04-5266 (RPL)TWf
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760)•777-7012
78-495 CALLS TAMPICO FAX (760) 771-7011
LA QUINTA, CALIFORNIA 92253 -INSPECTION REQUESTS (760) 777-7153
it.Charge Per Extension
BASE FEE .45.00
9.0000 -THOU BLDG 2,001-.25,000 72.00
_ ,� _ • ELEC POOL: PERMIT=RES
d tiona
les:c
;P=
45.00 Plan Check.Fee 11.25
I Valuation 0
Expiration Date.... 7/01/05
Qty Unit Charge Pere Extension
BUILDING PERMIT
Application Number
�4� 0-0-0.0.526-6- Date
7/01/04
Property Address
187`0°0=-VIA-=ME-LQDIA_
APN:
646-050-044-9 -21555 - r
Application description
.: POOL - RESIDENTIAL
Property Zoning..
LOW DENSITY -RESIDENT -IAL
;Application valuation.. :.. 10000'
Owner
Contractor
MANCILLA JAIME
LAGUNA FALLS CUSTOM
POOL/SPA
787.00 VIA. MELODIA -
8,1730. HIGHWAY 111., :STS.
#22'
`tA., QUI NTA
CA 92253 LA' QUINTA
CA' 92253
-
(760)' .34.7 8.977
EXEMPT
WC:EXEMPT
0 7./ 31 / 0 5
CSLB:... .8:18149..,
03./31/.0 5
. CCC: ` `C53 ..
Permit'MECH
POOL
Additional desc
Permit Fee
2.4.00 Plan Check Fee
6.:00.
Issue Date,
Valuation'
.0
Expiration Date
•7/01/05
Qty Unit Charge..:Per
Extension
BASE FEE
1$.00
1.00 ..9.:0.0.00
EA' MECH .FURNACE.< -100K :
9.:00
Permit'
BLDG, POOL PERMIT
Additional desc
r
Permit PPP
117.00. Plan.Check Fee
76.05
ate.
Valuatcm
100.00
x ra..- n at
7/01/05
4 1g.
it.Charge Per Extension
BASE FEE .45.00
9.0000 -THOU BLDG 2,001-.25,000 72.00
_ ,� _ • ELEC POOL: PERMIT=RES
d tiona
les:c
;P=
45.00 Plan Check.Fee 11.25
I Valuation 0
Expiration Date.... 7/01/05
Qty Unit Charge Pere Extension
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
ing Address:
Architect or Engineer:
Architect or Engineer's
Lic.
BUILDING PERMIT DECLARATIONS
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin
Code, and my License is in full force and effect. g with Section 7000) of Division 3 of the Business and Professionals
•
License No.
OWNER -BUILDER DECLARATION
exempt from the Co
I hereby affirm under penalty of perjury that I nbactors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to co'll; ct 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 ficensed putt M to the provisions of the Contractors' 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).):
(U 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 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 or 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. 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
theContractors' State license law.).
U 1 amm%exe/m/pt under Sec. B�& P.C. r this reason
Date ( �( - I Owner. /\
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of peduo of the following declarations: .
_ I have and will maintain a rtificate of consent to selfinsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the
,perfornmance "
of the work for which this perm 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:
Cartier 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 CaGml
foa,.and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall
forthwith comply with those proonssv
D`� ate f.� — 0 Applicant—
WARNING:
WARNING: FAILURETO SECURE WORKE COMPENSATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI INALPENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THO AND 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.
CONSTRUCTION LENDING AGENCY
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permits liiUed (Sec. 3097, Civ: C.).
Lenders Name
Lenders Address.. ti i
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 lhe.City•of la Quinta, its
officers, agents and employees for any act or omission related to C)e 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 correct. 1 agree to comply with all city and county ordinances and state laws relating to building
Zconstruction, and hereby authorize. representafives of thi u to enter upo the a property for inspection purposes.
at, (] Signature (Applicant or Agent):
Page 2
Application Number
04-00005266
Date 7/01/04'
Qty Unit Charge
Per
Extension
,,BASE,
FEE
.15.00
1.00 30.0000
EA ELEC
PRIVATE SWIMMING POOL
30.00.x.
-----------------------------------------------------------------------------
Permit.
PLUMBING
Additional desc
Permit Fee . . . .
33.00
Plan Check Fee
8.25.
Issue Date . .Valuation
. .
. . 0
Expiration Date
7/01/05
Qty Unit Charge
Per
Extension
BASE
FEE",
15.00
2.00 6.0000
EA PLB
FIXTURE
12.0.0
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'
PLACE AT PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
Paid Credited
Due
Permit Fee Total
219.00
.00 .00
219.00
Plan Check Total
101.55
.00 .00
101.55
Grand Total
320.55
..00 .00
320.55
PARC LA QUINTA HOMEOWNERS ASSOCIATION
Avail Property Management
P. 0. Box 1032
Palm Desert, CA' 9226.1-1032
(7601,568-2717
June 25, 2004
Mr Jaime Mancilla
78-700 Via Melodia _
La euinta CA 92253
RE: Architectural Variance Request
Dear Mr. Mancilla:
Your request for the installation of a pool/spa in your rear yard was reviewed
and. approved as submitted with the following conditions:
• . No materials will be stored in the street
•
All debris will be cleaned from the front of the house on a daily basis
• The construction of the pool/spa will be completed within 30 days
• All necessary permits from the City will be obtained.
• Any damage to the common area or neighboring houses will be your
responsibility to repair or replace.
Thank you for your cooperation in this matter.
Sincerely,
Cam Anderson
Project Manager
i
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t 30'x18"raised 6ond beam r` 1� ' (° 166 , = ;
23'0 _e
..� 13'0 ISS ' 28'0 P x
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[j8-700..Vja �VleCodzaly
Q�• _
CITY OFLAQUINTA-T
BUILDING &'SAFETY DEPT.
` FOR CONSTRUCTION
' M DATE gy '