05-1699 (RPL)a,
14� BUILDING & SAFETY DEPARTMENT
BO0
x 4� (7'60);7.77-7012
OF49\'NRALLC FAX (760) 777-701'1
A QUIZ c�� NIA 92253. INSPECTION REQUESTS (760) 777-7153
tl��►►�� BUILDING PERMIT
Application Number . . . . . `05-000-01699 Date 5/03/05
Property Address . . . . . 51809 EL DORADO DR
APN: 772-250-996-165 -31349 -
Application description POOL - RESIDENTIAL
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation . . . . 15000
Owner Contractor
ZAMORA ALPINE SERVICES
51-809 EL DORADO DRIVE WCC: STATE FUND .
LA QUINTA, CA.92253 WC: 2290023236 01/'01/06
CSLB: 786324 10/3.1/06
CCC: C53
-P.O. BOX 1504d*f VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 9 Date: ' �� `67s-
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
�D1\�7/ICAr✓TO<
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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 nd my License is in full force and effect.Q 6 % z 1
Li G se Class a3 License No� 7 U J 2 L
Dgte%7-QS Contracto p,'��IV
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' 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 70.00) 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 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.).
U 1, 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. , BA P.C. for this reason
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 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
7" issued. My worksgs' compensation insurance carrier policy number are: /
CarrieV 5r,+72� fUN!) Policy Number i�22 100
'L 3 � jb
_ I certify that, in the performance of the work for which this permits 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.
Date i/"5 -Det -OS ApplicanttDTD,
"'—�
WARNING: FAILURE TO SECURE WOqw7,Lf ja-4�
MPENSAM COVE G S UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED TLLARS ( 10 ,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODEAND ATTO EY'S FEES.
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.).
Lendefs Name n %n
Lenders 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 thinta, 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
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Dat0 / -0 `-^' Signature (Applicant or Agent)
----------------------------------------------------------------------------
Application Number . . . 05-00001699
----------------------------------------------------------------------------
Permit . . . . . . BLDG POOL PERMIT
Additional desc
Permit Fee . . . . 162.00 Plan Check Fee 105.30
Issue Date . . . . Valuation . . . . 15000
Expiration Date 10/30/05
Qty Unit Charge Per Extension
BASE FEE 45.00
13.00 9.0000 THOU BLDG 2,001-25,000 117.00
--------------------------------------- ----------------------------------
Permit . . . . . . MECH POOL
Additional desc
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 10/30/05
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 10/30/05
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 10/30/05
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. ALARMS/BARRIERS SHALL'BE IN
PLACE PRIOR TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- -7 -------- ----------
Permit Fee Total 266.00 .00 .00' 266.00
Plan Check Total 131.30 .00 .00 131.30
Grand Total 397.30 .00 .00 397.30
bin # f
Cit La Quinta
. y ]- of
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 5/909
Owner's Name:
A. P. Number:
Address: M0 A
Legal Description:
City, ST, Zip: N LL
Contractor: POOL'S q
Tele h
Address: S 5c/(TEA
Project Description:5WIMNa L Al
City, ST, Zip: ALM
TeleP hone: G 0 _2 S
? b
�G 3
State Lic. # : V 32 City Lic. #: 34170
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: e:Occupancy:
Lt pa
State ic. #:
A d'n Alter Repair Demo type (circle one .
Name of Contact Person:Sq.
Ft.:
#Stories:
# Units:
--TTelephone # of Contact Person: •
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections:.
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' 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