08-0467 (RPL)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253 'BUILDING & SAFETY DEPARTMENT
f' BUILDING PERMIT
Application Number':
C ti08-00000467
Property Address:
54006 RIVIERA
APN:
775 -030 -024 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
50000
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION >.
I hereby affirm under penalty of perjury hat I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B in ss and Professional de, and my License is in full force and effect.
License Class: C53 ice se No.: 820132
e: ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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).: .
(_ 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 Cade: 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.).
(_) 1 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: ^u
Lender's Address: f
LQPERAIIT
Owner:
RIVIERA VILLAS
1651 E 4TH ST NO 228
SANTA ANA, CA 92701
Contractor: J
FPD SERVICES INC
43653 PARKWAY ESPLANA
LA QUINTA, CA 92253 ,
(760)772-1111
Lic..No.: 820132
V
VOICE (760) 777-7012. .
FAX (760) 777-7011 ,
INSPECTIONS (760) 777-7153
aP\
Date: 3/18/08
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 DLOS INS Policy Number 01DKRM12000631
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 uld become subject to the workers' compensation provisions of Section
3700 of the Lab C e, I shall forth o ply ith those provisions.
4ate: pplicant:
WARM G. FAILURE TO SECURE W RKERS' 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 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 pursuarit 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 ordinances and state laws relating to bu' ing construction, and h febl autf rize representatives
of thi my to enter upon the above-mentioned prop rt for,inspection pufn
Dater Si re (Applicant or Agent):
1
Application Number .
. . . . 08-00000467
" Permit
BLDG POOL PERMIT
Additional desc
Permit Fee
414.50.' Plan Check Fee
269.43
Issue Date
Valuation
50000
Expiration Date
9/14/08
"
Qty Unit Charge
Per
Extension
BASE FEE
252.00,
25.00 6.5000
THOU BLDG 25,001-50,000
162.50
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0_
Expiration Date
9/14/08
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
9/14/08
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 . . . .
36.00 Plan Check Fee
9.00
Issue Date
Valuation
0
Expiration Date ."
9/14/08
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-
2.00 3.0000
EA. PLB GAS PIPE 1-4 OUTLETS
6.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA,FIREPIT(HEAT&GLO-2QI-58-1995)GA
LQPERn7IT .
Application Number 08-00000467
Special•Notes and Comments
S SHUT-OFF REQUIRED WITHIN 36!' OF RING_
ALARMS/BARRIERS SHALL BE IN PLACE AT -
PRE -PLASTER INSPECTION -.EQUIPMENT -
ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited. Due
Permit Fee Total 521.50` .00 .00 521.50
Plan Check Total 296.18 .00 .00 296.18
Grand Total 817.68 00 .00 .817.68
LQPERn1IT
Bin # '
City' of La QuAnd'f -
Building a Safety Division r '
- P.O. Box. 1.5,04, 78=495 Calle Tampico {•"
La Quinta, CA 92253 - (760) 777.7012
i
Building Permit Application and Tracking Sheet
Rermit.# /�
1
r ri
Project Address: .5yCO(p
Owner's Name: J^odiL
A. P. -Number:
Address:
Legal Description:
Contractor. �- J t Gr= S Z�
City, ST, Zip: ;
Telephone: ( .
Project Description: '
Address: 53E
City, ST, Zip: Lp,
' - Z3 x _ -5 3 SCJ +V i 7i=. 7->00 L
Telephone: (o0:'I 2.IlII I
State Lic. # : 1R, -,Q 13'� City Lic. #:
Arch., Engn, Designer:
Sppt LJ I r
t
Address:.
City, ST, Zip:
11
Telephone:. j;
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy: -
Project type (circle one): New Add'n Alter. Repair Demo
Sq. Ft.:
# Stories: '
# Units:
Telephone # of Contact Person: -7(A20._)-7Z_ . (
Estimated Value of Project: ZP? <-;b
t. APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal—' _
Req'd
Recd
TRACKING .
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
Energy Calcs.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical '
Grading,plan"
2"d Review, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A..Approval
Plans resubmitted
Grading
,
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fees
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
'
School Fees
'
Total Permit Fees