11-0434 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000434 .
Property Address: 81271 JASMINE CT
APN: 764-280-999-32 -300236-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 26000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I licens u rovisions of Chapter 9 (commencing with
Section 70001l of Division 3 of the Business a rofe i n s C e, and my License is in full force and effect.
License Class: C53 Lice a No.: 890670
ate:ontractor Or
Oo='
WNER-BUILDER DECLARATION
I hereby affirm under penalty of pexempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Bfessions Code: Any city or county that requires a permit to
construct, alter, improve, demolisstructure, 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, 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:
LQPERMIT
Owner:
KULYESHIE E. & COLE A.
81271 JASMINE COURT
LA QUINTA, CA 92253
Contractor:
PLATINUM POOLS & SPAS
77564 COUNTRY CLUB DRIVE
PALM DESERT, CA 92211
(760)772-7274
Lic. No.: 890670
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/29/11
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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.
-VII have and will maintain workers' compensation insurance, as required by Scction 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 STATE FUND Policy Number 1863573-2011
I certify that,in the perform of the work for which this permit is issued, I shall not employ any
person.in any manner so as t ecom s bjec o the workers' compensation laws of California,
and agrA that, if I shout beco e s je t t workers' compensation provisions of Section
rrv�3�700 of the or Code I s fort wi Iy with those provisions.
ate. ' i0' 011 pplicant:
WARNING: FA URE TO SECURE ORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI INAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITI N TO E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO , IN REST, 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, indemnity 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 or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the bove ' rmat n is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi ns uctio , and hereby authorize representatives
of this county to enter upon th bove-mentioned property r insp ctio purpo s.
ate: ature (Applicant or Ag
Application Number . . . . . 11-00000434
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
258.50 Plan Check Fee
168.03
Issue Date . . . .
Valuation . . .
. 26000
Expiration Date
10/26/11
Qty Unit Charge
Per
Extension
BASE FEE
252.00
1.00 6.5000
-----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
6.50
Permit MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date
Valuation . . . .
0
Expiration Date
10/26/11
Qty Unit Charge
Extension
.Per
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
10/26/11
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
10/26/11
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, WATERFALL. ALARMS/BARRIERS
LQPERMIT
Application Number . . . . .
11-00000434
----------------------------------------------------------------------------
Special Notes and Comments
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE
NOT
INCLUDED. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged
----------------- ----------
PaidCredited
----------
I---------- ----------
Due
Permit Fee Total 362.50
.00
.00
362.50
Plan Check Total 194.03
.00
.00
194.03
Other Fee Total 2.00
.00
.00
2.00
Grand Total 558.53
.00
.00
558.53
LQPERMIT
E
Bin #
CILy of LA Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Shee
Permit # rryy,,
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Project Address: t _
Owner's Name: U' ! ( W��'(�
A. P. Number:
Address: 61 J
Legal Description:
l.l4Tl?'«'>•'.'
Contractor:i+J 1. S4
City, ST ("
Zip: ,4 ` ��+ tN .
'Telephone: i>`'•<'s,:':'.">:?
' • � «izn :<:»>
Address: "1 �(�
Project Description: (N4
City, ST, Zip: ' AA4v%—Doott
Tele hone:
State Lic. # : City Lie. #•:
Arch., Engr., Designer: IWL ¢ VVVI�Fej
Address:
City., ST, Zip:
Telephone: . .
P
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v:::?,,:;:;iYj$''iris":,:;i{iiiiiii}:}i:iii;i:
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#I Stories:
# Units:
Telephone # of Contact Person:22S 541
1 Estimated Valued Project: C)%30
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees