06-0182 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant: Architect or Engineer:
/^+;
-----------------
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 Professionals Code, and my License is in full force and effect.
LicenseClassss: C53 '> tt����LicenseNo.: 573948 _
Dat��l�Y��tractor:\� J L- gGZ r;
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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 1$500).:
(_) 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.).
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.).
(_) 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:
GANTZ
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/25/07
Contractor: D d l'
RAZO POOLS U
81018 JAMIE WAY MAY INDIO, CA 92201 5 2007
(760)347-1617
Lic. No.: 573948 CITYOFLA�IlIAi
F1INIANnr TA
-----------------------------------------------
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 EXEMPT Policy Number EXEMPT
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 become subject to the workers' compensation provisions of Section
3700 of the Lab Code, I shalLfort with c`ply with those provisions.
D�r ��� PPlicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOr OVERAGE 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.
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 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, an hereby authorize representatives
of t1]ls�o�r�y tp.enter upq! above-mentioned grope or pection burp es.
�aT*J� /%y�5 ��lL
D e: Signature (Applicant or Agent):
Application Number .
. . . . 06-00000182
• Permit . . . .MECH
POOL
-
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
1/27/06. Valuation . . . .
0
Expiration Date
7/26/06
Qty Unit Charge
Per
Extension
BASE FEE
-15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
.317.00 Plan Check Fee
206.05
Issue Date . . . .
1/27/06 Valuation . . . .
-35000
Expiration Date
7/26/06•
Qty Unit Charge
Per
Extension
BASE FEE
252.00
10.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
65.00
Permit . . .
ELEC POOL.PERMIT-RES
Additional desc-.
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Iccue Data
1/27/0G Valuation
0
Expiration Date
7/26/06
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 . . . .
1/27/06 Valuation . . . .
0
Expiration Date
7/26/06
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
LQPERAIIT
Application
Number
06-00000182
-------------------------------------------
Special Notes and Comments
--------------
-------------------
BE IN PLACE
PRIOR TO PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE
NOT
INCLUDED IN
PERMIT.
--------------------------------------------------------------------------
Other Fees
. . . . . .
CHANGE OF CONTRACTOR
4.50
REPLACEMENT
INSP CARD
15.00 ,
Fee summary
Charged
Paid
Credited
Due
Permit Fee
Total 421.00
421.00
00
.00
Plan Check
Total, 232.05.
232.05•
.00
.00
Other Fee Total 19.50
15.00
.00
4..50
Grand Total
672.55
668.05
.00
4.50
LQPERM[T
Bin #
# I Submittal
Plan Sets
Structural Calcs.
Truss Cates.
Energy Cates.
Flood plain plan
Grading. plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of Project: ;rj obD
APPLICANT: DO NOT WRITE BELOW THIS UNE
Recd
TRACKING.
Plan Check submitted
City of La Quinta
PERMIT FEES
Item
Amount
Building & Safety Division
Reviewed, ready for corrections
Permit #
P.O. Box. 1504, 78-495 Calle Tampico
Called Contact Person
Plans, picked up
Plans resubmitted
OG dlPz
Plan Check Balance
La Quinta, CA 92253 -.(760) 777-7012
.
Construction
Building Permit Application and Tracking Sheet
Mechanical
Project Address: V9 61:�
L %
Owner's Name: r II
GAIL
A. P. Number: 7Z .,10
_ QQ
Z
Address:
Called Contact Person
Legal Description: L
Q.G 2 -Y$9t7 _
City, ST, Zip:
Contractor:T2,.
5
Telephone: ..
S.M.I.
Address:$ •
G A//
Project Description: 5 C
City, ST, Zip:
3" Review, ready for correctionslissue
Called Contact Person
Telephone: 760 Z
Developer Impact Fee
A.I.P.P.
State Lic. # : Q r'J
City LTc. #: �$ 3 Q �
n
B LCGAvS42
Arch., Engr., Designer: C�h
Address:
City, ST, Zip:
Telephone: 760 _2 2 :1
Construction Type:
pp Occupancy:
`
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
t
q �S p
Sq. Ft.: \.
# Stories:
# Units:
Telephone # of Contact Person: %n . YA -I h h-
# I Submittal
Plan Sets
Structural Calcs.
Truss Cates.
Energy Cates.
Flood plain plan
Grading. plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of Project: ;rj obD
APPLICANT: DO NOT WRITE BELOW THIS UNE
Recd
TRACKING.
Plan Check submitted
I /
PERMIT FEES
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plans, picked up
Plans resubmitted
Plan Check Balance
Construction
Mechanical
---------------
2°' Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
3" Review, ready for correctionslissue
Called Contact Person
�
Developer Impact Fee
A.I.P.P.
Date of permit issue
Total Permit Fees.
t/2
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00000182
Property Address:
78865`I;IMA
APN:
772-102-004- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
35000
c&t!t'44Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 License is in full force and effect.
License Class: B855505 855505
Dat .GContractor: /!`/— ✓ , a�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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.).
(_ 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.).
( ) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/13/06
Owner:
GANTZ
3558 BENDIGO DRIVE
RCH PALOS VERDES, CA 90275
k Contractor: -
U --- - IL
DESERT STAR BUINC74854 VELIE WA1Z2'� 1006
PALM DESERT, C
(760) 340-2112 CITYOFLAIMTA►
LiC . No.: 855SUS _....:.or- w"sa.
WORKER'S COMPENSATION DECLARATION
1 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
Xissued.
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 STATE FUND Policy Number 22930168
_ 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 become subject to the workers' compensation provisions of Section
3700 of the Labor Code,
I sshh�1/�jythwMct*w' ose rovisions.
D6te: Applicant://
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.
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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby aufr prize representatives
of this Founty to enter upon the above-mentioned property for ' ction pur
Date :. Signature (Applicant or Agentl:/JL�`
Application Number . . . . . 06-00000182
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
317.00 Plan Check
Fee
206.05
Issue Date . . . .
Valuation
. . .
. 35000
Expiration Date
7/12/06
Qty Unit Charge
Per
Extension
BASE FEE
252.00
10.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
65.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
7/12/06
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 . .
7/12/06
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
7/12/06
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
LQPERNIIT
Application -Number . . . . . 06-00000182
----------------------------------
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 421.00 .00
.00
421.00
Plan Check Total 232.05 .00
.00
232.05
Grand Total 653.05 .00
.00
653.05
LQPERMIT
DIMENSlu"N FLOOR PLAN
SCALE 1/811=11-011
d
CITY OF LA QUINT,'-\
BUILDING & SAFE -TY Dr-EP1-.
e ,
APPR OWED
170FI, CONSTAIUC-F101"I
t L
CONTRERAS DESIGN ASSOCIATES
Design / Site Planning
Jorge A. Contreras
Principal Designer
41-175 Carter Lane
Bermuda Dunes, California 92203
PHONE (760) 272-9516
FAX (760) 772-9732
contrerasolmos@ya(noo.com
REVISIONS
Z�
Z�
Z�
INSTRUMENTS Or SERVICE:
These drawings ore (an instrument
of service and remain the property
of Contreras Design Associates.
They are not to be reproduced or
offered to any third party without
the express written permission of
Contreras Design Associates,
DRAWN BY: I CC)NTRERAS
DATE :
JANUARY '2006
SCALE
1/811 = 1 1,011
KEYNOTES
1 'X1/2" THK. CONCRETE SLAB
2.
CONCRETE STEPS
3,
POOL EQUIPMENT
4.
ELECTRICAL PANEL
5.
24" HT. LOW WALL W/ CONCRETE ON TOP
6.
GAS METER
7.
MAIN DRAIN
8.
SKIMMER
9.
UNDERWATER LIGHt FIXTURE
10.
8' EDGE CONCRETE. SLAB
11.
WATER METER
12.
FOUNTAIN
13.
GATE
14.
INTERIOR STEPS
15,
EXISTING *FENCE WALL
16.
EXISTING COLUMN
17.
FLAGSTONE JO BE SELECTED BY OWNER)
18.
18' LANDSCAPED BUFFER
19.
MEDIA CENTER
20,
BBQ,
21.
FIREPIT
22.
CERAMIC TILE
23.
SPILLWAY
CITY OF LA QUINT,'-\
BUILDING & SAFE -TY Dr-EP1-.
e ,
APPR OWED
170FI, CONSTAIUC-F101"I
t L
CONTRERAS DESIGN ASSOCIATES
Design / Site Planning
Jorge A. Contreras
Principal Designer
41-175 Carter Lane
Bermuda Dunes, California 92203
PHONE (760) 272-9516
FAX (760) 772-9732
contrerasolmos@ya(noo.com
REVISIONS
Z�
Z�
Z�
INSTRUMENTS Or SERVICE:
These drawings ore (an instrument
of service and remain the property
of Contreras Design Associates.
They are not to be reproduced or
offered to any third party without
the express written permission of
Contreras Design Associates,
DRAWN BY: I CC)NTRERAS
DATE :
JANUARY '2006
SCALE
1/811 = 1 1,011