05-2940 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00002940
44540 VIA TERRA NOVA
604-032-999-5 -305212-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
�oNTnA 0 -1-0 n
T4ht 4 4 Q"
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Cie : I , License Po.: In
te:
aj(/j� )Contractor/
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. 7031.6, Business and Professions Code: Any city or county that requires a Nernii[ 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 (5500).:
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 ISec.
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—) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-70127
FAX (760) 777-7011
INSPECTIONS (760) 777-7153,,
Date: 7/15/05
Owner:
LIPPERT
44-540 VIA TERRA NOVA
LA QUINTA, CA
LA QUINTA, CA 92253
Contractor:
REMBRANDT POOLS & SPAS
INC
WCC: STATE FUND
WC: 1744664
10/01/05
CSLB: 800680
11/30/06
__-----_--________
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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.
XI 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 C53 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 California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall f with comply with [hose prov' ions.
atB' e: plicartf:
WARNI G: FAILURE TO SECURE WORKERS' COMPENSATION COVE GE 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 ce�ifyaut I have read this application and state that the above information is correct. I agree to comply with all
city nty ordinances and state laws relating to build'ng construction, and hereby author' a representatives
of toe to\`ypon the above-mentioned pr e r insp - p poses.
Date: co
(Applicant or Agent): f/
Application Number . . . . . 05-00002940
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check Fee
134.55
Issue Date . . . .
Valuation . . .
. 19760
Expiration Date . .
1/11/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit . . .
MECH POOL
Additional desc-. .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
1/11/06
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
1/.11/06
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
1/11/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2 00 6.0000
EA PLR FIXTURE
10:00
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
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
Application Number . . . . . 05-00002940
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 15.00
Plan Check Fee
.00
Issue Date . . . .
Valuation .
. 240
Expiration Date . . 1/11/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. 15 L.F. 4- EQUIPMENT
WALL,.CITY STANDARD. ALARMS/BARRIERS
SHALL BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION.
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 326.00
.00 .00
326.00
Plan Check Total 160.55
.00 .00
160.55
Grand Total 486.55
.00 .00
486.55
LQPERMIT
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City of La Quinta
Building S Safery Division
P.O. Box 1504, 7B-495 Cale Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Z 9 �(-0
Project Address: 11-115�40 //9- AJo
Owner's Name: 7/
\��°ZA
A. P. Num QUIj—,r iJC2 �A
Address: V/ l`3, %�-,�1� A]()
Legal Description:
City. ST. Zip: (,(
Contractor.�Pn
FTelephone:
p /�
Address: ''f O d U� A (> �%(� j �J
Project prion: f M31 JL 2a I `1 y /
``�
Ciry, ST, Zip: L�� L(? A) 7-4
Telephone: - -712 Z t � •' - ' =
k A,0,4I I
G L-- 7-7-- v 2 04
State Lic. # : o C j� City Lit #:
Arch., Engr., Designer.
S (/ I�/n C� CJA-L-1
Address:
t+1 w
City. ST. Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: LI- f j _3 11-qr
FL: O[7
N Stories:
N Units:
Telephone # of Contact Person: C S 3�
kilnwcdValue of Project: 2,,t'/'L-)0d
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
13 J01
item
Amount
Structural Cala.
Reviewed. ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Cbeek Balance
Energy Cales.
Plans picked up
Consruction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
V Review%. ready for correctionsliissre
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALE
H-O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Devebper Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. APpr
Date of permit issue
School Fees
Total Permit Fees
2 Vo
I9 deo
C,S4
9
18'9" TO P/L
POOC
CORNER OFA gFNT IN TH
CK ygRo lS
W
a
7'-1" R
9
+42"
+36
3'-0" R
5'-0" R O 7'
DEEP
ra 6'-6" R O
WATERFALL
4'-6" R BENCH
4'-3" R
rp
�Xa
316ft 5'-0" R s, i
DEEP 7\
CITY OF I -A QUI110!
BUILDING & SAFETY DEP i
APPROVED
FOR CONSTRUCTION
DATE 21 ( 3 /°$ BY TA
XIZ ,p
I )� I -I
r/
E
+12" RBB
+42" BOULDER
WATERFALL W/
1-100 W LIGHT
17'-5"
EMBRAND
POOLS & SPAS INC
CA. LIC. 800680 C-53
78-910 VIA VENTANA
TEL (760) 771-21222153
FAX (760) 771-2181
POOL & SPA SPECS
POOL SIZE: 35'X 21'6"
POOL AREA: 606 SF
POOL : 128 F
POOL DEPTH: 3'6" TO 7'
SPA SIZE: 7' DIA.
SPA AREA: 38SF
SPA PER: 22 FT
DECK AREA: BY OTHERS
COLOR/FINISH:
PUMP: 2 HP
FILTER: 460 SF
HEATER: 400K BTU
CONTROL: RS4 2— CONTROLS
CHLOR: SALT
CLEANER: NAVIGATOR
PLASTER: PEBBLE
TILE: QUARTZITE
POOL LIGHT: 1-40OW
SPA LIGHT: 1-100 W
RBB:
MISC: 1— WF UPLIGHT
1- 2HN WI- PUMP
DAVE & KELLY LIPPERT
ADDRESS: 44540 VIA TERRA NOVA
CITY: LA QUINTA
LOT: LA QUINTA DEL ORO
DATE:03/09/05
SCALE: 1 "=8'
DRAWN BY: JW
JOB :