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05-3884 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00003884 Property Address: 78375 AVENIDA LA FONDA APN: 770-164-013-1 -000000- Application description: POOL - RESIDENTIAL Property Zoning: MEDIUM DENSITY RES Application valuation: 19000 Applicant: Architect or Engineer: . 117, C.60��� - ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT D zoos dpi 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 Professionals Code, and my License is in full force and effect. License Class: /� .�p License No.: ae�te:rSS-o -o YContractor. 1' l e �.� [ �= fs OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 (9500).: (_ 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 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—) 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 VOICE (760) 777-7012 FAX (760) 777-7011, INSPECTIONS (760) 777-7153- Date: 9/02/05 Owner: POWER BROKERS Contractor: PICAZO POOLS & SPAS WCC: EXEMPT WC: EXEMPT CSLB: 836900 05/31/06 04/30/06 ------------------ 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. 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 insurance carrier and policy number are: Carrier C53 Policy Number - - - - - - - - - - - - - - - I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Oa Applicant/ a LA ;A/ 10 P: noo-L .a 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 Ouinta, 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 buil 'ng construction, and hereby authorize representatives of this county to enter upon the above-mentioned prop y for inspection purposes. Signature (Applicant or Agentl. Application Number . . . . . 05-00.003884 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 198.00 Plan Check Fee 128.70 Issue Date . . . . Valuation . . . . 19000 Expiration Date 3/01/06 Qty Unit Charge Per Extension BASE FEE 45.00 17.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2;001_25,.000 - 153.00 Permit MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . r Valuation 0 Expiration Date 3/01/06 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 . . 3/01/06 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 3/01/06 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 ONLY..ALARMS/BARRIERS SHALL LQPERMIT Application Number 05-00003884 ---------------------------------------------------------------------------- Special Notes and Comments ` BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT.. Fee summary ----------------- Charged Paid -------------------- Credited -------------------- Due Permit Fee Total 302.00 .00 .00 302.00 Plan Check Total 154.70 .00 .00 154:70 Grand Total 456.70 :00 .00� 456.70 WPERMTT if X X A Bl" #City of La Quinta Building et Safety Division P.O. Box 1504, 78.495 Calle Tampico La Quinta, CA 92253 - (760) 777.7012 Building Permit Application and Tracking Sheet Permit # 05— 3 So Project Address: D. r Owner's Namc: Address: :F,4D . �L I A. P. Number Legal Description: Cin•. ST. Zip: LA, Q J Contractor.PI&AZO &Q`J O Lf> Address: $Z-3 S jjt>J • I 1 . t- Q FTelephone: Project Description: 12,E 22� Poo L- 1 City, ST. Zip: ox*o C Q Telephone: QlSepj 341 • SIB SS' State Lic. # :8 3 900 City Lic. Arch.. Engr- Designer. Address: City. ST. Zip: Telephone: -_ - Construction Type:.(y()Aj 1TjF Occupancy: State Lic #: Project type (circle one ew Add'n Alter Repair Demo VSq. FL: IN Stories: # Units- nitsTelephone Name of Contact Person: D e-Lr-wa Pt G z-© Telephone# of Contact Person: 1,,-) W 34 7 ' S"S' imated Value of Proicct: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted 9 Z Item Amount Structural Cala. Reviewed. ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance Energy Cala Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review. ready for correctionsrossue Electrical Subcontaetor List Called Contact Person Plumbing GrAnt Deed Plans picked up SAU. N.O.A. Approval Plans resubmitted Grading IN HOUSE: '' Review. ready for eorrections/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 5PA RAISED -4F 12 -II W/4&MT1LEVEr- CAP CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE /,, SWIMMING POOL SPECI)F'ICATIONS POOL SPECIFICATIONS type: 1r4 C72oyND `' i2t: /22 X 22O surface area: = i perimeter. 2 =- depths: min. 61- O max. O SPA SPECIFICATIONS sizc:(p�_XDIotk surface area: perimeter dam wall width:I&L_length: 4' n spa raised:+ Z' spillway type: -n t C # of jets: notes: EXCAVATION /STEEL type of dig: $03C0 -T access: FEAJ elevation: .E> wall/fence removed by: . wall/fence type conc.removal: sod removal: — tree/stump removal: -- 6"r.b.b. "" 12"r.b.b. -- 18"r.b.b. surcharge: E_S bench/loveseal: tanning shelf water depth: GUNITE 6"r.b.b. 12"r.b.b. 18"r.b.b. bench/loveseat extended god step: -- spa dam wall wide spillway type: t_1� / DECIQNG SQ. FT.�7 OrlaFaES finish: -color: cantilever expansion joints: steps: type= deck drains: decco-drain: curb core: sand&visqueen: TILE & MASONRY coping type: 'D C- spillway type: 6"r.b.b. 12"r.b.b. '- l8"r.b.b. r.b.b. facing: T1 I AE trim tile: the type: .'I> equipment wall: X type: PLUMBING & ELECTRICAL plumbingsize::" fill line: tiro skimmer typc:�E►t£rwsTE # gas line: YDS elect.line: heater.size: filter. Z. E • u CL size: pool pump: SP Flo size: jet pump: — size: — sub -panel: — time clock.T GFIC. 1 extra GFIC. pool light: spa light: gas stubs- — electstubs: — plaster. color pebble: color NAME: Job address: City: LA 0011MI-EA ZO dater- IS ' CSS scale: �- CITY OF .LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS i�•3^?S AxVD.lAFoADA PERMIT NUMBER' 05,388OWNER «s� � BUILDER?CWrgn This form shall be posted on the iob 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.. FaLlune to comply will result in aa�stoppage of work and/or the voidance of building permit... For each applicable trade, all information requested below must be completed by applicant. ,"On File" is not an acceptable resoonn se `4 Trade / Classification Contractor ' � State Contractor's License 1�/orkers CoCommpensation Insurance City Business License Company Name Classification. (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp.' Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) 0=- 410,06 CONCRETE (C-8) FRAMING (C-5) ' STRUCT. STEEL (C-5. 0 ��� L+ . ®� MASONRY (C-29) PLUMBING (C-36). l�,A� Gtl ®Cr �' �� �� �C3® '� •� — [ '$ 1• LATH. PLASTER (C-35) tZ ISS (:A -L L� • S `i 10 0C Ea�P�Y s �"�P• I'� '� • �s` O DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) (� L.S • $ �® •�� ( ROOFING (C-39).. fad -or SHEET METAL (C-43) i FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) • SEWAGE DISj?. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13). LANDSCAPING (C-27) POOL (C-53) 4►l. e®.`f ! S © 72.� 3��� � rcodD S��•®© 1 IC•I•®� `T