06-2663 (RPL):J. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
• Application valuation:
Applicant:
06-00002663
80580 VIA TERRACINA
772-250-999-108 -30357 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
c&ty/ 4 4 a"
Architect or Engineer:
Pill
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TIM & JANE TRAVER
80580 VIA TERRACINA
LA QUINTA, CA 92253
Contractor:
Owner .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
I
Date: 7/14/06
JUL 17 2006 L
CITY OF LA QUINTA
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions 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 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: License No.:
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor:
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
ode, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
nce vier andjDolicy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
Career Policy Numbe
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
I certify th t, in the performance of the work for which thi 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 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
and agree that, if 1 should bec a subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
IF 3700 of the Labor Code al with comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
L
any plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Dater- �T'�%4plicant:
( 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
WARNING: FAILURE TO 139:1—REYORKERS' 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.).
(_) 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 contractors) licensed
pursuant to the Contractors' State Licens a .).
(_ 1 I am exempt under Sec. , B firrfor isn
Date: T2%�Owner:
CONRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury t the construction lending agency for the performance of the
work for which this permit is issued 1 . 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERAIIT
�l
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 ab ' formation is correct. I agree to comply with all
city and county ordinances and state laws relating to buil ' g co tructi n, and hereby authorize representatives
of this county to enter upon the above-mentioned pro rty f r ' sp , purposes.
Date: -O4gnature (Applicant or Agent):
Application Number . . . . . 06-00002663
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. . .
. 19524
Expiration Date
1/09/07
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
E:tpiration Date
1/09/07
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
3.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
1/09/07
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 . .
1/09/07
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
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
i
Application Number
Permit . . .
Additional desc . .
Permit Fee . .
Issue Date . . . .
Expiration Date .
Qty Unit Charge
. . . . 06-00002663
WALL/FENCE PERMIT
15.00 Pi
V
1/09/07
Per
an Check Fee . . .00
aluation . . . . 476
Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 22 L.F. 5' EQUIPMENT WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 326.00 .00 .00 326.00
Plan Check Total 153.05 .00 .00 153.05
Grand Total 479.05 .00 .00 479.05
LQPERMIT
Big #
City of La Quinta
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 .#
Project O.$8c-) �! 2
Owner's Name: f� ieTK t? Q ✓el'
A. P. Number:
Address: J25 -9d Q e X12
Legal Description:
Contractor: -
Address:
City, ST, Zip: 4 �e CQ , F,? -2 S 3
Telephone: 6o _ 71— a. e3
Project Description: oOl
City, ST, Zip:
Telephone:
_2 2 L A Ff s
State Lie. # : City Lic. #:p
Arch., Engr., Designer:
-
L
Address:
City, ST, Zip:
Telephone:Construction
Type: e ccupancy:
State Lie. #:
Project type (circle one): ew A d'n Alter Repair Demo
Name of Contact Person: ,f �.av
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 6 p _ 2 $Q —. Q673
Estimated Value of Project: 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Energy Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan*
2"' 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:
3" Review, ready for corrcetions/'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
ap pv0
15z
OWNER/BUILDER INFORMATION
Dear Property Owner
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you msy protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contract: are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own .abor and material personally.
Building permits are not required to be signed by property owners unless they ar? performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractor;' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760 '77-7ow
EY,�3'SIGNATURE/DATE
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PROPERTY ADDRESS
06--�>3
PERMIT NU BER(S)
th& fly H4� btAtwew
77725 Enfield Lane, #130
Pain Desert, CA 92211
(760) 772-4411 FAX (760) 772-4409
drpfly@ aoLcon
BY 20 DATE �Z
REVISED
MENS
51518 Via Sorento
Mountain Vlew Estates
La O nta
CLIENT: DESERT PAVER5 AND CUSTGM CONCRETE
80-550 Via Terrains
La G2uinta, GA Q2255
(160) 771-6685
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# 12-133
PAGE_
OF
200a IBC
2010 California Building Code
#4 HORIZ. CONT.
AT TOP
(TYP.)
12" CMU, SOLID GROUT A_L CELLS
(TYP.)
#4 VERT. AT 16" O.C. (TYP.)
DOWEL INTO EX. PO L WALL
WALL 5" MIN. WITH 111PSON
• I SET -XP EPDXY
(ICC -ESR 2508)
SPECIAL INSP. REQ'
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ASSUME-REINF.:
I #3 VERT.
AT 6" 0. C.
\ (TYP.)
GUNITE STRENGTH: F'C = 2500 PSI AT 28 DAYS
STEEL STRENGTH: FY = 40 KSI GRADE 40, ASTM A615
MASONRY STRENGTH: F'M = 1500 PSI
QPAFESS/p,��
F
R. F�F�lI vF
No. 33446
&p. 6-30-14
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SCALE: 112" = 1'-0"
CMU MALL. ON POOL BOND BEAM POOL -1 I A I
V`N L3f 4V1L V7: 30
100 f f 1 L040 I KHVLM t UIVS I KUB; I lUIV t'HUt l73/ !3J
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CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS 60-580 1hA7ft�C1>JA PERMIT NUMBER 0(o- Vy(o3 OWNER hM -FRAkJGP-- BUILDER a VOR
This form shall be posted on thejob with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the. Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "un riie" is not an acceptapie response.
TtadP l Claaf�cation - or
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# OF JETS: .
LIGHTS:
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ELEVATION:
DEEP RAMP:
BENCH/TAN-LEDGE:
CONC/SOD REMOVAL
TREE REMOVAL:
IRRIGATION REPAIR:
RBB LENGHTS:
ROCK POCKETS:
POOL PUMP: BOOSTER
BOOSTER PUMP:
HEATER:
TIME CLOCK:
POOL CONTROL,8
RETURN INLETS:
SKIMMER:
AUTO -FILL:
GAS LINE:
STUB OUTS:
CASCADES:
SPRAYHEADS:
POOL LIGHTS:
SPA LIGHTS:
PLUMBING SIZE:
STUB SET EQ:
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GATE TYPE:
R&R GATE:
BBQ
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BBQ MODEL:
TOP FINISH:
SIDE BURNER: a
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PEN LIGHT: c
PLUG OUTLET: n
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