08-0999 (RPL)c&t�t440
P.O. BOX 1504 " VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/12/08
Application Number: _08-00000999 Owner:
Property Address: 53731 VIA DONA FRANK KOZEL
APN: - 772-420-999-34 -298944- 53731 VIA DONA
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 40000 D
Contractor:
Applicant: Architect or Engineer: CAHUILLA POOL CONSTRUCT NC
P O BOX 2569 JUN 13 2006
PALM DESERT, CA 92261
(760)396-5686 CITY OF LA QUINTA
.i LiC. No.: 692059 FINANCE DEPT.
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am icense and r provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business andAofessiInali ode, and my License is in full force and effe
License fuss: C53 6 nse No.: 692059 A
&IaNER-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.).
(_ 1 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
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.
Y -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 FLTND Policy Number 0026982-2007
_ 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 b com subject to the workers' compensation laws of California,
and agree that, if I should eco su 'act to the workers' compensation provisions of Section
700 of the Labor Code, shall f rth rith comply with those provisions.
atCf e: scant:
WARNING: FAIL E TO SECURE WORK S' 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 i or ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin cons u' ion, and hereby authorize representat ves
of this cou ty t enter upon th ove-mentioned property f ins i n purposes.
D ture (Applicant or gent .
Application Number . . . . . 08-00000999
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 349.50 Plan Check Fee 227.18
Issue Date . . . . Valuation . . . . 40000
Expiration Date . . 12/09/08
Qty Unit Charge Per Extension
BASE FEE 252.00
15.00 6.5000 THOU BLDG 25,001-50,000 97.50
----------------------------------------------------------------------------
Permit . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/09/08
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 . . 12/09/08
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 . . 12/09/08
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 SHALLL BE IN
LQPERMIT
Application Number . . . . . 08-00000999
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE, FIREPIT AND BBQ NOT
INCLUDED.
Fee summary Charged
----------------- ----------
Permit Fee Total 453.50
Plan Check Total 253.18
Grand Total 706.68
LQPERMIT
Paid Credited Due
00 .00 453.50
00 .00 253.18
00 .00 706.68
Bin #
City of La Quinta
Building & 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: T53z3MI
wner's Name: M V(. ,figqo r'
A. P. Number: s" :�> 73 1
Address: . —3-- I Q (A
Legal Description:
Contractor.`,,�� �� c�jr
City, ST, Zip: L t tJ TA C4
Telephone:
Address: �. Q , QX 9S W9
Project Description:
City, ST, Zip:
` �►~ �... DA
Telephone: �-3�- ��
5.
State Lic. #: City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: I�
� ra
State Lic. #:
Name of Contact Person: s'
Construction Type: 69fio Y Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: c Q�Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
Constructon
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god 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
October 14, 2008
Mr. and Mrs. Kozel
80120 Via Pessaro
La Quinta, CA 92253
RE: Kozel/Pool and Driveway Changes
Lot 34D, 53731 Via Dona
Dear Mr. and Mrs. Kozel,
The Hideaway Design Review Committee met to review the plans showing the proposed
changes in the pool location and driveway for your home on Lot 34D. It was noted that
the pool location is 4'6" from the rear property line. A variance form will need to be
submitted for this work. The Design Review Committee and the Board of Directors
approves this variance due to the fact that the pool is not parallel to the property line
which creates a better transition to the grass slope and only 1 square foot of water surface
will be beyond the 5' line.
Thank you for your submittal and patience in our review of it. We look forward to
working with you further on the construction of your home.
Sincerely,
Hideaway Design ReYleyv Cpp;mittee
cc: DRC File, John Link, Wayne Connor
Bin #
City of La Quinta
Building U 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:�� _ �'�
Owner's Name:
A. P. Number:
Address: 6 �5 ---T' 1—
Legal Description:
City, ST, Zip:
Contractor:
Telephone:"
Address: ,V , `
Project Description:
City, ST, Zip: o
?VOL,
Telepho lw -�) 6(0 -5 !y
f: 2. "
State Lie. #(.6.51 &9 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
P
W-1900,00-1
IS FEAR M.,
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: J
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Pers
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
2" Review, ready for correctionsfiissue
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