07-2562 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
A�pplicati�on Number:
07-00002562
Property Address:
53713 VIA PISA
APN:
772-530-050- -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
45000
Tiht 4 4 Q"
Applicant: Architect or Engineer:
1�
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Busines an Pr l essionals Code, and my License is in full force and effect.
License Class: C53 License No.: q92059
Date: t WContra
r
OW ER -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 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 Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel 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).:
(_) 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 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.).
(_) 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 improve; 1h9reQn, and whn rnntracv; fnr rhe nrnjerts rntirh a rnnrrartnr(r) r99nQQd
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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:
LQPERMIT
Owner:
CHAPMAN RESIDENCE
53-713 VIA PISA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/19/07
Contractor:
CAHUILLA POOL CONSTRUCTION INC
P O BOX 2569C% v
PALM DESERT, CA 92261 '�' Com` a
(760)396-5886
Lic. No.: 692059
G � 4
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- — �"Ied
'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' compesa s pr
for by Section 3700 of the Labor Code, for the performance of the work for w ich 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 STATE FUND Policy Number 0010153-2007
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 beco subject to the workers' compensation laws of California,
and agree that, if I shou�hall
ject to the workers' compensation ovi5ions of Section
/�►0 of the Labor Codith comply with those provisions.
Date: l t �� ppl.
WARNING: FAILURE TO SECURE WORK S' OMPE SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES 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.
9: Cwl, yidavn uNun uvliwe lrehaif uaa dPP11WLIUn IS InaUe, eaen 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 the above in rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to building co t coon, and hereby authorize repr entatives
of this co my to mer upon the above-mentioned property r in a tion purposes.
Dale*.Z I(29g-nature (Applicant or Agent .
r
LQPERMIT
Application Number . . . 07-00002562
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
382.00
Plan Check
Fee
248.30
Issue Date . . . .
Valuation
. . .
. 45000
Expiration Date . .
3/17/08
Qty Unit Charge
Per
Extension
BASE
FEE
252.00
20.00 6.5000
--=--------------------------------------------------------=----------------
THOU BLDG
25,001-50,000
130.00
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0
Expiration Date
3/17/08
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
3/17/08
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 . . . .
39.00
Plan Check
Fee
9.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
3/17/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00 6.0000
EA PLB
FIXTURE
18.00
1.00 J.000U
EA PLS
WATER INST/ALT/REP
3.00
1.00 3.0000
-EA PLB
GAS PIPE 1-4 OUTLETS
3.00
----------------------------7-----------------------------------------------
Special Notes and Comments
POOL, SPA,.ALARMS/BARRIERS
SHALL
BE IN
Application Number . . . . . 07-00002562
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDE. ENTRY
FOUNTAIN PER APPROVED PLAN.
Fee summary Charged Paid Credited Due
-
--------------------------------------------------------
Permit Fee Total 492.00 .00 .00 492.00
Plan Check Total 275.80 .00 .00 275.80
Grand Total 767.80 .00 .00 767.80
LQPERMIT
Bin #
C.ity of La Quinta.
Building & Safety Division
P.O. Box 1 SO4, 78-49S Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet
Permit .#
Project Address:- 5 I -t) ..\. '
Owner's Name: � l A
A. P. Number:
Address: �3 �' V
Legal Description:
City, ST, Zip: `-A
Contractor: c"A 4SA I U�A
Address: I O _
, Telephone:
Project Description:
City, ST, Zip:
Telephone:. _
State Lie. # V1 ZO 31
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Construction T ype-:6tJN 1 T1e,'Occupancy:
Project type (circle one): New Add'n .Alter Repair Demo.
Name of Contact Person:
Sq. Ft::
# Stories:
# Units: .
Telephone # of Contact Person:
mated Value of Project.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIONG •
PERMIT FEES
Plan Sets ' . '
Plan Check submitted
Item
Amount
Structural Calcs
Reviewed, read y.for corrections
Plan Check Deposit
Truss Calcs.
Called ContactPerson
Plan Cheek Balance
Energy Calcs..
Plans picked up
Constructioa
Hood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"Review, ready for eorrections/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 correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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Construction contractor agrees that in accordance Pilth generally accepted construction !
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and property; that this requirement 5hall be made to apply continuously and not be, limited to : i
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normal Porking hours, and construction contractor further agrees to defend, indemnify and hold �
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I OWNER: to determine approximate ele vation of pool on Way of
LITE WATTS
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DUAL LEVEL SEATS yes
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design professional harmless from any and all liability, real or alleged, in connection V41th the ! .
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excavation.
DAMWALL
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performance of viork on this project, excepting liability arising from the 5ole negligence of design : i : 1,
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Pool area to be fenced. by owner per county or city ordinance.
Gates to be self closing and self latching.
DAMIYALL TOP
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SPILLWAY SIZE - X - WIDE
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Do not turn on pool light when pool is empty.
Wet down concrete shell at least twice daily for 14 days.
SPILLWAY-
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� Do not use rugger hose when filling pool as it will mark plaster.
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