11-0585 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000585
Property Address: .78930 GALAXY DR
APN: 609-470-068-6 -23773 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1500
T4i!t 4 4 Q"
Applicant: k ) Architect or Engineer:
alp
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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 7000) of Division 3 of the Business and essionals Code, and my License is in full force and effect.
License Class: C53 D35 i No.: 728796
ractor:
OWNER ILD ER DECLARATION
I hereby affirm under penalty of perjury t(a, am axe t from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Profe ions 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 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 ($500).:
1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. .
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
KLING ROBERT & VICTORIA
23 SHADE TREE
IRVINE, CA 92603
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/06/11
� � r
Contractor:
BUBBLE SPRINGS
200 1
P.O. BOX 1046 p +J
RANCHO MIRAGE, CA 92270
(760) 341-2336 C12'f��e$!shlYld
Lia. No.: 728796
------------------------------------------------
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' 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 EVEREST NATL Policy Number 760001635111
_ 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 beco ubject to the wos' compensation provisions of Section
• / 3700 of the Labor Code, 1 hu ei � cc yet those provisions.
ateL�pplicant:
WARNING: FAIL RE TO SECURE W RKERS' COMXIENION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIEIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COSOMPENSATION, 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.
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 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 infor ion is correct. I agree to comply with all
city and county ordinances an state laws relating to building co ucd h eb authorize representatives
;a�
hio a_utnntty to enter upo a above-mentioned property inspe io urp ./
6'✓� ignature (Applicant or Agent):
Application Number . . . 11-00000585
Permit
BLDG POOL PERMIT
Additional desc .
.
Permit Fee . . .
. 35.00
Plan Check
Fee
22.75
Issue Date . . .
.
Valuation
. . .
. 1500
Expiration Date
12/03/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
10.00 .2.0000
HND BLDG 501-2,000
20.00
----------------------------------------------------------------------------
Special Notes and
Comments
POOL REMODEL - TIE
STEEL & EPDXY &
GUNITE A SWIM -OUT
SHELF IN SHALLOW END
OF POOL. EQUIPMENT
EXISTING. 2010
CODES.
--------------------------------------------------7-------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid
----------
Credited
----------
----------
Due
-----------------
Permit Fee Total
----------
35.00
.00
.00
35.00
Plan Check Total
22.75
.00
.00
22.75
Other Fee Total
1.00
.00
.00
1.00 .
Grand Total
58.75
.00
.00
58.75
LQPERMIT
Project overview
Company Info-
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o
Existing Pool wim out 8" water depth
c, •wAYia FuTUa
with 2 umbrella sleeves'
Existing Spa
0
P.O. Box 1046
Rancho Mirage, Ca
Existing Decking
760.275.7676 cell 760.837.9018
BubbleSprings@msn.com
Customer Info
Kling Residence
Bob & Victoria Kling
Address: 78930 Galaxy Drive
City: La Quinta
State/Zip: Ca, 92253
Phone:
Cell:
Existing Pool Equipment Location
Email:
Existing Pool Specifications
Length: 39'
Width: 11'
Depth: existing
Perimeter: 113'
Square Footage: 454 sq.ft.
Material: _Quartzscape Onyx Plaster
Re
Water Features: Swim out at 8" water
depth w2 umbrella
.videnceith
sleeves
C!Pd OF LA QV@NTA
Spa Specifications
Length: 6.5
BUILDING & SAFETY DEPT.
Width: 6.5
APPROVED
Depth: existing
Perimeter: 26'
FOR CONSTRUCTION
Square Footage: 42 sq.ft.
Material: Quartzscape Onyx Plaster
DATE6 -L /l BY
r
Bin #
City Of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # S
Project Address: —7 lJ LA t
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor /
cs5/Telephone:
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Address:
Project Description:
City, ST, Zip: ,vim X/ -b �/i. 7 0
Telephone 7 S —%�i%G�
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State Lic. # : 7 AOO % O
City Lie. #:
Arch., Engr., Designer:
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Address:
City., ST, Zip:
Telephone:
State Lie. #:
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Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ,rQ Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2sd Review, ready for correctionsfissue
Electrical
Subcontoctor 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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees