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04-6835 (RPL)0 53 �E BUILDING SAFETY DEPARTMENT P.O. Box 1564 (760),777-7012 OF78-495 CALLS TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153 BUILDING PERMIT ' Application Number 04 0`0006835 J__ Date 1.0.42°0/04 Property Address 78,9-00,. ZENITH WY.. s �. APN: �' 60-9�5-6-0-023-23-2377D3— Application description POOL.- RESIDENTIAL I� .Property Zoning . . . . LOW DENSITY RESIDENT+++ IL OCT 2 0.2004 Application valuation . . . . 19600 CITF•OF LA QUINTA Owner Contractor FINANCE DEPT. - _ ----------------------- - - - - - - - -- - - - - - - - - - •h DAVISON DOUGLAS JAMES CLARKE POOLS 7890.0 ZENITH WAY 74866.LENNON PL, SUITE #A LA QUINTA CA .92253 PALM`DESERT CA 92260 .(760) 568-199 WCC: GRAN=TE INS WC: 9549497. 08/20/05 CSLB: 330970 10/31/04 CCC: C53 --------------------------------------------- Permit . . . . MECH POOL Additional-desc Permit.Fee '24.00 Plan Check Fee.. 6.00 Issue Date. Valuation . . . . 0 Expiration Date_. 10/20/05 Qty Unit Charge. Per, Extension BASE FEE 15.00 .,1.00 9.0000 EA MECH FURNACE <=100K' 9.00 Permit BLDG POOL PERMIT Additional.desc Permit Fee 207.00 Plan:Check Fee 134.55 Issue Date Valuation . . 19600 Expiration Date 10/20/05 Qty Unit Charge Per Extension BASE,FEE 45.00 18.00 9.0000 THOU BLDG 2,001-25,.000 162..00 Permit ELEC POOL PERMIT -RES Additional des'c Permit. -.Fee 45.00 Plan.Check Fee 11:25 Issue Date Valuation,0 'Expiration Date" 10/20-/05 Qty" Unit Charge, Per Extension BABE :FEE .15 : 00 .1.00 30. 0000. EA ELEC PRIVATE'•.SWIMMING POOL :'30.00 P.O. BOX 1504 • /: • w 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: t/ Date: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's 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, and Licens is in full force and effect. License Class License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 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 penally 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 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.). U I am exempt under Sec. , BA P.C. for this reason Date 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 issued. My workers' compensation insurance carrier and policy number are: Carrier 6wra.n i-1 c Zn!" Policy Number, 9Sq'9Y17 _ 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. Date �O ZO�UY Applicant 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. 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 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 Quinta, its officers, agents and employees for any act or omission related to the work being perforned 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. . Date �/U ZV U y Signature (Applicant or Agent): i Page 2 " Application Number 04-00006835. Date 10/20/04 Permit . . \.. . . . . PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation. 0 Expiration Date 10/20/05 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 ONLY. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO L PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT ' INCLUDED 'IN PERMIT. Fee summary Charged, Paid Credited Due Permit Fee Total -309.00 .00 .,CO 309.00 Plan Check Total 160.05 .00 Co 160.05 Grand Total 469:.05 .00 C0 469.05 SIZE: 38'X_14''_ SHAPE: FREEFORM AREA: 375'SQFT. PER1=91' DEPTHS: 44" TO: 5, - TO: 42" - LIGHT(S) I W., 500 CORD LENGTH: 50, LIGHT(S) N/A. W.: NIA CORD LENGTH:- N/A FILTER SUCT. SIZE: w, RET. SIZE* 2" QTY.: 2 FILTER PUMP 11 * 'AfISkRFLOW SKIMMER(SI: 1 SKIMMER SETBACK: MAIN DRAIN SIZE: 2" TYPE: SWEEP STUB: I WATER EFFECT SUCT, SIZE: N/A gET.SIZE, 'NIA QTY.: N/A WATER EFFECT PUMP CITY: N/A Hp: N/A MFG.: N/A HEATER QTY.: 1' - - SIZEd 400,000BTU MFG.:,LAARS. FILTER QTY.* i SIZE: 420 TYPE: ccp , MFG.: PENT tilR BACKWASH VALVE TYPE: SIZE: VALVE TYPE: I JANDY ELECT. SIZE: 21' -AUTO FILL QTY.: -MFG.: NEP PRODUCTS LETRO QTY: N/A COLOR: REMOTE SWITCH MODEL: 'MFG.:,. X-10 REMOTE SWITCH MODEL: N/A MFG.: N/A CHLORINATOR QM-'; -1 SIZE: MFG.:GOLDLIN'E MISC.: 2 JANDY VALVE ACTUATOR 2 LEN GORDON, SIZF7. :T ..SHAPE: SHAPF7 AREA: 38 SO FT. DEPTHS: '44" LIGHT(S) I W..' loo CORD LENGTH O 100' LIGHT(S) NIAW N/A CQgp LENGTH* FILTER SUCT. SIZE: CITY. RET. SIZE: 2" FILTER PUMP QTY.: HP: MFG: SKIMMER(S): N/A N/A qKIMMFR SETBACK - WATER EFFECT SUCT SIZE: N/A QTY.: N/A- RET. SIZE: -N/A WATER EFFECT PUMPjQTY: N/A HP: N/A" MFG.: - N/A. JET CITY: 6 SUCTI� SIZE:' 2-1/2" RET: SIZE: 2" JET AIR -2' -HEATERQTYm NIA rf SIZE: N/A MFG.: N/A FILTER QTY.: N/A SIZE: N/A' MFG.: N/A'. JET PUMP CITY: HP: 2 MFG.:'WMSPERFLOW MFG ' ��, BLOWER AMe- DLUVVCK Q": I tr nr: I AIR SUPPLY `CHLORINATOR QTY:k' SIZE: MFG.: 10 U AUTO FILL QTY.: N/A MFG.: REMOTE SWITCH MODEL: AS -2 MFG.: LEN GORDON REMOTE SWITCH MODEL: N/A MFG.: NIA MISC.: �n n plo, m AN m All q ............. ......... .... R., -1-TWN .5 0, OOL SPECS., SIZE: 38'X_14''_ SHAPE: FREEFORM AREA: 375'SQFT. PER1=91' DEPTHS: 44" TO: 5, - TO: 42" - LIGHT(S) I W., 500 CORD LENGTH: 50, LIGHT(S) N/A. W.: NIA CORD LENGTH:- N/A FILTER SUCT. SIZE: w, RET. SIZE* 2" QTY.: 2 FILTER PUMP 11 * 'AfISkRFLOW SKIMMER(SI: 1 SKIMMER SETBACK: MAIN DRAIN SIZE: 2" TYPE: SWEEP STUB: I WATER EFFECT SUCT, SIZE: N/A gET.SIZE, 'NIA QTY.: N/A WATER EFFECT PUMP CITY: N/A Hp: N/A MFG.: N/A HEATER QTY.: 1' - - SIZEd 400,000BTU MFG.:,LAARS. FILTER QTY.* i SIZE: 420 TYPE: ccp , MFG.: PENT tilR BACKWASH VALVE TYPE: SIZE: VALVE TYPE: I JANDY ELECT. SIZE: 21' -AUTO FILL QTY.: -MFG.: NEP PRODUCTS LETRO QTY: N/A COLOR: REMOTE SWITCH MODEL: 'MFG.:,. X-10 REMOTE SWITCH MODEL: N/A MFG.: N/A CHLORINATOR QM-'; -1 SIZE: MFG.:GOLDLIN'E MISC.: 2 JANDY VALVE ACTUATOR 2 LEN GORDON, SIZF7. :T ..SHAPE: SHAPF7 AREA: 38 SO FT. DEPTHS: '44" LIGHT(S) I W..' loo CORD LENGTH O 100' LIGHT(S) NIAW N/A CQgp LENGTH* FILTER SUCT. SIZE: CITY. RET. SIZE: 2" FILTER PUMP QTY.: HP: MFG: SKIMMER(S): N/A N/A qKIMMFR SETBACK - WATER EFFECT SUCT SIZE: N/A QTY.: N/A- RET. SIZE: -N/A WATER EFFECT PUMPjQTY: N/A HP: N/A" MFG.: - N/A. JET CITY: 6 SUCTI� SIZE:' 2-1/2" RET: SIZE: 2" JET AIR -2' -HEATERQTYm NIA rf SIZE: N/A MFG.: N/A FILTER QTY.: N/A SIZE: N/A' MFG.: N/A'. JET PUMP CITY: HP: 2 MFG.:'WMSPERFLOW MFG ' ��, BLOWER AMe- 7 DLUVVCK Q": I tr nr: I AIR SUPPLY `CHLORINATOR QTY:k' SIZE: MFG.: 10 U AUTO FILL QTY.: N/A MFG.: REMOTE SWITCH MODEL: AS -2 MFG.: LEN GORDON REMOTE SWITCH MODEL: N/A MFG.: NIA MISC.: 7 i.