08-1266 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: X08-000001266--1
Property Address: 53148 VIA DONA -
APN: 772-410-999-1,6 -298944-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 34700
T4ht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: . ) Architect or Engineer:
v
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm under penalty of perjury that I am licensed un ,provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profess' Code, and my License is in full force and effect.
Lice la s: C53 C27 cense No.: 419309
Date; Contracto
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 acivil 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 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 _ 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 ownerof-
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: 7/24/08
Owner:
ZIRINSKY
53148 VIA DONA
LA QUINTA, CA 92253
D
Contractor:
DESERT PARADISE POOL/SP NC AUG'78005 WILDCAT DRIVE SUI 04 A 0 4 2008
PALM DESERT, CA 92211
(760)360-7400 CITY OF LA QUINTA
Lic. No.: 419309 FINANCE DEPT
------------------------------------------------
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 ENDURANCE WORK Policy Number WEN1000 18-02
I certify that, in the performance of the work for which tH r s issued, I shall not employ any
person in any manner so as to become subject to ;Wwwws, compensation laws of California,
and agree that, if I should become subject to cers' compensation provisions of Section
700 of.theLa r Code, I shall fo mply with those provisions..
ate: OD
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL n
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). 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 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is co t. I agree to comply with all
city and county ordinances and state laws relating tobuildingconstruction,. ereby authorize representatives
of�thjs co my to ter upon th above-mentioned property for inspecti poses.
Dater Si tura (Applicant or Agent).
41•-. , i'
Application Number .
. . . . 08-00001266
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
317.00 Plan Check
Fee
206.05
Issue Date
Valuation
34700
Expiration Date
1/20/09
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
1/20/09
QtyUnit Charge
Per
Extension
BASE FEE
15.00
1.00` 11.0000
------------------------------------------------------------------------------
EA MECH FURNACE >100K
ti 11.00
Permit . .
ELEC POOL PERMIt-RES'
Additional desc .
Permit Fee
45.00 Plan Check
Fee
11.25
Issue Date
Valuation
0
Expiration Date
1/20/09
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
1/20/09
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, WATER FEATURE. ALARMS/BARRIERS
LQPERMIT
I Bin #
# Submittal
Plan Sets
Structural Cales.
Tr■ss Coles.
Energy Calls.
Flood plain plan '
Grading plan
Subcontaetor List
Grant Deed
H.0 -A. Approval
EY HOUSE --
Planning Approval
Pub. Wks Appy
School Fen
r
City of .La QuInta•
.. Riffi Ing -Sl;. Safety..DbrWen
P.O. Box 1504, 78-495 Calle Tampico
La QuhUa, CA 92253 - (760) 777-7012
Building' Permit Application and Tracking Sheet
,oz,flJ . Owner's Name:
. Address: 5 3) N V I A- OD N4,
City. ST. Zip:
r ' >< o .•' 1 Projext:lJea
a P�� L
;ity Lic. #:OLID
Construction Type: Occupancy:
PMo�3►pe(�'cIeone): Nev-,Adtl•'n Alter Repair .
. "Demo
D E Sq. FL: ' # Stories: # units:
Valve -of .
APPLICANT: DO NOT UOMT-8MOW THR9 NNE
Rec'd TRACKING
PERMIT FEES
Plan Check submittt9t
V
tact Peesoad epmitted ready for conact Persond up
Plans resubmitted
3" Regiew. ready for com
Called Contact Person
Date of permit here
- Item
Permit #L
ctions Plan Cheek Deposit
if
Plan Check Balance
.Project Address: 5 ' 1 it rg
A.Y. Number. ,
Legal Description:
X
Contractor.
X
7�
.Adeiress:lp -.-+tlLE- �
City, ST, Zip:
r
Telephone: e— M91
X
etionsfissue DrvdoW Impact Fre
Statc Lic. # : 3 - I
A LP.P.
Arch.. Engr., Designer:
Address:
City, ST, Trp:
ITdwPcnuwFecs,-
Telephone:
State Lie. #:
A
Name of Contact Person:
X
Telephone # of Contact Pews(%.
# Submittal
Plan Sets
Structural Cales.
Tr■ss Coles.
Energy Calls.
Flood plain plan '
Grading plan
Subcontaetor List
Grant Deed
H.0 -A. Approval
EY HOUSE --
Planning Approval
Pub. Wks Appy
School Fen
r
City of .La QuInta•
.. Riffi Ing -Sl;. Safety..DbrWen
P.O. Box 1504, 78-495 Calle Tampico
La QuhUa, CA 92253 - (760) 777-7012
Building' Permit Application and Tracking Sheet
,oz,flJ . Owner's Name:
. Address: 5 3) N V I A- OD N4,
City. ST. Zip:
r ' >< o .•' 1 Projext:lJea
a P�� L
;ity Lic. #:OLID
Construction Type: Occupancy:
PMo�3►pe(�'cIeone): Nev-,Adtl•'n Alter Repair .
. "Demo
D E Sq. FL: ' # Stories: # units:
Valve -of .
APPLICANT: DO NOT UOMT-8MOW THR9 NNE
Rec'd TRACKING
PERMIT FEES
Plan Check submittt9t
V
tact Peesoad epmitted ready for conact Persond up
Plans resubmitted
3" Regiew. ready for com
Called Contact Person
Date of permit here
- Item
j. Amount
ctions Plan Cheek Deposit
Plan Check Balance
Construction
- Mechanical
Kdousluue Electrical .
Plumbing
S.l►LL
Grading.
etionsfissue DrvdoW Impact Fre
A LP.P.
ITdwPcnuwFecs,-
-4.