05-4691 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application. description
Property Zoning:
Application valuation:
Applicant:
05-00004691
52075 AVENIDA OBREGON
773-214-015-4 -00000
POOL - RES'IDENTIAL
COVE RESIDENTIAL
8000 .
Architect or
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LAM LEONARD
111 CHELSEA CIR
PALM DESERT, CA 92260
VOICE (760) 777-7012
-FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Owner
---------------------------------
Date: 10/18/05
Lender's Name: nr
!'
Lender's Address:
LQPERMIT
or Agent): (` ,D��1 -�7
• LICENSED CONTRACTOR'S DECLARATION --
- :-WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury,that Iam licensed underprovisions 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 tiave'and will maintain a certificate,of.consent to self -insure for workers' compensation, as provided
License Class::. License No.:
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
1
issued.
Date " Contractor: -
_ I haveand'•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 workerscompensation
' ;� - OWNER -BUILDER DECLARATION'-
' insurance carrierand policy •number are:
' I herebyeffirm under penalty;of.perjury that I am exempt from the Contractor's State License Law for the
Carrier - • Policy Number
" following reason (Sec. 7031 :5; Busmessanii'Professions.Code:; Any cny or.county that-r'giiires a permit to
-Wl certify that' in -the performance of the work'for which this,permifis issued, I shall not:erriploy any
construct�elter, improve demolish, or: repair. any struc6re 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 signedstatemeni that he orshe is licensed pursuarit,to the provisions of the Contractor's State
and agree that, if I should become subject�rrh, workers compensation provisions of Section
bcense1Law'(Chapter 9i(commencing 4witli,Section 7000) of Division 3iof the Busmessiand Professions Code) or
700 of the Labor Codg, I shall forthwithply w'fftthose provisions.
_
i that he or she is exempt therefrom the basis for tlie,alleged exemption: ,. Any violaLoh of Section 7031 .5 by
4 ,
-and
any. applicant for a permit sublects.the applicant to.al civil penalty of not more'thin fivehuntlred dollars (5500).:
_
—Date R 6 A�licant:
(_) I;'as owner" property; -or my employees with wages as their: sole compensation, will do'the work, and
,the structure is not intended or:offeredfor. sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS'• COMPENSATION COVERAGE+IS':UNLAWFUL, AND SHALL -
Contractors''State;License Law"does,notapply to,an-owner of.property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES. AND CIVIVFINES•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 orishe did not build or
'improve for the purpose of sale.).' ' " - -- .,.
• APPLICANT ACKNOWLEDGEMENT
aIMPORTANT
.
`(W I, as owner of the property, am,exclusively contracting with licensed contractors to construct the project (Sec.
Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and, restrictions set forth on thisapplication.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 : Each person upon whose behalf this application 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 as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason)
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
i
of La Quints, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
Dal te: 1 i7 Owner:" �%�L
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 o work for 180 days will subject
CONSTRUCTION LEND GENCY
permit to cancellation. -
I hereby affirm under penalty of perjury that there is a constru ' ending agency for the performance of the
I certify'that I have read this application and state that the above information is cc rect. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C
'
city and county ordinances and state laws relating to building constructio eby au0orize representatives
of this county to enter upon the above-mentioned proper6&f 3)ins ction purpos' n
Lender's Name: nr
!'
Lender's Address:
LQPERMIT
or Agent): (` ,D��1 -�7
Application Number .
. . . . 05-00004691
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit-Fee
99.00 Plan•Check Fee
64.35
Issue Date
Valuation ..
8000
Expiration Date.. ,.
4/16/0.6
Qty Unit Charge
Per
Extension.
BASE FEE
.45.00
6'.00 9.0000
THOU. BLDG.2,001-25,000
54.00
Permit . .
MECH POOL
Addtional.desc .
Permit Fee'
24.00.. Plan Check Fee
6.00
Issue Date
Valuation
0.
' Expiration-Date. :
4/16/.06
Qty Unit Charge a
Per
Extension
BASE•.FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
Permit" . . .ELEC•POOL.PERMIT-RES
Additional desc .
Permit Fee:; :
45•.00 . Plan-Check Fee ...
3.75
Issue Date
Valuation ...
0
Expiration Date
•4/16/06
Qt:y Unit-'Charge
.Per
Extension.
BP;SE. FEE:
`15.00'
1:•00 30.0000
EA ELEC'PRIVATE SWIMMING'POOL
30.00`
Permit :PLUMBING
Pdd tiondl. de'sc
Permit Fee.
33.00 Plan.Check Fee
-8.25
Is"sue'Date
Valuation . . . .
0
Expiration Date
4/16/06
Qty Unit Charge
Per
Extension`
BASE FEE
15 : 00
2.00 6.0000
EA, PLB FIXTURE
12.00
•
1.00 3.00 '.00.
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
REPLACEMENT PERMIT FOR
EXPIRED.PERMIT
i�.
LQPERAIIT -
LQPERMIT
Application Number . . . . . 05-00004691
----------------------------------------------------------------------------
'Special Notes and Comments.
#0312-121 POOL/SPA ONLY..
ALARMS/BARRIERS 'SHALL BE IN-PLACE
PRIOR
TO PRE-PLASTER.INSPECTION.
Fee •summary Charged.
Paid
CreditedDue
Permit. Fee Total 201.00
.00
.00
201.00
_ Plan,'Check Total 82.35
.00'
.00
82.35
Grand Total 283.35
.00
.00
2:83.35
LQPERMIT
i La
ITY OF LA QUINTA
h � = EfUILDING & SAFETY DEPARTMENT
CF'yPOF Tt�'� CM
L _,' C\I I W 777-7012
I co !�OI�NSPECTION REQUEST LINE
cit I ka 777-7153
Cl_� � t o <l
Owner F,(D_fiT:ART) LAM
Contractor
Perm CN@_1jeri 0_lLZ_ 1
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 52-075 AVENEDA OBREGON
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE
U/G ELECTRICAL/ GROUNDING
FOOTINGS / STEEL
CONCRETE -SLAB
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED,
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
FRAMING COM81KATION
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION ,
u
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. (DRYWALL)
EXTERIOR LATH
GAS TEST
` SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING — L
U/G 'GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
ISM
, a..
ALL CONCRE !"a FLAT. .1I ORK SHALL BE r^.:aCyfD Ami
_.
MINIMUM OF 2" BELOW, r?%EEP SCREEDS.