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05-3661 (RPL)t � P.O. BOX 1504 VOICE 760 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 8/18/05 Application Number. OS -00003661 Owner: Property Address: 51335 CALLE-KAli2MA BUFFIN WILLIAM THOMAS APN: 770-166-016-4 -000000- P O BOX 134 Application description: POOL - RESIDENTIAL D Q LA QUINTA, CA 92253 Property Zoning: MEDIUM DENSITY RES Application valuation: 16000 AUG 2 2 2005 Contractor: Applicant: Architect or Engi eer CITY OF LA QUINTA PICAZO POOLS & SPAS FINANC�DEPT• 82365 HIGHWAY 111, SUITE 4101 I 92201 (760)760) 347-7- 5855 Lic. No.: 836900 ---------------------------------------------------------------------------------•---------------- 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 declaratioA: 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: C53 License No.: 836900 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �% issued. Date: _ ontractor: i r w LO � y� � ( ji s!j( S �i _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier E CEMPT Policy Number EXEMPT following reason (Sec. 7031.5, Business and 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 personinany 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 Lab . Code, 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).:e: — pplicant: pit C A " [." s tj � "v (!L 4(-Pil3y" (_) 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.). ( ) 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: Ilk LQPERMIT 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 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 property for/i7spection purposes. D •( — — Si ure (Applicant or Agent): / �+..� - Application Number . . 05-00003661 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 171.00 Plan Check Fee 111.15 Issue Date . . . . Valuation . . . . 16000 Expiration Date 2/14/06 Qty Unit Charge Per Extension BASE FEE 45.00 14.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 126.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/14/06 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 2/14/06 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 .. 2/14/.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•and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN LQPERMIT LQPERVHT Application Number . . . . . 05-00003661 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 275.00 .00 .00 275.00 Plan Check Total 137.15 .00 .00 137.15 Grand Total 412.15 .00 .00 412.15 CITY OF.LA QUANTA, SUB-CONTSACTOP LIST � JOB ADDR�SS61.8;W -AL. UA&AwPERMIT NUMBER OWN SuJ BUILDER T@ 206e2�' This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous Qlace. Only persons appearing on this list or their employees are authorized to work on this lob. 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 information requested below must be completed b a licant "'O Ml " �p �) , a y pp n. i e is not an acceptable response. Trade / Classification Contractor State Contractor's License rel porkers Compensation Insurance City Business License Company Name. Classification. License Number Exp. Date Carrier Name Policy Number Exp.' Date License Number Exp. Date ! (e.g. A, B, C-8) (xxxxxx) (xx/cx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx) EARTHWORK (C-12) Pic. A-zoC-1QS-17oAA-?Ct>Ls C.'S3 g?3(09 oc) •gyp S•51 CONCRETE (C-8) FRAMING (C-5) STRUCT. STEEL (C-51) , MASONRY (C-29) PLUMBING (C-36) �1�,�,�Gt7 '� ®!. �' �'� �?x �!O© i• �l ,� f• LATH, PLASTER (C-35) ��� •36 ! ��t+I.PL.'`( Cab.Q•. �� `•' • ' DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) A..cco t.S • $ Oen ��� ( a ROOFING (C-39) SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) SEWAGE DISO. (d-42) w PAINTING (C-33) i CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-121).LANDSCAPING (C-27) POOL (C-53) g �„ �.•d Q S ® 1 �Q 3�� � ���� s��•®� la•d•®s � ML W • s I , �•�L� O f . i n "Y Cl 01 d' C SWrMMING POOL SPECIFICATIONS POOL, SPECIFICATIONS � type: t-2e1A11TE Surface area:19 1��. pperimeter depths: min. S'— OO max. S I— SPA SPECIFICATIONS o size: (A XI t A surface area: Z&A perimeter. dam wall width: 121' length: 1 O spa 'sed.+ spillway type:/ i0.r' T 1 L E # of jets: notes: EXCAVATION / STEEL. type of dig: 7,mr,3eAT access: elevation: T. -b wall/fence removed by: wall/fence type conc.removal: sod removal: tree/stump removal: ' 6"r.b.b. — 12"r.b.b. 1 D 18r.b.b. surcharge: YES bench/loveseat: tanning shelf water depth: GUNITE 6"r.b.b. ^ 12"r.b.b.-18"r.b.b._' bench/)oveseat: extended 2°d step: spa dam wall width: 2-11 spillway type: p LDECIONG SQ.FT.$,J C!Jgr¢S finish: color: cantilever expansion joints: steps: type: deck drains: decco-drain: curb core: sand&visqueen: - f TILE & MASONRY coping type: rV L — I spillway type: 6"r.b.b. — 12"r.b.b._11)— 187r b.b. r.b.b. facing: trim tile: tile type: equipment wall: X type: PLUMBING & ELEC MCAL. plumbing size: 2" fill line: awj skimmer type:QtlJilCAb& # gas line: Vfr_S elect.line: heater. At I - U IL size• filter. '1 GL size: pool pump: 0111 e p FLS _sire: 1.,57 jet pump: size: sub -panel: time clock. GF1C. ter_ EA J e P extra GFIC. pool light: $00 spa light: t gas stubs: — electstubs: plaster color pebble: color. NAME: fJ lL I Job address: s City: scale: = date: 2 CITY O .LA QUINTA SUB -CONT ACTO LIST JOB ADDRESS SI•% CAc. (, Kc� M� PERMIT NUMBER OWNER 1139 BUILDER � 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. Fai]_UJre to COM131Y will result in a stoppage of work and/or the voidance of building permit... For each applicable trade, all information requested below must be completed by applicant. 76 File" is nest an arr.PntnhIPrp�nn IRS Trade / Classification Contractor State Contractor's Licenseorkery� s C sensation 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 License Number Exp. Date (xx/xx/xx) (xxxz) (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8) t't�►�.?.o��S•Ir•OAa.�c�3L.S L'►'s3 O� Q� .� S• _ FRAMING (C-5) ' STRUCT. STEEL (C-51) AeA2.0 60s S L° • 3 ©n . MASONRY (C-29) PLUMBING (C-36) ?16AZC ®!r L' is 3 �O® '�• — /� i LATH, PLASTER (C-35)ca IA.C.�Eµ.P�Y� �� ,� •' DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) A.•go� �,S • �j •��. ( 4 ROOFING (C-39). J, SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) •• SEWAGE DIS,R. (C-42) PAINTING (C-33) 4 CERAMIC TILE (C-54) CABINETS (C-6) ` FENCING (C-13). ' LANDSCAPING (C-27) POOL (C-53) .� 400.. 'a• [ I✓S ® "� IRS