12-1310 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 00001310
Property Address: ;.52555 HUMBOLDT BLVD
APN: 767-200-091-18 -34968 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 38600
Tiht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
EAST OF MADISON LLC
PO BOX 1482
LA QUINTA, CA 92247
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/05/12
D__FA,
NAV 02r'!
6 a2
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).:
(_) 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.).
(_) 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: Y'
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 construc ' n, and hereby authorize representatives
Oft cou ty t enter up n the above-mentionedrope fDyr p ioonn/p}�rpgs
Da l " ;e ignature (Applicant or Agen Iy:%%% i/'% `• C/
Contractor:
Applicant: Architect or Engineer:
MCINTYRE POOLS & SPAS, NC. CI �FLA-WIN`A
83695 AVENUE 45 FINAUrP "%PDT
INDIO, CA 92201
A
(760)342-3612
Lic. No.: 614611
-------------------------------------------------------------------------------------------------
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 declarations:
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 Clas C53 License No.: 614611
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ate: 4 ontractor: 4w/ "� -
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
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 BENCHMARK INS Policy Number AQW00402
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ 1 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
person in any 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 Labor 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).:
(_) 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.).
(_) 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: Y'
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 construc ' n, and hereby authorize representatives
Oft cou ty t enter up n the above-mentionedrope fDyr p ioonn/p}�rpgs
Da l " ;e ignature (Applicant or Agen Iy:%%% i/'% `• C/
Application Number
12-00001310
Permit . . .
BLDG POOL PERMIT -
Additional desc
Permit Fee . . . .
343.00 Plan Check Fee
222.95
Issue Date . . . .
Valuation
38600
Expiration Date
5/04/13
: Qty Unit Charge
Per
Extension
BASE FEE
252:00
14.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25;001-50,000
91.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
5/04/13
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'.
5/04/13
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 . .
5/04/13
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, FIREPIT. PERMIT INCLUDES 63
LQPERMIT
Application Number . . 12--00001310
Special Notes and Comments
LF. 1 1/2" & 186 LF. 2" GAS LINES.
ALARMS/BARRIERS 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 Paid
Credited
----------
Due
-------------------------------------
Permit Fee Total 447.00 .00
----------
.00
447.00
Plan Check Total 248.95 .00
.00
248.95
Other Fee Total_ 2.00 .00
.00
-2.00
Grand Total 697.95 .00
.00
697.95
LQPERMIT
2-0,pEtT_LINE
PLANTER
10,
L161-411 7f-6"
-70 %
PTI
PLANTER %
11
71-6POOL 14'
m
F--�
T-
zo
POOL/ 5PA HEATER
250,000 f3TU
EQUIPMENT
PLANTER
PLANTER
POOL /SPA
50 -PANEL
I
HIM] Mo ME
OF,',
B!--
F�CAR CONr�'TRUCT'ION
DATE_) 3y
ENTRY STEPS
1-112" GAS LINE
RE FIT
31
-------------
LOT 189 MADISON CLUB VILLAS
52-555 HUMBOLDT BLVD.
LA QUINTA, CA 92253
I&A
71u °®warve Is
II
a a %F a Ak 1k -1 a 1ILJ
MS U
veo 342 3612
N01r:
POOL SPA GAS PIPE --CALCULATION
POOL & SPA = 250,000 BTU
CUBIC FEET = 250
DISTANCE = 60'
SIZE OF PIPE = 2"
NOTE:
CONCRETE SURFACES, STEPPING STONES, WALLS,
FENCES AND PLANTING AREAS By OTHERS
V CONDUIT, 40 AMP ft WARE ELEC.
METER
2" GAS LINE --AGAS
R
t .
REVISIONS I BY
POOL & SPA SPECS.
POOL SIZE
281 x 141
FIRE PIT
= 250,000 BTU
CUBIC FEET
= 250
DISTANCE
= 150'
SIZE OF PIPE
VS3050
NOTE:
CONCRETE SURFACES, STEPPING STONES, WALLS,
FENCES AND PLANTING AREAS By OTHERS
V CONDUIT, 40 AMP ft WARE ELEC.
METER
2" GAS LINE --AGAS
R
t .
REVISIONS I BY
POOL & SPA SPECS.
POOL SIZE
281 x 141
POOL S.A.
392 SQ. FT
POOL PER.
84 L. F.
DEPTHS
TO
POOL PUMP
VS3050
HEATER
250,000 BTU
FILTER CCP 420
1 - f Off 71 !" "TA � U -
LIGHTS 4 Plut 1111 Im I
i." 111tati
SPA SIZE
T-6" x T -F
SPA PER.
56 SQ. FT.
SPA S,A.
30 L.F.
SPA DEPTH
31-611
JETS
DECK AREA
man
IR
CJ
L/
Clio
'M pt, rg" m
PON
a- Q0
�f co
MIN
0
11 Ing 11 co
01
e ga
CN
c"'11
CD
m
czoo Lc-) (=3�
T---4 Lc-)
I TY 0 F
13 U I L DI N G
FOR GONS-Ff:j DATE: 11/01/12
DATE
SCALE: IN= 1'-011
DRAWN BY: AV
JOB:
SHEET
OF SHEETS
Bin #
Permit #Y
b
f
City 6fla.Quinta..
Building & Safety -Division '
P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - -(7¢0) 777-7012 '
'Building Permit Application and Tracking Sheet
Project Address;
Owner's Name:
A. P. Number:
Legal Description:
Address:. _
ss
City, ST, Zip:
yr ✓1
Telephone:
Project Description:. o
I l .l
e
Contractor:
:, Zip:.
e.RA
ne : 2 _vJ
kAdd:'
. # :
Designer:
City Lic.ngr.,
t 2 It jO
10
City, ST, Zip:
Telephone:
Stafe Lit. #:
Name of Contact Person:
Telephone # of Contact' Person:
Coash action Type:, Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
r Sq. Ft.: #Stories: #Units:
6 2 Estimated Value .ofProject• 00
APPLICANT: DO NOT WRITE BELOW THIS UNE .
'
!t
Submittal
Req'd
Recd:
TRACKING
PERMIT FEES
Amount
Plan Sets
Plan Check submitted .
Item
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Plan Check Balance
Truss Calcs.
Called Contact Person
Energy Calcs.Pl77
ans picked up
Construction
Flood plain plan,
Plans resubmitted
Mechanical
Gradingplan':
r' Review, ready for correctiotis%;ssue
Electrical.
Plumbing
Subcontactor.'List
Called Contact Person
GranfDeed
Pians_picked up
S.M I.
AOA. Approval
Plans resubmitted
Grading.
IN ROUSE:
''" Review, ready for correctionslissue
beveloper Impact Fee
Planning Approval '
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
21
5PA
,NEL
LOT 18, MADISON CLUB VILLAS
52-555 HUMBOLDT BLVD.
LA QUINTA, CA • 92253
MA »IMP'ST .W,
nen■ M ■ r K r
a a�►aa� a a assi
m342-3612
NOTE: -
POOL & SPA GAS PIPE CALCULATION
POOL & SPA ='250,000 BTU
CUBIC FEET = 250
DISTANCE = 60'
SIZE OF PIPE = 2'
FIRE PIT GAS
PIPE CALCULATION
FIRE PIT
= 250,000 BTU
CUBIC FEET
= 250
DISTANCE
= 150'
SIZE OF PIPE
i
REVISIONS
I
POOL & SPA
I
SI
POOL SIZE
28')
- - - P�ERTY UNE
- - _
t
POOL S.A.
392
POOL PER.
84
-- ---
i
PLANTER
�
,
DEPTHS
,
TO ;
POOL PUMP
VS 3
HEATER
2500
.4' 7T'.6'
Q i
�%
Lo
i
;
FILTER
CCP
I \
POOL
PLANTER �%
!
LIGHTS
CONTROLLER
-4
wl Spa
T -s SPA 14'
ENTRY STEPS
10SPA
SIZE
7'-6"
SPA',PER.
56
FIRE PIT
1-111' GAS LINE 730
SPA S.A.
SPA DEPTH
3
OF
0 F
BL,,: f.sa,.�
JETS
,AFETY--------------------------
. DEF'
I ,
ROVED
1
-FLR-
STP,UCTIov—
7
_
_JET.PUMP_
DATE IgyDECKAREA
I ,
t
21
5PA
,NEL
LOT 18, MADISON CLUB VILLAS
52-555 HUMBOLDT BLVD.
LA QUINTA, CA • 92253
MA »IMP'ST .W,
nen■ M ■ r K r
a a�►aa� a a assi
m342-3612
NOTE: -
POOL & SPA GAS PIPE CALCULATION
POOL & SPA ='250,000 BTU
CUBIC FEET = 250
DISTANCE = 60'
SIZE OF PIPE = 2'
FIRE PIT GAS
PIPE CALCULATION
FIRE PIT
= 250,000 BTU
CUBIC FEET
= 250
DISTANCE
= 150'
SIZE OF PIPE
= 1-112"
NOTE:
Lim
Fli