE
6"r.b.b. 12"r.b.b.11,W_ I8"r.b.b.
bench/loveseat: ^ extended 2 -step:
spa dam wall width: 2�
spillway type:
DECKING
SQ.FT. O • finish:
color
cantilever expansion joints: i
steps: type:
deck drains: decco-drain:
curb core: sand&visqueen:
I
i
TILE & MASONRY
coping type: e -
spillway type:
6"r.b.b. 12"r.b.b.lf!Rm _18"r.b.b.
r.b.b. fitcingTltt...E.. trim tile:
the type:
equipment wall: X type:
PLUMBING & ELECTRICAL
plumbing size: n fill line: 0
skimmer type: #
gas line: elect line:
heater. size: O
filter. L size:
Pool pump: size:
jet pump: size:
sub -panel: time clock:
GFIC._AgT F92r21 F• extra GFIC.
pool light: -40 40 eJ • spa light:
gas stubs: clect.stubs:
plaster color
pebble: color:
NAME: / ,
.lob address -51-315 GALLS KkL1MA
City:
scale date• S• '�