09-0834 (RPL)P.O. BOX 1504
•t 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000834 Owner:
Property Address: 81810 GOLDEN STAR WY ERICKSEN
APN: 764-280-999-112 -300235- 81810 GOLDEN STAR WAY
Application. description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 19000
Contractor:
Applicant: Architect or Engineer: CLASSIC POOLS & SPAS
79461 AVENUE 40TH
BERMUDA DUNES, CA 92203
(760)413-4867
Lic. No.: 935936
I
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/20/09
— — — — — — — — — — — — — — — — — — — — — — — — — — —r— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
LI ENSED C4/ugber
'S DECLARATION
I hereby affirm under penalty of perjury ha I am licenp ovisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Bu and Profeo e, and my license is in full force and effect.
LicenseC ss: C13C53 eI 935936
ate: ntract
I hereby affirm under penalt'7-afle—rjury that I am a empt from the Contractor's State License Law for the
following reason ISec. 7031 .5, Business and Prof ssions 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).:
(_ I 1, 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 ISec. 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.).
(_ 1 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:
LQPERDIIT
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
insurancecarrier and poli number are:
Carrier NATIONAL INS l Policy Number 200090117388
1 certify that, in the perfor rice of the work for ich this permit is issued, I shall not employ any
person in any ma
so to become suyiefo the workers' compensation laws of California,
and agree that, if I s ul - become subject e workers'compensation provisions ofSection
3700 of the Labor C shall forthwithply with those provisions.
WARNIN(J: FAILORE TO SECURE WORK ERXXOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION T THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODR' 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 old harmless the City
of La Quinta, its officers, agents and employees for any act or omission re to to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application ecome null and void i wor is not commenced
within 180 days from date of issuance of suc ermit, r cessation o wor for 180 days will subject
permit to cancellation.
I certify th t I have read this application and state that the ove inf rmation is orrec I agree to comply with all
city and mk
nces ands to laws relating to buil g const ction, an hereb authorize representatives
of thi %ty%upon t above-mentioned prope for,nsp ction pur oses.
Date: 2ature (Applicaft or Agent):
Application Number . . . . . 09-00000834
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 198.00 Plan Check Fee 128.70
Issue Date . . . Valuation . . . . 19000
Expiration Date 2/16/10
Qty Unit Charge Per Extension
BASE FEE 45.00
17.00 9.0000 THOU BLDG 2,001-25,000 153.00
-----=----------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check Fee 6.50
Issue Date . . Valuation . . . . 0
Expiration Date . . 2/16/10
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 2/16/10
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 . . . . 27.00 Plan Check Fee 6.75
Issue Date . . . . Valuation . . . . 0
Expiration Date 2/16/10
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.0000 EA PLB FIXTURE 6.00
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
SPA ONLY & GAS STUB FOR FUTURE APPROVED
LQPERA11T
Application Number . . . . . 09-00000834
----------------------------------------------------------------------------
Special Notes and Comments
APPLIANCE. ALARMS/BARRIERS SHALL
BE IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary Charged
----------
Paid
Credited
--------------------
Due
---------------------------
Permit Fee Total 296.00
.00
.00
296.00
Plan Check Total 153.20
.00
.00
153.20
Other Fee Total 1.00
.00
.00
1.00
Grand Total 450.20
.00
.00
450.20
LQPEn11T
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico r
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
'Project Address':OwneesName:
A. P. Number: 'Addrdss: p �
Legal Description: City, ST, Zip: Cog
Contractor. ( �5 Telephone:
Address: q bf l- V Project Description:
City, ST, Zip:
Telephone _ (Q
e;4-
State Lic. #
city Lic. 1 �I
i / 3/
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone- 1�. Construction Type: Occupancy:
State Lic. #:,yr, `�< project type (circle one): New Add'.n Alter Repair Demo
Name of Contact Person �G Sq. Ft.: # Stories: T#�n7its
Telephone # of Contact Perso ( (. Estimated Value of Project: " �� U
APPLICANT: DO NOT WRITE. BELOW THIS LINE
# Submittal Req'd Recd TRACIGNG PERMIT FEES
Pian Sets . Plan Check submitted Item Amount
Structural Caics.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance.
Title 24 Caics.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2°" Review, ready for corrections/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 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
�—Cadssa Macrocarpa
Boxwood Beauty
® Hibiscus Hybrids
Hibiscus Hybrids
(��--Rose Roribundia Iceberg
Rose Floribundia Iceberg
�Dietes Vegeta Morea
Fortnight Lily
osmarinus oflicinalis Tuscan Blue'
Hlbiscus Rosa -Sinensis
Chinese Hibiscus
—Calliandra Inaequilatera Powder Puff
81-810 Golden Star Way
0 —Olea Europa Fruitless Olive 'Mul l' 1 24" Box La Quinta, Ca. 92253
0 �,
,..Io Chamaerops Humilis Mediterranean Fan Palm 1 24613ox Scale V=1/8"
D
0[4;]—Syagrus Romanzoftlanum Queen Palm 2 24"Box