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04-3338 (RPL)dy 4 I BUILDING & SAFETY DEPARTMENT P.O."B©x--f504 (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Numberi-+.s`: . . . 04-00003338 Date; 4_/08/04 Property Address 45930 LA FLOR LN APN: 604-460-026-26 -29563 - Application description-. POOL - RESIDENTIAL Application valuation . . . . 10000 Owner ------------------------ ROBNETT LORI 45930 LA FLOR LN LA QUINTA CA '92253 Contractor ------------------------ VACATION POOLS. 9522 DONALDSON ROAD LUCERNE VALLEY CA 92356 WCC: STATE FUND WC: 2290019334 01/01/05 CSLB: 351673 01/31/05 CCC: C53 ---------------=------------------------------------------------------------ Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . 117.00 Plan Check Fee 76.05 Issue Date . . . . Valuation . . . . 10000 .Qty Unit Charge Per Extension BASE FEE 45.00 8.00 ---------------------------------------------------------------------------- 9.0000 THOU BLDG 2,001-25,000 72.00 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 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.75 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 .00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS .00 P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: MKIMBROT.14i Date: Architect or Engineer: Architect or ngineer's Address: ri Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm er penalty oLpeq that I am licensed under provis' ( mme�cwg int ection 7000) of Division 3 of the Business and Professionals license Class e, and ice se l for e } 007 Contractor_ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the C tractors' 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 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 (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 or through his or her own employees, provided that the improvements are not intended or offered for sate. 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.). U 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. , B.& P.C. for this reason Date WORKERS' 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 pRilicy ued. ve and ' t ' nsation insura as requir by Section 3700 of"any ode, for the performance of the work for which this permit is s M e surance carrier n bA" Cartier Number I ce ify that, i the performance of the work for which t is permit is issued, I shall not empon in any manner so as to become subject to the workers' compensation laws of Cali ia, and a e th , if I sh Id become subject to the workers' compe sation provisions of Section 3700 of the Labor Code, I shall fort with comply ose provisi Date Applicant WARNING: FAILURE TO SECURE WORKERS' C�jSdNS,f4 OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND L S 000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATT NEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perju that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders 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 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 ull an void if ork is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancel tion. I certify that I t ave read IN application and state that the above inform tion i core I agree_I with all city and county ordinances and state laws relating to building cons tructi n, a d her authorize representatives of this c to ante up a •ab ve-m ' ed property for inspection purposes. Date Signature (Applicant or ant): Page 2 Application Number. ---------------------------------------------------------------------------- . . 04-00003338 Date 4/08/04 Special Notes and Comments POOL ONLY (NO HEATER). ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary ----------------- Charged Paid Credited Due Permit Fee Total -------------------- 186.00 .00 ---------- .00 ---------- 186.00 Plan Check Total 94.05 .00 .00 94.05 Grand Total 280.05 .00 Ob 280.05 _ M W/ UaJve N 'A�VACATION POOLS & SPAc .� 9522 Donaldson Road Lucerne Valley, CA 92356 (760) 248-6045 (760) 248-2919 FAX Lic. #C-53-351673 Sales Locations Bermuda Dunes, Irvine, California City, Rialto, Lucerne Valley 1 800 999-1811 S_ /%j at4, t v a- i L: ,q G,, f s+,*L /X 8 , UA -6 -A -.r- 0,-) T& r N = ^j 4r Lam. 'L-Pj V "M bvc'GY-C� 5 be -eve C) -5, eq N C -.V^, cc /V V-,eg SIZE /S X �O AREA PERI ETER DEPTH S -" — TILE CHOICE RBB. 'o FT. COPING 2,'4A2- ,'4A -POOL ELECTRICAL BY POOLCAPACITY GALS PUMP CAPACITY GPM MOTOR HP HP MOTOR HP HP FILTER41-go 0-4k SQ FT FILTER RATE GPM HEATER SIZE BTU TURNOVE HRS SUCTION LINES RETURN LINES SKIMMER MODEL CHECK VALVE GASLINE BY FT. POOL LIGHT zz-r__ CLOCK ELECTRICAL BY FT.�Aer AUTO CLEANER CHEM.FEEDER PLASTER COLOR DECK BY /000 SQ. DECK TYPE - STEP FT. S 7 SPA SPECS. — SIZ I ED LITE 410TS DUAL LEVfL SVW DAMWALL A RE -INSPECTION FEE OF. $30 DAMWALL TOP WILL BE CHARGED IF THE APPROVED SPILLWAY SI X WIDE PLANS A 1V�F�#CT�AKA*T Mume responsibility for DATE SPILLW THE SIT aFaRe Ao SWEM Iks, driveways, cement #� INSPECTI Nabs, sewers, lawns, trees, fences, retaining walls, pp��oneorshrubs. Name: p �j N C� T �gg� W c�S� ��{{��99ade through a neighbor's property L q -Flo V, it is understood that you, the owner, have that Address: 30 neighbor's permission and assume full responsibility. City: + �► DATE�.,.r,,. � LRACLOT#