10-0778 (RPL)P.O. BOX 1'504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000778
Property Address: 52555 VINO
APN: 767-660-014- - -
Application description: POOL_ - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 21000
Applicant:' Architect or Engineer:
alR
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LICENSED CONTRACTOR'S DECLARATION
I
+
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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. .
LC;Ctor:
a;s: C_0 License No.: 802919
OWNS - ILDER 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 703.1 .5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _) 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 _ 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY r '
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: A
VOICE (760) 777-7012
FAX (760) 777=7011
INSPECTIONS (760) 777-7153
Date: 8/19/10
Owner:
FIAMENGO
52555 VINO
LA QUINTA, CA 92253 `
O1
Contractor:
AZURE POOLS AND SPAS
P.O. BOX 10641
PALM DESERT, CA 92255 H
(760)322-7665 U
Lic . No.: 802919 CIZ� Q¢. Riot —
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 DELOS INS CO Policy Number 03DKRMI2002794
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 agrA that, if I should bee a subject to the workers' compensation provisions of Section -
/X^lam . a70d ,ZbSe Labor Code, L a rt 'th comply with those provisions.
�e:y �`f/) f plicant:
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 1$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 arid 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.
1 certify that I have read this application and state that the above information is correct. I agree to comply with all '
city and county ordinan d state laws relating to buildinM�s hereby authorize representativesof this c� er above-mentioned property f -
i )))nature (Applicant or Agent):
LQPERMIT
W
Application Number
'10-00000778
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
21G.00 Plan Check Fee
.140.40
Issue Date . . . .
Valuation
21000
Expiration Date
2/1b/11
Qty Unit Charge
-Per
Extension
BASE FEE
45.00
19,00 9:0000
THOU- BLDG 2,001-25,,000
171.00
Permit ... .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
' Issue Date
Valuation
0
Expiration Date
2/15/11
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 ..
2/15/11
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 . . . .
3.3.00 Plan Check Fee
8.25
Issue Date
Valuation
0
Expiration Date
2/15/11
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 174 OUTLETS
3.00
Permit '
WALL/FENCE PERMIT
LQPERMIT
Application Number . . . -10-0.0000778
Permit WALL/FENCE PERMIT.
Additional desc .
Permit Fee . . . . 15:00
Plan Check
Fee
.00
is§u(e Hate . . . .
Valuation
224
Expiration Date 2/15/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
POOL/SPA, WATER FEATURES/BOWLS, FIRE
FEATURE AT BACK OF POOL, 14 L.F. 3- AC
ENCLOSURE, CITY STANDARD. SHADE
ENCLOSURE AT.POOL EQUIPMENT, BBQ &
FIREPIT BY SEPARATE PERMIT.
-
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER .INSPECTION. 2007 CODES.
Other Fees . . . . : BLDG STDS ADMIN (SB1473)
1:00
Fee summary Charged Paid
Credited
Due
Permit Fee Total 335:00
.00
.00.
335.00.
Plan Check Total 166.40
.00
.00
166.40
Other Fee Total 1.00
.00
.00
1.00
Grand Total 502.40
.00
.00
50.2.40
LQPERMIT
Bin #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # ^I
Project Address: rj Z C�: vi Yl o
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:,AJ I s S
I%� V Ol
City, ST, Zip:La Ovin,
Y : _ �:•k�fi
Telephone:
Ate
Address: C)
Project Description:
City, ST, Zip:
)'
a G� s'
Telephone: 0 , -3 Z Z ?W
State Lic. #: City Lic. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
•.-
State Lic. #:
i
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:
# Stories:
#Units:
Telephone # of Contact Person: E) .1:7Z.-
Estimated Value of Project: IT.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIUNG A
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Coles.
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.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:- .
3a Review, ready for corrections4s.sue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees