08-1279 (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:
I,,"
ve
08-00001279
81923 ELYNOR CT
764 -040 -027 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
55000
Architect or
P'[*
T'4a Q
d4t 4 �W
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury/"t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B ines and Professionals Code, and my License is in full force and effect.
License ss: B-053 License No.: 820132
te: ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business an 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 ($500).:
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_ 1 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: PIK
LQPERMIT
Owner:
JIM & JAN LHOTKA
81923 ELYNOR COURT
LA QUINTA, CA 92253
Contractor:
FPD SERVICES INC
43653 PARKWAY ESPLANADE EAST
LA QUINTA, CA 92253
(760)772-1111
Lic. No.: 820132
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/29/08
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 DLOS INS Policy Number 01DKRM12000631
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner o as to become subject to the workers' compensation laws of California,
and agree that, if I o d become subject to the workers' compensation provisions of Section
3700 of the Lab Cod I shall forthwith comply with those provisions.
jals� ('cant:: FAIL E TO SECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN PLOYER TO CRIMI L 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 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 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 t above information is correct. I agree to comply with all
cit�hi
unty ordinances and s to laws relating to uit ing construction, and hereby authorize representatives
of n to enter upon t above-mentioned p pertfor inspection purposes.
�' Sig cure (Applicant or Agent(:
Application Number . . . . . 08-00001279 .
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
437.00 Plan Check
Fee
284.05
Issue Date . . . .
Valuation
. . .
. 55000
Expiration Date
1/25/09
Qty Unit Charge
Per
Extension
BASE FEE
414.50
5.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
22.50
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0
Expiration Date
1/25/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------- z
EA MECH FURNACE >100K
11.00
. . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
1/25/09
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 . .
1/25/09
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
LQPERMIT
Application -Number . . . . . 08-00001279
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
----------------- ----------- ---------- ---------- ----------
Permit Fee Total 541.00 .00 .00 541.00
Plan Check Total 310.05 .00 .00 310.05
Grand Total 851.05 .00 .00 851.05
LQPERMIT
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FOR:. STOKER POOLS
44-267 MONTEREY AVE. STE. C
PALM DESERT, CA 92260
REVISIONS:
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760.772.1111 - office 760.772.0012 - fax
LICENSE # C53 820132
SITE PLAN
PREPARED BY:
TAMARA FARRINGTON
PROJECT: Jim and Jan Lhotka QePool & Spa
81923 Elynor Ct., La Quinta, CA
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760-578-8941
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Co N INT PO BOX 5786 760.772.1111 -office 760.772.0012 -fax POOL, SPA &
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FLATWORK
PREPARED BY: PROJECT: Jim and Jan Lhotka Cabana, Pool & Spa
00 TAMARA FARRINGTON 81923 Elynor Ct., La Quinta, CA PLAN
Bin #
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City of La Quints
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # \
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Project Address: y jo
Owner's Name:T f (nA $ Jf'hn
A. P. Number:
Address:
Legal Description:
City, ST, Zip: (,,p_
Contractor: ' S?M-(A- CE3 QC ,
Telephone:
Address: t,)-' 7 Li ti;Ll `r? (!` ? Jlk Ji
Project Description:
City, ST, Zip: �•i� t_Y l %? r 1 C/►—
/
%.�(, lA-' r Y 7 S IiT l., �1-
Telephone: SIO(✓ ' ��
State Lic. # : k "i,
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: I
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
J
Name of Contact Person: JTZ;se i,l i ,e -,
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: .� % `�
Estimated Value of Project: (:;–S a o 0 �^
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
oG
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy 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