09-0149 (RPL)4 4
P.O. BOX 1504 Qum&
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000149 Owner:
Property Address: 80204 VIA TESORO SCOTT PAVLOFF
APN: 772-250-018-10 -31349 - 80204 VIA TESORO
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3'/90U
Contractor:
Applicant: Architect or Engineer: MC CALLUM POOLS
46576 VIA CELESTE
�O�-- INDIO, CA 92201
(760)775-5685
Lic. No.: 818835
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: C53 License No.: 818835
Date: 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 .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 ($500).:
(_) 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.).
(_) 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—) 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
VOICE (760) 777-7012
FAX (760)' 777-7011
INSPECTIONS (7.60) 777-7153
Date: 2/20/09
o-'`-• � ice..-,- ` 1
L�
< :7f.
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 EXEMPT Policy Number EXEMPT
_ 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 1 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: Applicant:
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 to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Application Number . . . . 09-00000149
Permit . . . MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check Fee 6.50
Issue Date . . . Valuation . . . . 0
Expiration Date 8/19/09
Qty Unit Charge PerExtension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
----------------------------------------------------------------------------
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 336.50 Plan Check Fee 218.73
Issue Date . . . . Valuation . . . . 37900
Expiration Date 8/19/09
Qty Unit Charge Per Extension
BASE FEE 252.00
13.00 6.5000 -THOU BLDG 25,001-50,000 84.50
----------------------------------------------------------------------------
Permit . . . ELEC POOL PERMIT -RES
Additional desc . .
Permit Fee . . 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Expiration Date 8/19/09
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 . . 8/19/09
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, MASONRY BBQ ISLAND (INSERT
LQPERMIT
Application Number, . . . 09-00000149
---------------------------------------------------------------------------
Special Notes and Comments!;
APPLIANCES BY HOMEOWNER).
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED.
----------------------------------------------------------------------------
Other Fees . . . . . . . , . BLDG STDS ADMIN (SB1473) 2.00
Fee summary Charged
Permit Fee Total 440;50
Plan Check Total 244!73
Other Fee Total 2.00
Grand Total 687:23
LQPERMIT
Paid Credited Due
.00 .00 440.50
.00 .00 244.73
.00 .00 2.00
.00 .00 687.23
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CITY CODE
REQUIRMENT
QUARTZITE STONE BAND FINISH EQUAL POTENTIAL
BONDING GRID
in
.1.12' RAISED 20'
DECKING
POOL
PEBBLE FINISH
\ N SP
3'-6";k
7'- 6"
I
i POOL STEPS
-6"-12._18•
i INTO POOL
Ij COVERED PATIO
+ P.B
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yDECKINr -0- p,g —
ELEVATION LLVEL
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EXISTING HOME POOL EQUIPMENT 00.
2 -PENTAIR V45PERFLUVVPUMPS
1-420 CARTRIDGE FILTER
1-400,000 BTU HEATER
I AND CONTROLL SYSTEM FOR AUTOMATION
EXISTING GAS & ELECTRICAL
STUB OUTS
FOR POOL EQUIPMENT
r,
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P.B iI
+111" RAISED SPA
W/STAKED STONL
SPILLWAY .JETS LOCATION
TO BE DETERMINED BY H.O.
I.
2 -STEPS t6" AND +17."
�Alstu
P.B
4'
7'-0"X2'-6" BBQ ISLAND
QUARTZITE STONE FINISH
INSERT APLIANCES PROVIDED
UY. H.O.
J -BOX FOR
POOL LIGHTS
& AIR LINE
DECK DRAINS TO
FXI.STING DRAINAGE SYSTEM
P.B
,I
EXISTING HOME
Feb 12 09 02:41 p mccallum pools 7607755685 p.1
Bing
City of La Quinta
Building and Safety Division
P.O. Box 1504
78-495 Calle Tampico
La Quinta, CA 92253
Pernzitg
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Building Permit and Application Tracking Sheet
Project Address: 80-204 Via Tesoro
Owners Name: Scott Pavloff
A. P. Number:
Address: 80-204 Via Tesoro
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: MCCALLUM POOLS
Telephone: 760-777-6699
Address: 46-576 VIA CELESTE
Project Description:
City, ST., Zip: INDIO, CA 92201
Pool and Spa
Telephone: 775-5685
0
State Lic. # 818835 City Lic.# •
Arch- En r., Designer:
Address:
City, ST. Zip:
Telephone:
Construction Type: Occupancy:
Project Type: New Add'n Alter. Re air Demo
State Lic. #:
Contact Person: JOE
Sq. ft. # Stories: # Units:
Telephone of Contact: 275-6403
Estimated Value: $37,900.00
I CITY OF LA QUINTA SUB—CONTRACTOR LIST
JOB ADDRESS Yo - aUy - V I G +Ccs .o PERMIT NUMBER OWNER Uo BUILDER. V'n'CC8' �l �., Qc�r���
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. bnly 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
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License Number
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Exp. Date
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(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
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Exp, Date
(xx/xx/xx)
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SEWAGE DISP (C-42)
PAINTING (C-334
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