08-1040 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001040
Property Address:
81794 VIA LA SERENA
APN:
767-200-011-16 -318742-
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
17000
T,ityl 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MIKE KETCHUM
81794 VIA LA S
LA QUINTA, CA
JUS
Contractor: 1
DESERT PARADISE PO
78005 WILDCAT DRIVE S
PALM DESERT, CA 92211
(760)360-7400
Lic. No.: 419309
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
1 P"?
Date: 6/17/08
---------------------7---------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under pr isions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals, 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 C27 se No.: 419309
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
t�
ate: (7 �6 nntractor:
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
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 ENDURANCE WORK Policy Number WEN1000818-02
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance 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
person in any manner so as to become subject to the kers' 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
and agree that, if 1 should become subject to the e ' compensation provisions of Section
. License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith c those provisions.
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 (5500).:
ate: pplicant:
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
000
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE T RE WORK 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 TO 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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the propel ty, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) 1 am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 c I agree to comply with all
city and county ordinances and state laws relating to building construction, a y authorize representatives
of thi my to enter tip the above-mentioned property for inspection S.
ate: ! gnature (Applicant or Agent):
Application Number . . . . . 08-00001040
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee
180.00 Plan Check Fee
117.00
Issue Date . . . .
Valuation
17000
Expiration Date
12/14/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
135.00
Permit
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/14/08
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 . .
12/14/08
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
12/14/08
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
RMIT
Application Number . . . . . 08-00001040
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 284.00 .00 .00 284.00
Plan Check Total 143.00 .00 .00 143.00
Grand Total 427.00 .00 .00 427.00
LQPERMIT
Bin #
•
City of La Quints
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # 0
�'�
0
Project Address:�`
(— A e IZE A
Owner's Name: /K f _ �N(Jjyl
A. P. Number:
Address: e -')Gj L( �� 5'eA
Legal Description:
Contractor: j.��erz �Qra S
City, ST, Zip: Z—)4 Q ollu-M
Telephone:
Address: /OV
Project Description:
City, ST, Zip:001
Telephone: S (0 D— 7 4f00 y
State Lic. # : 30 c� City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: �b,Q
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: 7�U 5-118 L/ i V-;7
Estimated Value of Project: I v
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 Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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:-
''d 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
1Ld
Special Misc. +
'; r .. ._..:_...:... _ (E)AL GATETO SWING
G
,. ,
EXISTING DRAIN .
[TOTAL DECK
oorAWAY'FROM POOL AREA A 869 SQ. FT.
SELF CLOSING &SELF a
JOB#
Property Line Wall
1
Fire Pit. ..,..
2
RBB Facing
l _
I
GUNITE:
Stone Steps
51
Fireplace
_ .
Veneer on Outside of Spa ;.
_
(1) 420 CLEAN
Stone Waterline
Special Misc.
..BREAK DOWN
TILE.
Special Misc.
Group 1;2,3: Yes N�
..
Tile Trim: Yes" No
& CLEAR FILTER
-❑ Steps ❑ Benches 13 Lore Scots
j
POOL:
IRON:
Special Misc.
PLASTER / PEBBLE::
—(1) SKIMMER
t
-
-(1) AUTO -FILL
P=90'
TO1 INTELLICHLflR
"SALT
RI
r
.
SYSTEM
RBBANT
NAVGATOR
3
I
EXISTING CONCRETE
II
�POOL
A=77 SQ.
FT.—(1)
2 POOL. LIGHT
�,, ,.
STOOP TO REMAIN
CANT.
j=
—(1) �) TIME CLOCK
A=47 SQ. FT.
u,
TOTAL CANT.
i=
A-124 :SQ, FT. "
COURTYARD URTYARD DEC
-
A=68 SQ. FT.
POOL DECK
:.
A=785 SQ. FT.
1Ld
Special Misc. +
'; r .. ._..:_...:... _ (E)AL GATETO SWING
G
,. ,
EXISTING DRAIN .
[TOTAL DECK
oorAWAY'FROM POOL AREA A 869 SQ. FT.
SELF CLOSING &SELF a
JOB#
Property Line Wall
1
Fire Pit. ..,..
2
RBB Facing
3
Equipment Mall `
GUNITE:
Stone Steps
51
Fireplace
Special Misc.
Veneer on Outside of Spa ;.
71
Stone Waterline
Special Misc.
WOOD:
TILE.
Special Misc.
Group 1;2,3: Yes N�
Tile Trim: Yes" No
-❑ Steps ❑ Benches 13 Lore Scots
Special Misc.
IRON:
Special Misc.
PLASTER / PEBBLE::
Type
1Ld
Special Misc. +
'; r .. ._..:_...:... _ (E)AL GATETO SWING
G
,. ,
EXISTING DRAIN .
[TOTAL DECK
oorAWAY'FROM POOL AREA A 869 SQ. FT.
SELF CLOSING &SELF a
JOB#
ADDENDUMS DATE SELECTIONS
1
STOrrr
2
BOULr>rtR.S
3
DECK COLOR
4
PEBBLE?PLASTER
51
sruc o CDLUR
61
WATERLLNE
71
GROUT COLOR
MAP BOOK REF. TRACT NO,
The ASSOCIaq Prepared Especially For. KETCHUM -RESIDENCE
Pool Spa Professionals
street 81-794 VIA LA SERENA
CALIFORNIA city LA QUINTA. CA, (CARMELA
T ) HIS CL PHONE
:' :1..ANI2SCAPE
Phone,Cell ceu Phone 949 :922 {I49$