04-3494 (RPL)tlft,�Gv
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
cl0F94� �i,.,-495 CALLS TAMPICO FAX (760) 777-7011
LA Q.UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153
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BUILDING PERMIT
Application Number 04-000.03494 Date 4/16/04
Property Address . . . . 81696 IMPALA DR
APN: 764-270-999-78 -300232-
Application description . . . POOL - RESIDENTIAL
Property Zoning . . . . . . MEDIUM HIGH DENSITY RES
Application valuation .. 19000
Owner Contractor
SHEALA QUINTA CALIFORNIA POOLS &.SPAS.
C/O JEFF MCQUEEN P.O. BOX 1280
88.00 N GAINEY CENTER 350 COACHELLA. CA 92236
SCOTTSDALE AZ 85258 (760) 398=9222
WCC: STATE FUND
WC: .04600061168 01/01/05
CSLB: 656128 10/31/04
CCC:. C8, -C27' -C29-051
-----------------------------------------------------------------------------------
Permit . . MECH POOL
Additional desc
Permit Fee. 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 9.0000 EA MECH FURNANCE <=100K 18.00
Permit. BLDG POOL PERMIT
Additional desc
Permit Fee. . . . . 198.00: Plan Check Fee 128.70
Issue Date. Valuation . . 19000
Qty Unit Charge Per Extension
BASE FEE 45.00
17.00 9.0000 THOU BLDG 2,001-25,000 153.00
-----------------------------------------------------------------------------
Permit ELEC POOL PERMIT -RES
.Additional desc
Permit Fee 45.00 Plan Check Fee 11.25
Issue Date . .. Valuation 0
Qty 'Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000.EA ELEC PRIVATE SWIMMING POOL 30.00
M
P.O. BOX 1504 u
78-495 CALLE TAMP 'CO
LA QUINTA, CALIFORNIA 92253 44a
Application Number:
Applicant:
Applicant's MailingOu
Add ess:
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012 'i -
FAX
fFAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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 Pmtessionals
G se c ass `'ce � °force and effect.
�--- --- S!G/2
License No. - y
6
L.� Date • ~-- •. -�/� Co�tradOf
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sea 7031.5. Brininess and Professions Code: Any
city or county that requires a permit to coriir uct, atter. improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for the permit to role a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' 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).):
U 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 (Sea 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 or tvough 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 of she did not build or improve for the purpose of sale.).
(--) 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.).
U I am exempt under Sec. . BA P.C. for this reason
Data Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to W"4nsure 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
'ss ed. My wo co ensation insurance carrier and policy nun_ber are:
Cartier Policy Number _ O C/ 6i OA�(,y �/ (,,
_ I' t, in ttie performance of the work for which this permit is issued, l sha I not employ any person in any manner so as to become subject to the workers'
compensation laws of Cardomia, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
.�- _forthwith comply wmtm those
Date- � p Appr n� t
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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the wok for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
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 a 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 Oulnta, its
Officers. agents and employees for any act or omission related to the wok 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.
1 certify that I have read tris 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 a upon above-mentioned property for inspection purposes.
Uzi y -
Date —� -- �'—Signature (Applicant -WAgent):
y
Page 2
Application Number . . . . .
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04-00003494
Date 4/16/04
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Permit . . . . . . PLUMBING
-----------------------
-----------------
Additional desc
Permit Fee. 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. . 0
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
--------------------------------------7-------------------------------------
GAS PIPE 1-4 OUTLETS
3.00
Special Notes and Comments
POOL AND SPA ONLY. BBQ ANSI Z21-58-1195.
ALARMS BARRIERS SHALL BE IN PLACE
PRIOR
TO PREPLASTER INSPECTION.
Fee summary Charged
------'-----------
Paid Credited
Due
----------
Permit Fee Total 309.00
--------------------
.00 .00
----------
309.00
Plan Check Total 156.45
.00 .00
156.45
Grand Total 465.45
.00 .00
465.45
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TYPE u N :I -T. SIZE x
P R E — OU N 11 TF-
PERIMETERDEPTHS MIN, LI ,0 MAX
UNDEP\GROUND
TILE
SIZE —L X FT.
TILE TYPE
SPA DAM WALL WIDTH
WATER LINE
DE CK
PR CE — P E B I3 L -
TILE TRIM
SPECIFICATIONS
TYPE u N :I -T. SIZE x
SURFACE AREA OF POOL
PERIMETERDEPTHS MIN, LI ,0 MAX
SPA c'PECIFICATIONS
�HSQ.
TILE
SIZE —L X FT.
TILE TYPE
SPA DAM WALL WIDTH
WATER LINE
NO. OF JETS e k
TILE TRIM
L ;HTS
QUARTER ROUND
RAISED SPA AT
SPILLWAY TYPE 4=�
SPECIAL NOTES
DECKING
50. FT
-
EXCAVATION S FE
FINISH
TYPE
ACCESS FROM
EXPANSION JOINTS
ELEVATION
CANTILEVER \4
DEEP END RAMP
DECK DRAINS
LOVE SEAT
OJECCO DRAIN
CONCRETE REMOVAL LOADS
CURB CORE
SOD REMOVAL LOADS
STEPS
TREE REMOVAL BY
STEP FACE
IRRIGAITON REMOVAL BY
TILE BASE
IRRIGATION REPAIR
SAND AND VISQUEEN
6' R.8.8. ft,
RIBBONS
R fl:•
MOW STRIP
18' R.B.B.
24'
m,Et
-DEP _rrj,77TT)
TNN SHELF
MASONRY
ROCK PfCKErs—_
COPING TYPE
CENTERS
R.B.B. FACING
SPILLOAY 'TYPESIZE
STEPS
PLUMBING
PROP: EXT. 'HALLS
FILTER SIZE
POOL PU'i_, SIZE 7
PLANTER 'WALL
OOST
BER PUMP SIZE
% RETAINING WAi t S
EQU - 1
IP, WALLS "T
ADO'L PUMP SIZE
FIREPIT
ADO'L PUMP SIZE
('-AG'
NEATER SIZE
ofyt'_-rojf.
TIME CLOCK
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SUB PANEL
ADO'L OUTLE
SKIMMER TYPE
FILL LINE
PE9_E3L_E/ffL_ASTFR
GAS LINE
LJOHTS POOL
FGUNTAINS/SPRAYHEADS
LIGHTS SPA
ROLLED BOND BEAM
SHEER DESCERIS
BEHIND SPA
LIGHTS IN POOL SPAz•
EYEBALLS
Ir
STUB SET EWIPMENT
f7
FENCING
MISC. )'Am
FEENCE TYPE j
PLUMBING SIZE
FH 417—
HEIGHT
GATE REVERSAL
G
3UNITE I
DEEP END RAMP
EXTENDED 20d STEP
LOVESEAT
SPILLWAY TYPE
ESI'_ S rAHT
`J �4_
CANTILEVER
COWLETION Jr_1111A_
Esl� I
COPING
0TI H rER
R.B.B. - SEE STEEL
OWNER R P�P_05951 E3 rL rr I _FS
OWNER TO; (1) DETERMINE THE APPROXIMATE ELEVATION OF POOL OR SPA AT LAYOUT ON DAY OF EXCAVATION
(2) TAKE NOTICE THAT POOL AND EQUIPMENT LOCATIONS ARE SUBJECT TO ACCEPTANCE OF
LOCAL BUILDING DEPARTMENT AT TIME OF ISSUANCE OF PERMIT
(3) ;YET DOWN CONCRETE SHELL AT LEAST TWICE DAILY FOR SEVEN DAYS AFTER SHELL 15 INSTALLED
(4)B
AGREE THAT CALIFORNIA POOLS IS NOT RESPONSIBLE FOR UNDERGROUND CONDITIONS OR OBJECTS,
AND ANY DAMAGE TO CURBS, 3OE`ffALXS, DRIVEEWAYS, LAtNNS, (A OTHER ITEMS IN THE ACCESS AREA
(5) SEE THAT ALL FENCING, GATES, AND CARAGE I)GORS MEET LOCAL CODES FOR A POOL ENCLOSURE
PRIOR TO PREPU'�STER INSPECTION
(6) FILL POOL IMMEDIATELY AFTER PLASTER, (FOLLOW INSTRUCTIONS -- DO NOT USE RUBBER HOSE)
e TM
AT NOT;CE THAT THIS DRAWING IS THE SOLE PROPERTY OF CALIFORNIA POOLS AND AT ANY
USE VATHOUT WRITTEN PEF6051SION OF CALIFORNIA POOLS, INC. IS PROHIBITED BY LAW.
OWNER APPROVES PLAN, POOL, AND EQUIPMENT t-OCATIONS AND HAS READ THE RESPONSIBILITIES AND NOTICES ABOVE.
SiGNATURE(S) DA rE
SWIMMING POOL PLAN FOR:
NAME
MELLFN ESSENCE
'STREET 81:=9-96 'IMPALA NR-1VE
_d0B —TRILOGY
ADb_RffS CTTY LA QUINTA
PHONE 0 F F I C rE p r -
'r
LOT 78 TRACT PAGE BOOK
MAPBOOKPAGE NO, Try
MAIL ADDRESS
CONSTRUCTION OFFICE PHONE NO,
SCALE
DATE
DRAWN BY
SOLD BY
CHECKED BY
2-26-04
AG jf��
JEFF
P,, --[F- V IS 11] N S DATE
A �I
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INSPECTION EEE OF t3O
1 ICITY-OFU-
,111 Ii L BE CHARGE) IF THE APPROVED -—ILA-05
F1
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P-L��'" N-S-ANID40B--G�ARD,-AIR-E-NOT-ON----- BUILDING & �PFFZTY DI
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A,
J5H 111 SITE FOR A SCHEDULED
ECTI'O Ni._
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— N 0 - E/X C E- PIT 10 N S 1 f
DIV . . . . . . . .
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STONE
4�7 4,
T ILE
BOULDERS
DECK COLOR
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PEBB./PL
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SIGNATURE
DRAINAGE NOTE-, Drainage and irrigation for planters and Polls, by
others, unless otherwise noted.
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