08-0441 (RPL)P.O. BOX 1504'
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application' description
Property Zoning:
Application valuation:
X08-0-0-000.441
-80465 VIA TALAVERA
772-250-999-149 -30357 -
POOL - RESIDENTIAL
LOW'DENSITY RESIDENTIAL
15000
Architect or Engineer:
.a 1A_
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 icense No.: 810111
at '` -�% ntractor.
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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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 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 _ 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.).
(_ 1 1 am exempt under Sec. , BAP.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: - i
Lender's Address:
LQPER\11T
Owner:
MARVIN GRAY.
80465 VIA TALAVERA
LA QUINTA, CA 92253
Contractor:
PICASSO POOLS INC
78078 COUNTRY CLUB DR,
-BERMUDA DUNES, CA 9220
(760)345-4600
Lic. No.: 810111
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/13/08
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
y3�7,0000 of the La r Co, s all fo hwith c ply with those provisions.
te: "tl plicant:
WARNING:* FAILURE TO SECURE WORK ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES A$ 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 to building constr ction, and hereby authorize representatives
of this county to enter upon above-mentioned propert nspection pureses.
te: 7'9 nature (Applicant or Agent):
Application Number .
. . . . 08-00000441
Permit . ...
BLDG POOL PERMIT
Additional desc .
Permit Fee.
162.00 Plan Check
Fee_
105.30
Issue Date . . . .
Valuation
. . .
. 14936
Expiration Date
9/09/08 _
Qty Unit Charge
Per
Extension _
BASE FEE
45.00
13.00 9.0000
THOU BLDG 2,001-25,000
117.00
Permit
MECH POOL
Additional desc .
Permit Fee . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
9/09/08
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
Fee11.25
Issue Date . .
Valuation
. . .
. 0
.
Expiration Date
9/09/08
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
9/09/08
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
' Permit . . . ... . WALL/FENCE .PERMIT
' LQPERAiIT
Application Number . . . . 08-00000441
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date Valuation
. . .
. 64
Expiration Date 9/09/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
------------------------------ ---------------------------------------------
Special Notes. and Comments
POOL/SPA, 4 L.F. 4'' EQUIPMENT WALL, CITY
STANDARD. GAS STUB OUT FOR FUTURE AND
SEPARATELY PERMITTED APPROVED BBQ.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited
Due
Permit Fee.Total. 281..00 .00
.00
281.00
Plan Check Total 131.30 .00
.00
131.30
Grand Total 412.30 .00
.'00
412.30
LQPERn4IT -
Rin g
G•y o Lg Quin.b
Bdi& :E Safety Division
P.O. Box 1.504, 784rS- CaUe Tampim .
1a .QL irm, CA 922-5s" - (760) 777-701
adinc Pernut AppEcarion and Tracking
Permit �\
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ue PLAN FOR ;
,� • Q� GRAY RESIDENCE
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' }g 'ADDRESS: 80-465 VEA T VERA .
LA QUI NTA CA s s r•
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*' POOL { . .
+i K SIZE: 35' 5" x 17'6"
a v u AREA: 597 SF ..
LIC #810111 - �` y y e '] - t n 'PERIMETER 125 LF
_ + � � � �. i � DEPTH: -3' 6" TO -5' 6"
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t SPr1. SIZE' 9'x 7'6'
C7 V r ..^M . �' c t. G t Ft?� • '` . '_' AREA: 53 SF '.
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