12-1169 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12=00001169
Property Address: 55539 FIRESTONE
APN: 775-151-003- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 28000
Ta9v 4 e(P Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
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--------------------- --- --------------C,tTX_0EUkq lINTA----I
LICENSED CONTRACTOR'S DECLARATION rucru. -
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.
Lice se Class: C53 -C27 License No.: 823017
Date: 0` Li- I t-ntractor: &ILr
OWNER -BU ER 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).:
(_) 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
VOICE (760' 0 1
FAX (76 77-70
INSPECTIONS (760) 777-7153
Date: 10/03/12
Owner:
BILL GORDICA
55539 FIRESTONE
LA QUINTA, CA 92253
Contractor:
MCRAE POOL & SPAS
79105 DESERT STREAM DR
LA QUINTA, CA 92253
(760)774-6343
LiC. No.: 823017
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 Labor Code, 1 shall forthwith comply with those provisions.
te. to- y' (L plicant:
WARNING: FAIL RE 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, indemnity 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 authorize representatives
of this county to enter upon the above-mentioned property for inspect/i n ur
dale. [ 0' Y-fZ,�si Lure (Applicant or Agentl:
a
Application Number . . . . . 12-00001169
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 271.50 Plan Check Fee 176.48
Issue Date . . . . Valuation . . . . 28000
Expiration Date . . 4/01/13
Qty Unit Charge Per Extension
BASE FEE 252.00
3.00 6.5000 THOU BLDG 25,001-50,000 19.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . 0
Expiration Date 4/01/13
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 4/01/13
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 4/01/13
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. ALARMS/BARRIERS SHALL'BE IN
LQPERMIT
Application Number . . . . . 12-00001169
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2010
CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary
Charged
--------------------
Paid
Credited
--------------------
Due
-----------------
Permit Fee Total
375.50
.00
.00
375.50
Plan Check Total
202.48
.00
.00
202.48
Other Fee Total
2.00
.00
.00
2.00
Grand Total
579.98
.00
.00
579.98
LQPERMIT
CITY OF LA .QUINTS, SUB=CONTRACTOR LIST
JOB ADDRESS Jc 5' S3 q Fl REPERMIT NUMBER OWNER G29M*Qg BUILDER AACF ROD --c
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must -tie approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade /Classification
C ontractor :.:
. ...::.::...... . .. .
<..:..:;<::>:.;:<: :::S ate:Contrac License >. = Woikei Co saLori: nsurance: `::' :.:.:'
........ t .. for s. :....:: s... m en .
Cit :'Business License::_.
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date Carrier Name
(xx/xx/xx) (e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp, Date
(xx/xx/xx)
EARTHWORK (C-121 .
Z
Ll 6 S O 8
'4-36 -1 N V
7 6 o.4 O i
lo -1-0
CONCRETE (C-81 `Q
R. C L - C -
N
FRAMING '(C -5i:
STRUCT. STEEL (C-51)
yJ
65�.�
U c�
1 JQ'� f l R�' SVI
- '7
G-.20-13
MASONRY (C-29)
PLUMBING (C-36)4tAeep
skh v6
<< f ( f•
��
J (l
/ /
LATH; PLASTER I6135)
r
DRYWALL (C-9)
HVAC. (C-20)
ELECTRICAL. (C-10); .'.
Ts --7
'.2)`
ROOFING' (C=39)::;':::;``<: .
SHEET METAL (6=43)
FLOgRING 10:151: ' :''
GLAZING (C-17)
INSULATION (C-2) .
SEWAGE DISP (C-42)
PAINTING (CG33)
CERAMIC TILE (C-54)
CABINETS IC -6)
FENCING (C-13)
LANDSCAPING (C=27)
POOL (C-53)
"Wen Egt ';4 gwjw�)
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tow.c
c lI
74XnLZq[8P1?_
0-13
#
Permit #
Project Address: S • 3�J
A. P. Number.
i Legal Description:
i
Contractor: (r'
i
Address: 7 •/O j'-
City, ST, Zip: LA <Fvl•d
Telephone:
State Lic. Z50
Arch., F,ngr., Designer:
Address:
City., ST, Zip:
Telephone: `'0
State Lic. #: 2-S 01
Name of Contact Person:
Telephone # of Contact Person:
N Submittal Req'd
Plan Sets
Structural Calci.
Truss C21cs.
Title 24 Calci.
_ � ,Flood plata plan �..
- -- - ' Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval.
Pub. Wks. Appr
School Fees
City of La Quinta
Building 8t Safeiy Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit-Application'and Tracking Sheet
Owner's Name:. L+
Address:
City, ST, Zip: LA q0t'
W
MA
Telephone:
�2 Project Description: omo f r4_ �vm rw
MEMO
Y
Construction Type:.
Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Estimated Value of Project:
Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd
TRACKING
PERMIT FEES
Plan Check submitted
Item Amount
Reviewed, ready for corrections
Plan Check Deposit. .
Called Contact Person
Pian Check Balance
Plans picked up
Construction
-Plans.resubmitted -
Mechanical— - -
2" Review, ready for correctionsitssue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.L
Plans resubmitted
Grading
Review; ready for corrections/issuc
Developer Impact Fee
Called Contact Person
Date of permit issue
Total Permit Fees
C, `-� .
RAISED —`
PLATFORMS
FOR SCUPTURE
W/ LIGHTING
I L DRAG , 11 W
I
:ANTER PLANTER
Jr . .. .. .
I
I
E 36'-0*
,o
NEW POOL
& SPA
PLANTER +12"
Q DRA I N'
I •
.y
7 R:
i
m�
+12"
+18"
ml mmmmmommmm
RAISED
PLATFORMS
FOR SCULPTURE
W/ LIGHTING
EXI5TIN(
RAISED
PLATFORMS
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
+18, FOR CONSTRUCTION
x
DATEI ZgBY ATG
DRAIN
RAISED
PLATFORM
o
i
in PLANTER � ' DRAIN \
POSSIBLE LOW WALL
• �i — OR LANDSCAPE
( ' . BARRIER TO HIDE
#allow' POOL EQUIPMENT
•armaw