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04-4471 (RPL)W U I� �iAY 2 4 2004 � BUILDING & SAFETY DEPARTMENT P.O.�B'o�c=-504T (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . 04-00004471_- Date 5/20/04 Property Address . . . . . . 44455-FOXTAIL CIR APN: 604-081-048-85 -22982 - Application description . . . POOL - RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 25000 Owner Contractor SARA LJUNGLCULL LEE CONSTRUCTION, MICHAEL 44-455 FOXTAIL CT 53930 AVENIDA MADERO LA QUINTA CA 92253 LA QUINTA CA 92253 '(760) 333-8690 WCC: EXEMPT WC: EXEMPT 02/28/05 CSLB: 6029470 02/28/05 CCC: C53 ---------------------------------------------------------------------------- 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 ---------------------------------------7------------------------------------ Permit . . . . . . BLDG POOL PERMIT ' Additional desc Permit Fee 252.00 Plan Check Fee 163.80 Issue Date . . . . Valuation . . . . 25000 Qty Unit,Charge Per Extension BASE FEE 45.00 23.00 9.0000 THOU BLDG 2,001-25,000 207.00 ---------------------------------------------------- : . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 t P.O. Box 1504�� VOICE (760) 777-7012 Taf 78-495 CALLE TAMPICO FAX (760) 777-701 1 LA QUINTA, CALIFORNIA 92253, INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 641( 7 Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Lic. No.: BUILDING PERMIT DECLARATIONS -5�,>9-a� 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 my Lice s f I for effect' License Class �� 3 /Lficeense No. Date Contractor /� r tr �i r C / e e C �!i! S /" C- 41 - OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for ft following reason (Sec. T031.5, 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 penalty 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.). (-.) I am exempt under Sec. , BA P.C. for this reason Date Owner. 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: Cartier Policy Number 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 beco subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1 Date y / Applicantlc_ />\ 7— 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 1 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 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 notco menced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. rrect. I certify that I have read this application and state that the above information is co1`o 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 abov phoned property for inspection purposes. Date 2 9 O/ Signature (Applicant or A r -- Page 2 Application Number . . . . . 04-00004471 Date 5/20/04 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 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 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged ----------------- ---------- Permit Fee Total 354.00 Plan Check Total 189.•30 Grand Total 543.30 Paid Credited Due ---------- ----------- ---------- .00 .00 354.00 .00 .00 189.30 .00 .00 543.30 12" raised bond beam 27'-0" Access 1 .. is I� 2- 2' shear descents 171'V�W 6' 30' -0" t N White Plaster m , color concrete t. 1 iD I Existing concrete i 4 i 1 Equipment Residence Stack spillway ,— 2- 6" steps NA �. v 1� �1 • r� A RE -INSPECTION FEE OF $3 WILL BE CHARGED IF THE APPROVE PLANS AND JOB CARD ARE NOT C THE SITE FOR A SCHEDULE INSPECTION. NO EXCEPTIONS! "BACKYARD RESORTS" By Michael Lee Construction Office (760)777-9838 fax(760)771-9676 Licensed since 1990 0 ° U C53-602947 Name: Sara Ljunglcull Street:44-455 Foxtail Crt City: La Quinta Job Address: same Phone Office Res. Lot Tract Page Book Scale 1/8"=1' Date Spa spec. Size 7' x 7' Area 32' Per. 23' Spa dam wall width 6' No. Jets 5 No. Lights 1 Spa raised 12" Spillway Type Special notes Pool spec. Size 14' x 30' Area 356' Per. 87' Depth Min. 3'6" Max. 6' R.B.B. 20'x 12" Love seat N/A Extra steps N/A Tanning. Ledge N/A Rock pockets N/A xcavation: Type Bobcat j IElev. Deep end ramp Removal: 400' Sod Plumbing: Hayward Equipment Size: Filter 3020c Heater 400,000 Pump 2hp 2nd pump 3rd pump Type of controls time clock Fountains/sprayheads (2)- 2'shea descents No. of Skimmers 1 Lights I ecking: 400' Sq.ft. Finish Broom olor TBD Deck drains teps 8' Notes Quartzite as per plan Tile: . Type Group 3 Step trim yes Type Masonary: Coping type Cantalever yes Access wall N/A Equip wall N/A Fire pit BBQ length Pebble Plaster White Color Size