10-0110 (RPL)P.O. BOX 1504
.78-495 CALLE TAMPICO
t
LA QUINTA'; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: L-10'_00000110 -TM 'Owner:
Property Address: 47490 VIA MONTANA ' PALMER RESIDENCE
:. APN: 643-120-044-272 -261.52` 47490 VIA MONTANA
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 _.
..Property Zoning: LOW DENSITY RESIDENTIAL
Application Valuation: 4500 O
" -- Contractor:
App' ant: Architect or Engineer: CLASSIC"POOLS & SPAS
79461 AVENUE 40TH
BERMUDA DUNES, CA 922031
(760)413-4867 ---
VVV LiC. No.,: 935936
VOICE (760) 777-7012
FAX(760)777-7011
INSPECTIONS (760) 777-7153
Date: 2/16/10
FEB 1'7 2010
CITY OF LA f )(,;3' TA
-----------------------------------------
LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
hereby affirm undecpenalty of -perjury that I am licensed un er 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 Busi ss and Professional 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 Class: C13 C53 - Li ense No.: 935936
_
for by Section 3700 of the Labor Code, for the performance of the work for which thispermitis
----
IACGCode,
issued.
ntractor'
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the labor
for the performance of the work for which this permit is issued. 'My workers- compensation
- OW R -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 NATIONAL INS Policy Number 200090117388
following. reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I 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' compensationlawsof 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 sho Id ecome subject to a workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or -
37 0 of the Labor Co hall forthwith o ply 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).:
Date: - QApplicant:
1 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 sate (Sec. 7044, Business and Professions Code: The
WARNING. FAI URE -TO SECURE WORKER OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law does not apply to an owner of -property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the -
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within -
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). •
APPLICANT ACKNOWLEDGEMENT
1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to anowner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed
.. 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuantto the Contractors' State License Law.)"
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ 1 I, am exempt under Sec. , B.&P.C. for this reason
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.
'
Date: Owner: -
2. Any permit issued as a result of this application becomes null and void i ork is not commenced
-
within 180 days from date of issuance of such permit, or cessation o ork for 180 days will subject
CONSTRUCTION LENDING AGENCY
permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance.of. the
I certify that I have read this application and state that the above information i co ect. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). -
city and county ordinances and state laws relating to buiIdi g construction, a d'h eby authorize representatives
-
of this county a ter upon the above-mentioned pro pe ty r inspection p pos
Lender's Name:
_
_
� ?Date: 'Signature (Applicant or. Agent):
Lender's Address:
-- - -
LQPERAIIT
•-Application Number 10-00000110
Permit . . PLUMBING
Additional desc -
Permit.Fee 21.00`
Plan Check
Fee
5.25
Issue •Date
Valuation
0
Expiration Date 8/15/10
Qty Unit Charge Per•..
Extension
_ BASE
:FEE
15.00
1.00 6.0000 EA PLB
FIXTURE
6.00
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Special'Notes and Comments
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- WATER FEATURE TO POOL SPLIT MAIN
-
DRAINS
--- - - - PER APPROVED ' PLANS & _ S. T .
Fee summary Charged
Paid Credited
Due
-------•--- ---------
Permit Fee Total 21.00,
.00
00
21.00
L Plan Check Total 5.25
.00-
:00
5.25
Grand Total, 26.25
.00
00
26.25
LQPERMIT -
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
in '�
Project r ' f
Addre
J � 4 —Y�� �
Owner's Name:
A. P. Number:
Address: r U
Legal Description:
Contractor: l� (� l , S
City, ST, Zip:
Telephone:
Address:
Project Description:
City, ST, Zip:
/
Telephone: l :.
VYLt-es
State Lic. # City Lic. #:
Arch., Engr., Designer:
f 'TO
Address:
I , e h S
City, ST, Zip:.
,
Telephone:
Construction Type: O ancy:
State Lic. #:
Project type (circle one): New dd'n lter Repair Demo
Name of Contact Person: �c
Sq. Ft.:
# St *ries:
# Units:
Telephone # of Contact Person: �Q
Estimated Value of Projec \j< U
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balanc
Energy Calcs.
Plans picked up
Construction
7d oA
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
1 DA#j0
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd 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
r l
-f.
THESE PLANS, DRAWINGS • AND SPECIFICATIONS ARE NOT TO BE REPRODUCED,
CHANGED • OR COPIED
IN ANY FORM OR MANNER .WHATSOEVER WITHOUT 'THE
EXPRESSED WRITTEN" CONSENT OF CLASSIC POOLS/SPAS
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PLANT LEGEND
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PALMS
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GH GFwnaerops hMils 24' Box 7 MUNI
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GH. CLOW crops hums 56' Bax 2 MU
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PANEL
`L/ SHRUBS
SYR NAME SIZE GM.G0MT18Tir
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BO Bougltea 10MIa-la' 5 gal. - 20
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8axpowihNltea
BRP Bogamilea Royal Purple. 5. gal. 22
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BR eeacmea recavata 15 gal 3 ..
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DRIVEWAY
Elephant Foot Tree
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GA Gypenn altemNlolk s 5 gal. • 2
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Ikrid+ello Plant .
AL GAP GoeselphlopulcherMa 5901. 3
Red Bird of Porodbe
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BaxnoodIctal
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6JV Idea YeNchli' 5 gal. Fa
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Hbbcus (Red)
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f NF Phemtm texxa 5
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7J mcheba JmrtmroWes 1 901 IO hhRe ."
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c9CCa C4 G4111ard a he4wlatera 15901. 15 Vine
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Pink Powder Flhr
61%G= GpVERS -
SYM. NAME SIZE 61Y. GOMI•>$n
. •. •Llriwi`f SYNTHETIC LAVH
a„aQ 'Arhona Gobble' 3' to T for overflowing Basalt Golums
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Ar,a color to be selected by oreer -.
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3/8• Mn— - 'CALIFORNIA GMJY BG. 2 6rd+es tHck In street side
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only.
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•. �`� 4' BUFF Colored carrrste mow s✓?'KJ -
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.. 'Posta Blonde' B.Aders - T to s• riarreter. ,.
-NAME+
PALMER RESIDENCE
Y�ZaSSI C POOLS / Spas
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ADDRESS+ 47-490 VIA MONTANA
Landscaping
..
CITY, INDI❑, CA 92201
ti
(760) 345-8302
Lic. # C 53-935936
PHASE, — TRACT, — .' - L❑T# —
SCALE: 1/16"=1'0"
.