05-5227 (RPL)P.O: BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153,
Date: 11/29/05
Application Number:
r'0 5-.0000.5.22.7
Owner:
Property Address:
.79914 VIENTO DR
COHN BRETT & CARA
APN:
609-380-999-36 -293234-
79914 VIENTO DRIVE
Application description: POOL - RESIDENTIAL
LA QUINTA, CA 92253
Property Zoning:
LOW DENSITY RESIDENTIAL
n
Application valuation:
20000,
D
Contractor:
DEC
Applicant:
Architect or Engineer:
HYSELL POOL COMPANY
O 5 1005
P O BOX 954
CATHEDRAL CITY, CA 922 5
CItyOF
(760)322-0834FpygN
EDEpTTA
I
-.
Lic. No.: 841120
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 Lice a No.:' 84 120
Date:nb tractor:
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 apermit 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.). '
(_ 1 I, as owner of the property, am exclusively contractingwith 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 am exempt under Sec. , B.&P.C. for this reason -
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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
WORKER'S COMPENSATION DECLARATION
Lhereby 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 E7 EMPT Policy Number EXEMPT
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, i hould become subject to the workers' compensation provisions of Section
3700 of the bor 1 oe, all forthwith cor'y►{,�►�y`with tho'se(Jp/r/�✓p S.
nt
WARNING: FAILURE TO SECURZAAAORKERS'COMPENSAJ19N CO GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C441L FINESVP 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
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, andAhe 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'ng construction, and ereby aPorize�rethsentatives
9J. -this county. to enter upon the above-mentioned pro erty spection pur os .s.i
Daterr
Sign e (Applicant or'Agent):
.:Application Number . . . . . 05-00005227
;
Permit . . BLDG POOL PERMIT
Additional desc
Permit Fee 207.00 Plan Check
Fee :
134.55
Issue Date Valuation
. . .
. 20000
Expiration Date 5/28/06
Qty Unit Charge Per -
Extension
BASEFEE-
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 5/28/06
. 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 _ 5/28/06
" 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 .. 5/28/06".
Qty'" Unit Charge Per
Extension
BASE ' FEE
15.00
2.00 6.0000.EA '" PLB FIXTURE
12.00
1.90, 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. ALARMS/BARRIERS SHALL BE IN
ILQPERMIT
rJ'
CITY OF LA QUINTA SUB-CONTR CTOR LIST r
(�— —�.� BUILDER
JOB ADDRESS C PERMIT NUMBER OWNER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their em oyees 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 File" Is not an acceptaDle response.
Trade / Classification
Contractor
State
,.......:......
Contractor s License
of ens Comperlsatioriansurance: `.;' ` : ° :''
City. Business
License: <.::
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/ x)
Carrier Name
le.g. State Fund, CalCompl
Policy Number
(Formant Varies)
Exp. Date
(xx9/�xx/xx) .
License Number '
Exp. Date
Ixx/2x�x/xx)
EARTHWORK JC712) : ;.
(� ► ' l r
' .. 11-IL
3�
lL�
Q �p c
! 0 (�0 �v✓
�� d�o�UC9
r(7xx(xxJ)
!i—1
CONCRETE (C-8) ` Nt
1
k
FRAMING :IC -51
STRUCT: `STEEL (C-51)
MASONRY (C-29)
PLUMBING, -(C-36)'
I)W
C6
LATH; PLASTER (C-35)
s! A FL)MD
0 46002-9'1
DRYWALL (C-9)..::'.
HVAC. (C-20)
ELECTRICAL. (C-10) :. .
00
ROOFING (6=391.`;.
SHEET METAL (C-43)
'77777777
FLOORING lC.:151;':';: `
GLAZING (C-17)`.
INSULATION'. (C-2)
SEWAGE DISP> (C-42)
PAINTING (6=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (CG27).:=:
_ a
POOL (C-53)
t