05-4978 (RPL)C►.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
05-00004978',
78835 ZENITH WY
609-560-014-14 -23773 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
144
Architect or Engineer
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner: '
CHAD SMITH
78 -835 -ZENITH WAY
LA QUINTA; CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/09/05 ..
Contractor:
PELHAM POOL CONSTRUCTION D � 2005
12155 PALM 'DRIVE SUITE B173 ►r0° O `''
DESERT HOT SPRINGS, CA 92240
(760)251-7175 Ot191i
�. Lic- No.: 823469 CtANC�®SPT•
LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of f the Business a rofessionals Co nd 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 Cla C e No.: 823'469
for by Section 3700 of the Labor Code, for the performance of'the work for which this permit is
�cto
issued. -
Date: �;
_ 1 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
OWNER -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 EXEMPT Policy Number EXEMPT
. 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' compensation laws of California,
permit to files 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
and agree that, if I should becom.2 subject to the workers' compensation provisions of Section
37 0 of t Labor Code, I forthwith compl se 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 IS5001
-
•Date:. 7' Applicant: '
1 1 1, 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
WARNI G: AILURE TO SECURE WORKERS' COMPENSATION 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 15100,000). 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 I, 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 an owner of
conditions and restrictions set forth on this application. '
- property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law:).
whose benefit work is performed under or pursuant to any,permit issued as a result of this application,
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. Anypermit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance ofsuchpermit, or cessation of work 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 is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1. -
city and county ordinances and state laws relating to building constru nd hereby a e ' presentatives
• - .-
of this cou to nter upon the above-mentioned property ecti u oses
Lender's Name:
. Date;l Signatures (Applicant or Agent): e '
Lender's Address:
`-
,LQPERMIT
. - Application. Number
05-00004978
Permit . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
5/08/06
Qty Unit Charge
'Per
Extension
BASE FEE
15.00
`^ 1.00 11.0000
EA MECH FURNACE >100K
11.00
--------------------------
--------------------.---------
---------
------------
Permit . . .
BLDG POOL PERMIT INV_ FEE''
Additional desc
Permit Fee
486.00 Plan Check
Fee
-157.95
Issue Date . . . .
Valuation
23856
Expiration.Date
5/.08/06..,:
Qty -Unit Charge
Per
Extension
BASE FEE
90.00
_ 22.00 18.0000.
THOU BLDG 2,001._25,000
396.00
Permit
ELEC POOL PERMIT -RES'
Additional desc .
Permit Fee . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
5/08/06
Qty Unit Charge
Per
Extension'
BASE FEE
15.00
` 1.0.0 30.000.0
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
5/08/06
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 GAIS,PIPE.1-4 OUTLETS
3.00
Permit
WALL/FENCE PERMIT
LQPERMIT
.
Application Number 05-00004978
Permit . ... WALL/FENCE PERMIT
Additional desc.
Permit -Fee .". . 15.00
Plan Check
Fee..
.00
Issue Date.. . . .
Valuation
. . .
. . 144
Expiration Date 5/08/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes.and Comments
- POOL_ &, SPA_. 9 , L. F. ,4!- EQUIPMENT BLOCK
WALL, ORCO SYSTEM. ALARMS/BARRIERS
'- SHALL BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. INVESTIGATION FEE ASESSED
PER 1997 UNIFORM ADMINISTRATIVE CODE
$3.04.5 FOR WORK BEGUN WITHOUT BUILDING
PERMIT.
Fee summary. Ch"arged Paid
Credited
Due
Permit Fee Total 605.00
.00
00
605.00
Plan Check Total 183.95
.00
.00
_
183.95
Grand Total X788.95
.00
.00
788.95
• LQPERMIT.
' z
j }, [,} CITY OF LA.O.UINTA SUB-CONT",CT LIST I °c
JOB ADDRESS + 1 1 ((w� PERMIT NUMBER?OS" y 9 %g OWNS ) ^ BUILDER_ ] � ► Al �DC7l o
This form shall e place. Only persons appearing on this list or their employees are authorized to work. 15 (D
on this job. Any changes to this list must tie approved by the Building Division prior to commencement of work. Failure to comply will result In' stoppage of work and/or the voidance I
of buildin ermic. For each applicable trade, all information re ue6tad below' -must be corn -laced b II "
Trade r Classification
a cant. On Flle is not an acce table res once.
: s,; ^ 9fa e,Contr et" 'a. 11 sti of Meng on, nsura
Company Name' Classification Ucense Number Exp. Date Carrier Name Paley Number Exp. Date
(e.g. A, 8, C -B) (xxxxxx) Ixx/xx/xx) [o.g. State Fund, CalCompl (Format Vain) Ixx/Kx/xx)
City. 84stn
License Number '
(xxxxf
LkenYa(i >'.•
Exp. Date
lxx/xdxx)
EARTHWORK (C 12}...
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MASONRY.IC•29)
.LUMBING 1C-36)
LAT►1: PLATER {C-351 ;
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DRYWALL ('C-91..:. ..
ELE.CT.R)CAL IC=101-, -t-.
SHEET METAL (C:42)
fCbOR1NG
GLAZING (C:1:7)`' ' .:..
INSULATION:`IC-21, ..:
SEWAGE DISP. �{C-421
PAINTING IC -§3)
CERAMIC TILE (C-94)
CABINETS (C-61-
FIENCING 1C-131
LANOSCAPING 1C-27):'.'
POOL (C•53 `
iC7
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C3- Duni �-Q, QP (2anl -e
Io(i113 .1, . ��oo ,
Oct 27 05 10:38a Pelham Pools (760) 251-0228
10/27/2005 THU 10:19 FAX v
Bin #City of. La. Quinta
Building ex SA Division
�Y
P.O. Box 1504, 78-495 Calle Tampico
Pegnit ►><
La Quinta, CA 92253 - (760) 777-7012
Building Permit .Application and Tracking Sheet
Project Address: — 3 •, VL Owner's Name. '77C
A P. Number. �` (� ` �' k J ,
`i Address: '�71.�
Legal Description: City ST, Zip: LAC,) /o
Contractor`. ? �1 C4.Vyl C; S Telephone
Address: i2 1 .s L m'.(�f Project Description:
City. ST, Zip
j
Telephone _' Ca L I • nCi�
State Lie. # : -c3 Z J �-{ City Lic.Li
#: /
Arch., Engr.. Designer t— ( 1'1 C
Address: -• 3 • t Q7 "� 1 �" l' — `u -s --"l1
City, ST,' Zip:
Telephone: YO ConstiuctionType: ecicI Occup-cy: -J
State Lic. #:. 7; > Project type (circle one): ew �Add'n Alter Repair Deno
Name of Contact Person f Sq. Ft.: U # Stories- .'tl / # Units: N
Telephone # of Contact Person: i " �'( Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE "
p.2
#
Submittal
Rcq'd
Rec'd TRACIQNG . PERMIT FEES
Plan Sets
Plan Cbeck submitted "T4 /0 % Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit
Truss Cala.
Called Contact Person Plan Cheek Balance
Energy Calm
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"Revie:w, ready for eorreetionsfitsoe Electrical
SabcontaetorList
Called Contact Person Plumbing
Graal Deed
Plans picked up S.M.L
ILO.A. Approval
Plans resubmitted Grading
IN HOUSE:-
' ' Review, ready for eorreelions✓issae Developer Impact IVice
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
73J Ct4j-
A
1
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N ` �
PmEL Apoo`
CWW41 Foo Wate82 e469res- Reno e
CA STAT E LIC rJ _
00
N i
5112'
N 4
N ARE-1SpECTION FEE ,OF $3� -: -�� J . .
APPROVED
o WILL. BE CHARGED IF THE
PLANS AND JOB CARD ARE NOT ON . ,
THE SITE FOR A SCHEDULED. Ew
INSPECTION: POOL SPECS
NO EXCEPTIONS! Size:1Tx30'
` Area: 465
Perimeter: 95'
Depths: T x5 1/7x 4'
(��;�TA Waterline:Group 3 Tile
BUILDN & SAFES DEPT•
BUILDING Elevations: 0" .
., ����® \9 ED Filter: 300sq.ft.
0
d FOR CONSTRUCTION sq. ft. Cactridge
Heater: ,
E'
M
' - DATE%BY 400,000.B.T.U.
4�5 Circulation Pump:
%
/. r .
CL 1.5 H
P
/. Jet Pump:
Y 2.OHP
Smith Residence 1 Time Clock:
.N 1
• Way.
��� Intermatic T104RE
'7.8_835 Zenith V� y (, Light:American 500Watt
LO La Quiilta, CA - Spa Light: A.P. 10OWatt
9225 3 Jets: 6
N Spillway: Stacked Stone
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0