09-0045 (RPL)r,
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000045
Property Address: 81821 VIA SAN CLEMENTE
APN: 764-010-008-10 -31910 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Applicatl6n ValUatl6h! ibuuu
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B C27 C53 ^ License No.: 810111
ate: � Al - D ntractor: W
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 a civil penalty of not more than five hundred dollars ($5001:
1 _ 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.).
( ) 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
Owner:
LA QUINTA.57 ESTATES INC
78401 HWY 111 STE
LA QUINTA, CA 922533
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/16/09
JAN 2110'D'
Contractor:
PICASSO POOLS INC q;I9�f e'-'� x)14
78078 COUNTRY CLUB D #206:::'•' '��•-
BERMUDA DUNES, CA 92203
(760)345-4600
Lic. No.: 810111
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 STATE FUND Policy Number 290-0001790
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 California,
and agree that, if I should become subject to the workers' compensation provisions of Section
33700 of the Labor Code, I shall forthwith comply with those provisions.
,date:/
" 1-D/ plicant:�
WARNING: FAILURE TO SECURE WORKERS' 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating tob ' ding construction, and hereby authorize representatives
of this county to enter upon th bove-mentioned pro ert or inspection purposes.
D-�(I"� Si ature (Applicant or Agent):
ca.
Application Number . . . . . 09-00000045
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 162.00 Plan Check Fee .
Issue Date . . . . Valuation . . . .
Expiration Date 7/15/09
Qty Unit Charge Per
BASE FEE
13.00 9.0000 THOU BLDG 2,001-25,000
105.30
15000
Extension
45.00
117.00
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/15/09
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 . . 7/15/09
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 7/15/09
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. ALARMS/BARRIERS SHALL BE IN
LQPERMU
• ri
Application Number . . . . . 09-00000045
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary
Charged
Paid
Credited
Due '
-----------------
Permit Fee Total
--------------------
266.00
.00
--------------------
.00
266.00
Plan Cheuk TULdl
131.30
.UU
UU
131.33
Other Fee Total
1.00
.00
.00
1.00
Grand Total
398.30
.00
.00
398.30
LQPERMTT
9'x5'6" KIDNEY SPA@ +18"
STACKED STONE SPILLWAY.
INSTALL 5 SPA JETS
STUCCO OUTSIDE OF SPA
Bin =
0ty of- L3 Quinta
Bddamn.ar. Safe*y Division
P.O. Boz 1.504, 76 :'9-S.Ca1ie Tampico .
!a Quina, CA '?22>; - (7 Q) 1=01
Bd, din; Permit Applicadon and Tracidn; She=E.
Perm f
1 mm's Tiar�c: i� 0
�.�J rl
A- P. Nmi2b= .A,dd7--,a, IV ScLn Cl c ert± —
za
Ll Des t)don: Ci* . s. EM: L A l A K,
Ct�IIITdCiil ' C 1=itpnone: -
c L�
Adams �"1 t z, ProiYt D scintion:
State Lie r _ 8 Q, t ! Cin• Lie
cm', sr Zip:
lr,.'_ y,yTyS.v
,.. Cop== C=
T}:pe: Crr-�
-
5-ate Prole^ l,vpe (cis pie one): ?dwt a dc'n Ah= Ric Demo
T.atnc�ni e vr I '. L'rits
-Tclmonc=of Con= IZI -C � Orr5 srs
APPLICANT: DO NOT WRi'Tr B=LOW THIS LINE
R j Submirmi
I Rcq'd I Recd
TR4CT:ING '
PER!47 FEES
Plan Sets
I )
Pao C-beck submitted
/
Item I
Amaunt 1
Strucural Cnlcs
I
Revit-wi ed rsdr fir corrections ,
Pan Check Dc ss2
Trus Calts.
�' I
Called Contact Pr—son. !
Plan Check E:,anet
•Tale;'. CaieS.
Plant picked up I
Cons action
Tloo¢ Plain plan
I
i
Plans r:submin-d I
R1ecsanical I
_
_Gradinc pian
I
'-" Rntirw. reads for corrcctionsiissue I
EI_r_rictl
Subconmaor Lis
I
I
Callcti Conznct Perini I
Plunnbin; i
--G'raat Drs
I
I
Plans picked up
S_M1ls.
-H? O_A_Approta1
!
'Pans rrsubmined
Graaitt?
"-Revirx, ready for cormtiacvissue
I
Dn•-loper lmpmn F
•Planuing Approval
,
Called Contact Pcrson
I,Pub. Wks. Appr
!
- Datc of permit issnc
1
Total Permit:fcs