09-0912 (RPL)T414t 4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/27/09
Application Number: 09-00000912 Owner:
Property Address: 81389 GOLDEN POPPY WY PENCE
APN: 764-280-999-108 -300236- 81389 GOLDEN POPPY WAY
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 40000 /3J
Contractor:
Applicant: Architect or Engineer: CLASSIC POOLS & SPAS 4 -
79461 AVENUE 40TH�f�
BERMUDA DUNES, CA 92203 q
(760)413-4867
Lic. No.: 935936
--- -
LI ENSED CONTRACT 'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury thI am licensed unde ovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busi and Professional e, and 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 I ss: F413-1 ice a No.: 935936 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. e
Oate: ff*Xracto • 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
WNER-BUILDER DECLARATION insurance carrier and policy number are:
1 hereby affirm under penalty of perjury th m exempt from the Contractor's State License Law for the Carrier NATIONAL INS Policy Number 200090117388
following reason (Sec. 7031.5, Business Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for h 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 erson in any manner so become subje t the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State nd agree that, if I shou b ome subject th workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cod s all forthwit com y with those 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 ($500).: ate pplicant: -
(_) 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 WAR IN FAILURE TO SECURE WORKER PENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJEC AN EMPLOYER TO CRIMINAL P LTIES 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 ($100,000). 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 1, 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,
(_ 1 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 Ouinta, 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. Any permit issued as a result of this application becomes null and void if work is commenced
within 180 days from date of issuance of such ermit, or cessation of work for 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 tha I hav read this application and state that the , ov information is correct. I gr a to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and c my o dinances and state laws relating to buildi g co struction, and hereby th rize representatives
rl.te.'
the above-mentioned grope for in action purposesLender's Name: ignature (Applicant or Agent):
Lender's Address:
LQPERMIT
i
l
Application Number . . 09-00000912
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
349.50 Plan Check -Fee
227.18
Issue Date . . . .
Valuation . . .
. 40000
Expiration Date
2/23/10
Qty Unit Charge
Per
Extension
BASE FEE
252.00
-------15_00--------6_5000-THOU
BLDG 25,001-50,000 ----------------97_50
-------------------------
--
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/23/10
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
2/23/10
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 . . . .
33.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
0
Expiration Date
2/23/10
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
Permit . . . .
WALL/FENCE PERMIT
LQPERMIT
U
Application Number . . . . . 09-00000912
Permit WALL/FENCE PERMIT
,
Additional desc . .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . Valuation'
240
Expiration Date 2/23/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA., 15 L.F. 3 1/2' EQUIPMENT
ENCLOSURE, CITY STANDARD, WATER FEATURE.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. 2007 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
-Fee summary. Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 468.50 .00
.00
468.50
Plan Check Total 253.18 .00
.00
253.18
Other Fee Total 2.00 .00
.00
2.00
Grand Total 723.68 .00
.00
723.68
0
LQPER I[T
City of La Qdin ta j
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
b
Project Address: -38� Q
Owner's N e:
A. P. Number: Address 8 p
Legal Description: City, ST, Zip:
Contractor: Tele hone:'
Address: Q ProjectD/escription:
City, ST, Zip: -Fn
Telephone: LfI �2) (Y�)//, ."..'
l ✓ V�{/ vii�ti\.•''] � y Y •4�hi'' V fj Vim_` l � � � •
State Lie. # City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: \ ;w Construction Type: Occupancy:
A�=i
State Lie. #:.- =.�y <;�yy x pro ect }}���., //circle one . New Add'n Alter Repair Demo
.:Ya•,.Y.'= ''•,'' •\ - V I)e
Name of Contact Person: Sq. FL: # Stories: # Units:
Telephone # of Contact Person: Estimated Value of Prqjbq..Q Ov 0
APPLICANT: DO NOT WRITE. BELOW THIS LINE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance.
Title 24 Cala.
Plans picked up Construction
Flood plain pian
Plans resubmitted Mechanical
Grading plan
2"° Review, ready for correctionstissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up. S.M.I.
H.O.A. Approval
Plans resubmitted
IN HOUSE:-
''� Review,.ready for corrections/issue mpact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date or permit issue
Lradin
School Fees
it Fees
Classic
Pools / Spas
Landscaping
Office: (760) 345-8302
Lic# C 53-935936
4'L X 4'W X 5'H Natural
Boulder Waterfall to spill
onto Flagstone
Decking.
►n
r
Natural Flagstone
Decking. Slope
toward Pool.�14
Seat
V4011 -
+IS" RBB with (2) 15"
Sheer Descents
O
-5'
Pool
(16' X 50')
-4'
f- ry
Area Drains, rn
j typ. ❑
PENCE
j RES I DEN GF -
j EDATF
' _ LA r: U STA
,!\IG & SF, DEPT.
R CONST�� iON
.0q
BY
j a 7-
I
NOTE:
Existing 5ideyard Sidewalk to
remain. Sidewalk shall be
covered and protected from
foot traffic and heavy
equipment during Pool and
Landscape Construction.
New Colored Salt Finish
p Concrete Decking with 6"
California Edge
(500 sq,. ft.) �
Pool/Spa
Equip. with
sound wall
DF]
7'-0" Dia., +15"
Raised Spa with
Concrete Gap,
Stucco Veneer and
6'-0" wide Stacked
Stone Spillway.
15'-1"
Tanning Shelf with
Umbrella Sleeve
New Concrete Decking
05" Broom Finish
Banding - 75 sq,. ft.)
Scale: I/8"= I' -®'I
PENCE RESIDENCE
GASITA SI�COLDEN POPPY WAY
LA QUINTA, GA 12253
TRILOGY
DATE: 0S/13/0q