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08-0976 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: X06-00000976�� Property Address: 053075 .-VIA CHIANTE APN: 772-550-010- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 22000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury that I am lic used under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an fessionals Code, and my License is in full force and effect. LicensjCs: A LicenseNo.: 859859 - te: ractor. ' OWNER -BUILDER DECLARATION - I hereby affirm under penaltyof ry that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, siness 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 signedstatementthat 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 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 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 ODate: 6/09/08 Owner: BLAKE SCHWARTZ 53075 VIA CHI E LA QUINTA., CA 92- 3 C%ry 0 7 Contractor: ��N�Nc�Q 100 FG D HENRY'S ENGINEERING �FATTq P.O. BOX 10290 INDIO, CA 92.202 (760)275-6956 f LiC.. No.:.859859 i WORKER'S COMPENSATION DECLARATION I herebyaffirm 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 STATE FUND Policy Number ' 236-000953 I certify that, in the performance of a work for which this permit is issued, I shall not employ any _ .person in any manner so as t ecome subject to the workers' compensation laws of California, and agree that, if (should ome subject to the workers' compensation provisions of Section . 3,77000 of the Labor Cod hall forthwith comply with those provisions. Zate: / �"U_ v plicant: ' WARNINAWURE TO SECLTRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN 6MPLOYER 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 per it, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t a ve information is correct. I agree to comply with all city and county ordinances and state laws relating to il, i g construction, and hereby authorize representatives of this cou to enter upon the above-mentioned p for inspectio oses.- Dat �� "�Signa t (Applicant or A n LQPERMIT Application Number 08-00000976 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee 225.00 Plan Check Fee 146.25 Issue Date . . . Valuation 22000 Expiration Date 12/06/08 Qty Unit Charge Per Extension BASE FEE 45.00 .20.00 9.0000 THOU BLDG 2,001-25,000 180.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . Valuation 0 Expiration Date 12/06/08' 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 12/06/08 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 12/06/08 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 . . . . .. 08-00000976 ------ ---------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due Permit Fee Total 329.00 .00 .00 329.00 Plan Check Total 17.2.25 .00 .00 172.25 Grand Total 501.25 .00 .00 501.25. LQPERMIT Bin # City of La Quinta Building 8E Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA•92253 - (760) 777-7012 Building Permit Application and Tracking Sheet • Permit # Project Address: -'3 d 7 ,S" vJ Ar- W A,,—�,' Owner's Name: SG�w A. P. Number: LA j,, V -,N— Z Z L4 Address:30.33, Legal Description: Contractor: Q City, ST, Zip: A,�� g( Telephone: 30�j 3 6 Address: Project Description: aG G City, ST, Zip: �N c Telephone: State Lic. # : S S City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: 11 l nom ScJ �J'�' Telephone: g r� Construction Type: Occupancy: State Lic. #: 3 3 Lt c..( L Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: � # Stories: #Units: Name of Contact Person: 0 C—, qn G Telephone # of Contact Person: S G Estimated Value of Project: Z 2 co 00 s APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted % Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2n' 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 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: `08=00000976 Property Address: `53075 -VIA CHIANTE APN:' 772 -550 -010 - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 22000 • I VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Owner: BLAKE SCHWARTZMAN 53075 VIA CHIANTE LA QUINTA, CA.92253 ---------------------------- Contractor: Applicant: Architect or Engineer: Owner ------------------------------------------------- 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: License No.: Date: Contractor: - t OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Lia 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 plicant 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 toanowner 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 I - 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 --------------------- ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 policyq umber are: Carrier. 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, if I should become subject'to-the workers' compensation provisions of Section rj4rA of the Laboi Code I shall forthwit�i�6niply, with those visi V pplicant:.''d`%�` /a✓ D'' 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. Date: 7/31/09 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 r ^ 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this sccou y to ter upon the above-mentioned propeizct o/iononn purpoi Date: / 0 d (Signature (Applicant -or Agent �l e LQPERDIIT Application Number . . . . . 08-00000976 Permit . . . MECH POOL l Additional desc . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date .. . . . 7/01/08 Valuation 0 Expiration Date 12/28/08 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 . . . . 225.00 Plan Check Fee 146.25 Issue Date 7/01/08 Valuation . . 22000 Expiration Date 12/28/08 Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 THOU BLDG 2,001-25,000 180.00 ' Permit .'. . ELEC POOL PERMIT -RES ' Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . 7/01/08 Valuation 0 Expiration Date 12/28/08. �. Qty. Unit Charge 'Per Extension " BASE FEE 15.00 1.00 30.0000 EA EL'EC PRIVATE SWIMMING ------------------------------------------------------------------------------ POOL 30.00 . Permit PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 . Issue Date . . . .. 7/01/08 Valuation . . . . 0 Expiration Date 12/28/08 Qty Unit Charge, Per Extension BASE FEE 15:00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.00.00 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 LQPERDIIT Application Number . . . . . 08-00000976 ,.Special Notes and Comments ----------------- PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Other Fees . . . . . . . . REPLACEMENT -- ---------------- INSP CARD 15.00 Fee summary Charged Paid Credited Due Permit Fee Total -- 329.00 -------- 329.00 ---------- ---------- .00 .00. Plan Check Total 172.25 172.25 .00 .00 Other Fee Total 15.00 .00 .00 15.00 Grand Total 516.25 501.25 00 15.00 LQPERMIT 0212.7/2009 10:45 FAX Cool -Air 2002/003 INSTAUATION CERTIFICATE' (Page 3 of ii) CF -6R Site Address Permit Number ,5 3 0?, 5 V j 4 4W I A j t -t LaQ. a. �ur� 4.,a , An installation cottificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building depart neat (upon request) and the building owner at occupancy, per Section 10-103(a). HVAC SYSTEMS: Heating Equipment ��y t ���• Equip Type CEC Certified M$. Nemo and Model # of Identleal Efficiency o (AME, 01e.) ' Duct Locasion butt or Piping Heating Loud Hating Copacity heat Number - S 2CF-1R value attic, Cie.) R -value wft (Btuthr �4rJ �ttv V",Vw,,,,,L.000a L �►r� 4 . ` Q,- "$ 18,000 Goya � kll • �� � � Z N33te 4tCti' Z 14 Apr" T !� —�i 18,000 . A` Cooling Equlpment .. -J�& Y I j t [aNY" Epp Type (Pkg. heat CEC Cornified Mfr, Ngme and Model Number 0 or Identical S temsLICF-IR Eff`eieney I (SEER or EER) valae Duct Location anti etc. Duct R -value . Cooling Load M41r(B=/hr) Cooling Capacity .. l 13 , y Ar <.& X -S Cd.�D..la .'�w.w' Y�lz�i3 �S �►ICa Z t3 . 9 A'r�r-,t. Q,- "$ 18,000 Goya � kll • �� � � Z N33te 4tCti' 1 � 3 . ci /err. c_ R. -� ' 3fo,�o 1. > symbol reads greater than or equal to what is indicated on the CF -1R value. Include both SEER and EER if compliance credit for higb EER air conditioner is claimed. ✓ k1, the uudersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner rZ W eAr in,V cv )r A i a� 4e o u v, n o 4 a) (w Signature; Date: Coptea to; BUILDING DEPARTMENT, HERS RATER'(IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005