12-1376 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00001376
Property Address: 53544 VIA DONA
APN: 777-420-008-3 -298944-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:. 33000
Applicant:
�u1.Ct/IAesf�J1/L
Tiht °F 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
D Nov 2 2092
OF
VOICE (760) 777-7012
FAX (760) 777-7011
`J INSPECTIONS (760) 777-7153
Owner:
EHLERT, BARRY M/M
35 AUTUMN GARDENS SE
CALGARY, AB T3G 2-V1
Contractor:
VACATION POOLS INC
PO BOX 10940
INDIO, CA 92202
(760)775-0468
LiC. No.: 856835
Date: 11/21/12
--------------------------------------------------------=----------------------------------------
UCENS!�R CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I ed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
?amicen
Section 7000) of Division 3 of the Busi s arof Tonal, Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C53 License No.: 856835
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
9 J -
issued.
���t—
Da te• �j• Contractor:
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are: ,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1948584-2012
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
I certify that, in the perforrrt of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
_ rce
person in any manner 6 as to b ome subject to the workers' compensation laws of California,
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
and agree that, if I s uld beco a subject to the workers' compensation provisions of Section
/� �370�the Labor od✓; sh I f h it omply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
-
i
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
/`/, b/r
Date: plicant:
(_ 1 1, 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
WARNING: FAILURE TO SE E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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
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 ae . for ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buil ' c stru tion, and hereby authorize representatives
of this Qloynty tO enter upon the above-mentioned prope y r insp tion purposes.
Date: /' ( t—ilgnature (Applicant or Age
Application Number . . . . . 12-00001376
Permit BLDG POOL PERMIT
Additional desc -
Permit Fee . . . . 304.00 Plan Check Fee 197.60
Issue Date . . . . Valuation . . . . 33000
Expiration Date 5/20/13
Qty Unit Charge Per Extension
RDGR, FRE 252.00
8.00 6.5000 THOU BLDG 25,001-50,000 52.00
----------------------------------------------------------------------------
Permit MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/20/13
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 . . 5/20/13
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 . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . 0
Expiration Date 5/20/13
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.0000 EA PLB FIXTURE 6.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL AND SPA AT REAR YARD ONLY [1-1/4
INCH GAS PIPE FOR HEATER ONLY] THIS
LQPERMIT
Application Number . . . . 12-00001376
----------------------------------------------------------------------------
Special Notes and Comments
PERMIT DOES NOT INCLUDE EQUIPMENT WALL,
FIRE PITS, OR WATER FEATURES. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
November 21, 2012 1:18:53 PM AORTEGA
Fee summary Charged
----------------- ----------
Permit Fee Total 399.00
Plan Check Total 221.35
Grand Total 620.35
LQPERMIT
Paid Credited nue
---------- ---------- ----------
.00 .00 399.00
.00 00 221.35
.00 .00 620.35
Bin.#
5
Crtj, of La Quina
Building 81 Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 --(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
IZ •t'',�Io
Project Address: vf_J
0/4 /
Owner's Name:.
A. P. Number.
Address: 513
Legal Description:
Contractor. CC'Irl (.
City, ST, Zip: q -h,, f 4-
Telephone: % �'DYtx; ... :sem
Addr090
Project Description:
City, ST, Zip: lG C-41-
Telephone:
State Lic. # :
City Lic. C
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #: -
Name of Contact Person:
. ^
>� Y
,, w : , . ,.r
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: OC GO (g
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionirmsue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
''" Review; ready for correctiansfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
+Ia", T X Q' SPA
5' WIDE TILE SPII
TANNING SHELF
18" W.D. WITH
UMBRELLA SLEE,
6 -1T -y -
OF LA QUIi�1TA
BUILDING & SAFETY DPT.
AP P- q9 rT�D
i�ON\ s
ifl21lrY
VACATION POOLS, INC.
P.O. Box 10940
Indio, CA 92202
Ph. (760) 775-0468, Fax(760) 775-0469
License # C-53-856835
NOTE:
Landscape elements (Trees,
Shrubs, Vines and Lawn) and Patio
Furniture shown for illustration only.
'Unless by separate bid.
CONTRACTOR cannot assume
responsibility for damage to curbs,
sidewalks, driveways, cement slabs,
sewers, lawns, trees, fences, retaining
walls, sprinklers, wires, valves,
telephone or shrubs.
When access is made through a
neighbor's property it is understood
that you, the owner, have that
neighbor's permission and assume full
responsibility.
DATE 51ONATURE
Scale: I/8"=1' -O"
HIDEAWAY LOT 250
55-544 VIA DONA
LA OUINTA, GA Q2255
HIDEAWAY GOUNTRY CLUB
APN 777-420-008
DATE: 11.21.12 1 REVISED:
O \
\ e FOOEfiL� U5PAA \
\N j
.18', -7- X 9' SPA WITH
R 5' WIDE TILE SPILLWAY Cry
TANNING SHELF
18• YID. WITH
UM5KELLA SLEEVE
\ FRONT
\ LOT 250 YARD
POOL -5' 30'-8° .53-544 VIA DONA
11'X 54' LA GiUINTA, GA 82253
\
m
\
NOTE:
Landscape elements (Trees,
Shrubs, Vines and Lawn) and Patio
f=urniture shown for illustration only.
Unless by separate bid.
.,,_*VACATION POOLS, INC.
P.O. Box 10940
a- Indio, CA 92202
Ph. (760) 775-0468, Fax(760) 775-0469
License # C-53-856835
GONTRAGTOR cannot assume
responsibility for damage to curbs,
sidewalks, driveways, cement slabs,
sewers, lawns, trees, fences, retaining
walls, sprinklers, wires, valves,
HIDEAWAY LOT 250
55-544 VIA DONA
LA allINTA, GA 82253
HIDEAWAY COUNTRY CLUB
telephone or shrubs.
APN 771-420-008
When access is made through a
neighbor's property it is understood
the owner, have that
DATE: 11.21.12 REVISED:
nighbthatou,
e or's permission and assume full
C)
responsibility.
DATE 515NATURE
Scale: 1"=20'-0`