05-2204 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
0.5-0,0002204
79811 DECLARATION CT
6'04-511-026-33 -24197 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
11W—— YX�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
I hereby'affirm under peneh';of perjury, that I:am licensed under provisions of Chapter (comm g wi
Action 7.000),of visi the Business and, Professionals Code, and
dQLicense st r� ec
&/ License lass: Lice 9th r
8'. Contracts C�i(I�.�
OWNER -BUILDER DECLARATION
I hereby ;affirm under penalty of perjury that 1 am exempt from the i.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 orshe°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 bass for the alleged exemption. Any violation of Section 7031.5 by
any applicant for permit:subjects the applicant to a civil penaltyof not more than five hundred dollars (8500)::
1 _) I, as owner of the property„or my employees with wages as their sole compensation, will do the viork,<and
the structure is not intended or offered for sale (Sec. 7044,: Business and Prdfessions 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 ocher 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 sa(e.l.
(_) 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 toen owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Law.).
( ) l 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 performanceof the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMflT
Date: 6/07/05
WORKER'S COMPENSATION DECLARATION
Thereby 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 ,partormance 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
ode, for tha;pe noe of work for which
and agree that, if.l should. or re sub' to the workers' compensation provisions of Section
, �70� the Labor Cod sha (fo with rovisions.
!fate%�A(� ApPlic
WARNING: FAILURE TO SE RE WORK R COMPENSATION CO RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER CRIMINAL PE ALTIES AND CIVI FIN UP TO ONE HUNDRED THOUSAND
DOLLARS ($.160,600). ADDITION TO THE COST OF COMP TION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby madeto the Director of Building and Safety for a-permibsubjectto 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, Indemnifyand hold harmless the City
of La Quints, its officers, agents and employees for env 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 cessationof work for ISO dayswilbsubject
permit to cancellation.
I certify that I have read this application and state that the above irrfo;Zc is correct. 1 agree to comply with all
city and county_ ordinances and state laws relati i 'n onst on, a ereby auth representatives
Of thi oun o e�pon the above -menti props f r in^ ion p ses,
Date Signature (Applicant Agent
Application Number . . . 05-00002204
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
2.52.00 Plan Check Fee
163.80
Issue Date . . . .
Valuation . . .
. 25000
Expiration Date . .
12/04/05
Qty Unit Charge
Per
Extension
BASE FEE
45.00
23.00 9.0000
THOU BLDG 2,001-25,000
207.00
Permit . . ..
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date ..
Valuation .
. 0
Expiration Date
12/04/05
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
12/•04/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
-------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
P.LUMBING
Additional desc . .
Permit. Fee . .
33_.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date
12/04/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0.000
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
----------------------------------------------------------- 11 -------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMrr
Application Number . . . . . 05-000022.04
---------------------------------------------------------------
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
Permit Fee
Total 356.00 .00
.00
356.00
Plan Check
Total 189.80 .00
.00
189.80
Grand Total
545.80 .00
.00
545.80
LQPERMIT
CITY OF LA QUINA
CN BUILDING
W
APP Ov
a CO ION
6 f,10 fMo
[DA By
ti
iD
LO
M
i
m
N
m
is
CD
LO
r`
M
m
Ln
com
N
t`
CD
LO
CD
94F BBQ SHELL
NO +317_MASONRY
CITY PERMIT PLAID ONLY
QTZ VENEER CAP STACKED STONE WATER FEATURES 0 I
SS ACCESS.DOOR +611 & +12' PLUMBED RETURNS FOR URNS TO
G&ERUNS
27" SS GRAND TURBO HARDWARE
ANSI Z21.58a +1p _ +1$' +1
+18' ' o QTZ VENEER RBB
i2QTZ VENEER RBB
I - UPUGHTS
X331
3 FT FIRE FIT4c
+12' COCR
NETECUR8
QTZ VENEER EXT.
ANSI Z223A
1,475 SF COLOR CONCRETE
DEMD ABOVE
T14S_LINE ONLY �-
—5'3
Sawwl pallial
fortrench
do not demo this concrete
FPA
PRESTON RESIDENCE
79-811 DECLARATION COURT
LA QUINTA CA 92253
APN: 604-511-026
SPA 0 41 B"
STACKED QTZ SPILLWAY
QTZ VENEER EXT
CONCRETE CAP
PIL
salt system
EQUIPMENT
LOCATION la
So& in Fast.
��
01 23 456
CANYON VIEW POOLS*
Jay -Bishop
O18os: 780 778 2700 Cell: 76D 272 0494
Access repair
I sod If needed
POOL
425 SF
_16'0
loo LF
US o 0
us
-12' Wd
o us
-12' wd
x_53
516
21061N -HOME_
Demo and repour
CONTROLLER
Goggia area concrete
PRESTON RESIDENCE
79-811 DECLARATION COURT
LA QUINTA CA 92253
APN: 604-511-026
SPA 0 41 B"
STACKED QTZ SPILLWAY
QTZ VENEER EXT
CONCRETE CAP
PIL
salt system
EQUIPMENT
LOCATION la
So& in Fast.
��
01 23 456
CANYON VIEW POOLS*
Jay -Bishop
O18os: 780 778 2700 Cell: 76D 272 0494
Access repair
I sod If needed