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04-6972 (RPL)W-1 �117A116t: Utr'r. I I iJGrAR I mG/`/ I P.O. Box 1504 (760).777-7012 + C��1pF9ti' `78-495 CALLS TAMPICO r` ' `' `' FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT AppliFation Number . . .04-.00006972_ Date 10/27/04 Proper'Gy Address 52030 AVENIDA VILLA APN: 773-234-001-22 -000000- Applicat'ion description . . . POOL - RESIDENTIAL. t Property Zoning . . . . . . COVE RESIDENTIAL Application valuation . . . . 17000 Owner Contractor SMITH SETH B BLUE HAVEN POOLS -030 Q�r �,.(.,QQ�� NOT.Se? 2318 S. VINEYARD AVENUE CA g 9 ONTARIO CA, %91.7,6- 76425.3 • q;2253 - t WCC: SPIEGLER WC: 07KR0000891 03/10/05 CSLB:' 618892' 05/31/05 ; CCC: C53 -------------------------------------------------------------- :. -------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 180.00 Plan Check Fee ,. 117.00 Issue Date . . . . Valuation 16827 Qty Unit Charge Per Extension BASE FEE 45.00 15.00 9.0000'THOU BLDG 2,001-25,000 ---------------------------------------------------- 135.00 ; -------------.------.----- Permit . . . . . . MECH POOL Additional desc Permit Fee 24.00 Plan Check Fee :': 6.00 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ------'----------------------------------------------------------------------. Permit . . . . . . ELEC POOL PERMIT -RES Additional desc - ti Permit Fee . . . . 45.00 Plan Check Fee 1.1.25 Issue Date Valuation . . . . 0 Qty, Unit'Charge', Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit PLUMBING t Additional desc ■ ,- Permit Fee . . . . 33.00 Plan Check Fee .'8.25 C&lf 4 P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT VOICE (760) 777-7012 FAX (,760) 777-7011 INSPECTIONS (760) 777-7153 Application Number: % Date: /D Applicant: I Architect or Engineer: Appncanrs Mailing Address: -W--1 Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 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 my License is in full force'and effect. License Class r --5I Ligense No. 618892 -z9-Oy I herebyaffirm under U OWNER -BUILDER DECLARAW penalty of perjury that I am exempt from the Contractors' State License Law foF{he 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 ofjAe 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).): (--) 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 Owner I hereby affirm under penalty of perjury one of the following dec a attiiionsRS' COMPENSATION DECLARATION _ 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 �p�L�oLcy�purober re: Carrier Clarendon National Policy Number b%9600Mrf _ 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, j>; I should become subjecS to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall sions. forthwith comply with those provi�/ ! WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COEFEE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS. I herebyaffirm under CONSTRUCTION LENDING AGENCY 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.). 01 Lender's Name Lender's Address IMPORTANT APPLICANT ACKNOWLEDGEMENT 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 Ouinta, 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 agree to comply with I city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon thea ve mention grope r inspection purposes. ate —��ignatur.pplicant or Agent): Page 2 Application Number 04-00006972 Date 10/27/04 Issue Date . ." . . Valuation 0 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 3.0.0 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS, .3.00 Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . 15.00 Plan.Check Fee 00 Issue Date . . . . Valuation 173 Qty Unit Charge Per Extension BASE' FEE 15.00 Special Notes and.Comments POOL/SPA, 8 L.F. 51.BLOCK WALL, CITY STANDARD,.GFI & GAS,STUB FOR FUTURE BBQ. ALARMS/BARRIERS SHALL BE.IN PLACE,AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due . Permit Fee Total 297.00. 00 00 297.00 Plan Check Total 142..50 00 ..00 142.50 Grand Total 439.50 .00 .00 43.9.50 III i �rThe Most Dependable 'Y Custom Pool Builder in "} Southern California YF Since 1954. W5 rt - = CUSTOM DESIGN FOR: NAME:_ _S �- i � / , WRESS. Sc�-3 U,6 / 11,q Cm: /4 s// A,, 7414 HOME TELEPHONE r OFFICE#: S Z -eg -Z 217 LOT: TRACT: ARNO MAP BOOK PAGE CROSS STREET: SPECIFICATIONS � f TYPE: SIZE:_x SURFACE AREA POOL. 3y Y PERIMETER: 3 DEPTHS: MIN.�•�_MA%. SPA SPECIFICATIONS r SU 7y/.41►'� ELECTRICAL: By �f? TW CLOCK: SUB PANEL-. DAM WALL WIDTH: 12 NO. OF JETS S LIGHTS IN POOL- f SPA JJ SPUWAY(S): / s7c � ,� /7 POOL PUMP: SPA @LOWER, ' BLOWER: 11P WATERFEATURE PUMP: BOOSTER PUMP: INP - . SAA BOOSTER: FREE STANDING SPA - ft': 12* � STUBS: MISC is. Yi� 5 2r MISE GUWTE ROPE RIGS: GRAS RAN.S- IrRB.S. 12'RBB. - 1rR8B. 24'R.S1. - 30' R.8 B. EXCAVATION LOVESEAT: EXTENDED 2nd STEPS: TYPE NOTCH RAISED BOND SEAM DEEP END RAMP: 1iI� SPA DAM WALL WIDTH: FENCE REMOVED BY d wvE / NOTCH SPA DAM WALL rX.8,8. -Ir A.B.B. IrA.BB. mW, 20A.9 B. 3D' R.B B. TRASH REMOVAL (LOADS)' CONCERE?E REMOVv AL (LOADS) : / TREE REMOVAL BY: T ILE L CCPING: II STD. WHITE -BULLNOSE BRICK: t STUMP REMOVAL eY: FLAGSTONE: OTHER. T0.E GROUP: - TILE TRIM ' $ILEMtSCI: , r R.B.B. Ir Rea. Ir R.8 8 2r R.B.B. 30' R.B.B. DECI(a1G C 11PT0: ( �' SO F, FINISH: COLOR: SURCHARGE LOVESEATNSOE: ! SwImOff SPA WALL WIDTH:f Z I STEPS: CANTILEVER: .� MASTIC: CURB CORE: PLUMBING FUER /�! I BI �p POOL PUMP Z HP: Z SO DECCO DRAM:' AREA DRAMS: HEATER: Bc �✓ 60 PATIO FOOTING SQL: SPA BOOSTER PUMP: w. PLASTER VICERFEATUREPUMP: „ HP SAW CLP: P -TRAY: ST WDARD- _ SMART BWM: �/ E GAS IJNE: 70 Y STUBS: SHEER DESCO:TSI RAIN. r OTHER. . LIGHTS N POOL / IN $PA. a/ SPECIAL EOUIPMENT: MISC. DELUXE MAI NT KP: POOL COVER DNNG BOARD: SLIDE: SMAR W-. OTHER is 1 Ay /e) 11-61— 61—OWNER 'OWNER RESPONSIBILITIES OWNER TO- (1) Determine the nlppmornate elevation of pool or We of leyolA on day of excavation. j (2) Take notice Mat'poof and eiWorent location is subject to acceptance of local building departRYent at time of Issuance of pernvt. (3) Wet down concrete then at least twice daily lot seven (T) days after Shen is installed. (4) Take slice that BLUE HAVEN POOLS IS NOT RESPONSIBLE for: underground conditions or objects, and any damage to curbs, sidewalks, dmeways, fawns or other items in access area. (S) See that at forcing, gates, and garage doors meet local codes for a pod enclosure prior to pre -plaster inspection. (6) Fit pool Wmmedately after pfaster. (Follow instructions, do not use rubber hose) p (7) NO VERBAL AGREEMENTS APPLY. I (B) Fencing to meel all local Code requae ner95 by buyer prior t0 pre -plaster inspection. Owner approves plan, pool, equipment Iodations and understands decking Is for Illustration ONLY. Owner understands they aro to receive tq, ft of decking per contract. Signed: -- -Date: