05-4678 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00004678
Property Address: 81365 GOLF VIEW DR
APN: 762-410-036- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Ta�/440"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GRIJALVA
81-365 GOLF VIEW DRIVE
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: METROPOLITAN POOL
WCC: GRANITE I
WC: WC1848863
j CSLB: 816057
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 Busi e d P e icnals Code, and my License is in full force and effect.
License Class: J Licen No.:
ate: `� d5 Contractor:
OWNER-BUILDERCLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the ontractor's State License Law for the
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 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.).
(_) 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
of
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/17/05
n7�06
WY OF LA QUINTA
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
IJP' Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier C53 -B Policy Number - - - - - - - - - - - - - --
_ 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, i �Cla,
d b s e bjea t ew workers' compensation provisions of Section
3700 of the LaboI hall h ith c mply with those provisions.
D e: d5 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMP SATIO COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN IL 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.
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 abov ation is correct. I agree to comply with all
city and county ordinances and state laws relating to b it g nst i n, and hweby authorize representatives
of this county to enter upon the above-mentioned prop rty r nspe io urp ses.
D e: f/ �Z Signature (Applicant or Agentl: ,
Application Number
Permit .
Additional desc
Permit Fee
Issue Date
Expiration'Date
. . . . 05-00004678
BLDG•POOL PERMIT
252.00
4/15/06
Plan Check Fee .
Valuation . . . .
163.80
25000
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
23.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
207.00
Permit . . . MECH POOL
Additional desc .'.
Permit Fee
26.00
Plan Check Fee
6.50
Issue Date
Valuation . . .
. 0
Expiration Date
4/15/06
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
4/15/06
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
4/15/06
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 ONLY. ALARMS/BARRIERS
SHALL
LQPERMIT
lv
Application Number . . . . . 05-00004678
------------------------7---------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT. -
Fee summary Charged Paid
---------------------------
Credited
----------
Due
----------
Permit Fee Total 356.00 .00
----------
.00
356.00
Plan Check Total 189.80 .00
.00
189.80
Grand Total 545.80 .00
.00
545.80
LQPERMIT
08/23/2006 11:46 FAX 6612595324
efice
BWEtits,91sm,"
HIEN.
World's hargest!
August 24, 2006
To City Of La Quinta
Attn: Greg Butler
Mr. Butler,
Blue Haven Pools
23230 Lyons Ave. Santa Clarita, CA 91321
Tel (661) 259-5313 Fax (661) 259-5324
Lic. No. 916057
Tbis letter shall serve as a request to extend the swimming pool permit that was issued for
the address of 81365 Golf View Drive, La Quinta. The last inspection that took pace at
this site was November 17, 2005.
The limited lack of work that took place at this location was due to the follo'wing reasons:
I am a licensed pool builder in the Los Angeles County area, with an office located in
Santa Clarita, California. I am also the owner of the residence at 81365 Golf View Dr,
La Quinta. This residence is not my primary residence but one that I visit as time allows.
Based on the actual inspection at this site it is apparent that my time has been limited.
Somehow it seems that work at my residence takes a backseat to projects that I was
working on in Los Angeles County. area. I anticipate requesting a pre plaster inspection
for the swimming pool within the next 3 weeks, if I am granted this extension.
Please consider this request and accept my apology for the time delay.
Thank ou /
Ron. Grijalva
President
Metropolitan Pool Builders
IDBA Blue Haven Pools
Also owner of 81365 Golf View Drive
l o a
Q001
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