09-0977 (RPL)T44tt 4
P.O. BOX 1504 �VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/11/09
Application Number: 09-00000977 Owner:
Property Address: 80092 VIA TESORO TOLL CA V
APN: 772-250-018-3 -31349 - C/O KEVIN D DUERMIT
Application description: POOL - RESIDENTIAL 8901 E MOUNTAIN VIEW 200
Property Zoning: LOW DENSITY RESIDENTIAL SCOTTSDALE, AZ 85258
Application valuation: 17000
Contractor: kCtITYOF
Applicant: Architect or Engineer: PICASSO POOLS INC
41800 WASHINGTON ST B105-43BERMUDA DUNES, CA 9220317 2009
(760)345-4600
LiC. No.: 810111 lA QUINTA
FINANCE DEPT.
--- ---------------------------------------------------------------------------------------
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
7Licse Class: B C27 CS License No.: 810111 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: - (i ntractor: 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 290-0001790
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this 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 I should become 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 3700 of the LabModshall forthwith co�Iithhose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 4
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:e: �` 1) A scant:
1-) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and e
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' 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.). APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7094, Bt19i.,99r, •+nn Prnfossinns CndP: The, CQnt(ayt9rs' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a 666traCtor(sl uceriseu 1. Crrah p9r9on ..f+nn ...hnse hehalf this e,rinlicat1411 IS made, each Person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued m a result of tills apNutadui.,
I—) I am exempt under Sec. , BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop toorj, pec tion purpo
atm e. "� i'D nature IAppticant or Agent): l/\.y
Application Number . . . . . 09-00000977
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
180.00 Plan Check
Fee
117.00
Issue Date . . . .
Valuation
. . .
. 17000
Expiration Date . .
3/10/10
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
135.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
3/10/10
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 . .
1
Permit Fee . . . .
15.00 Plan Check
Fee
3.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
3/10/10
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Permit . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
33.00 Plan Check
Fee
8.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
3/10/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1:00 3.nnnn
RA PTB WATER INST/ALT/REP
3.00
1.00 3.0000
----------------------------------------------------------------------------
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Permit . . . WALL/FENCE PERMIT
Additional desc . .
LQPERMIT
Application Number . . . . . 09-00000977
Permit . . . . .
. WALL/FENCE PERMIT
Permit Fee . . .
. 15.00
Plan Check Fee ..
.00
Issue Date . . .
.
Valuation . . .
. 64
Expiration Date .
. 3/10/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG-STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged Paid
--------------------
Credited
---------------------
Due
Permit Fee Total
269.00
.00 .00
269.00
Plan Check Total
135.50
.00 .00
135.50
Other Fee Total
1.00
.00 .00
1.00
Grand Total
405.50
.00 .00
405.50
LQPERMIT
1
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PEP!,"IT FEES
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ccus uetion
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Date or permit issue
a
Total Permit Pcrs
SPA:
9'6" x 66"
@ +18"
STACKED STONE SPILL
-6"
W/D o
cc
ITiT/I w
POOL:
36'6'x 14'
TILE WATER LINE
T- 5 WATER DEPTH
PEBBLE FINISH
CONCRETE COPING
TANNING SHELF @ -6" W/D
QDH - MTV 374
LIC #810111
Vw/D
36'-6" io10'-0"
G�
P/B
09/09/09
POOL
SPA
CONCRETE
AREA:
380 SF
49 SF
223 SF
PERIMETER:
105 LF
26 LF
1B"=1' SCALE
PAVERS: 809 SF
80-0'12 via
LA QUINTA
TBI - 3
COURTYARD AREA
INSTALLED BY TOLL
TESORO
CITY OF LA 01
BUILDING & SAFE
AP FkO ul
FOR C
BY_
DAT.E.
CITY STANDARD WA
4'W
4' T
6" THICK
STUCCO AND PAINT
TO MATCH HOUSE
HEATER TO BE
4' AWAY FROM
OPENING WINDOW
IN -TA
DEPT•
wD
�Y
4..ti
A'. .
IN -TA
DEPT•
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