05-3978 (RPL)79907 Amora Dr
05-3978
IIIIIII VIII I I II II IIII 49
IE
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00003978
Property Address: 79907 AMORA DR
APN: 609-380-999-67 -293234-
Application description: POOL = RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL'
Application valuation: 20000
T-v4t 4 4 0"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GERTNER
79-907 AMORA
LA QUINTA, CA
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: HYSELL POOL COMPANY
WCC: EXEMPT
/ WC: EXEMPT
i-_ 4-,) CSLB: 841120
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section70 Lof Division 3 of the Busin ss and Professionals Code, and my License is in full force and effect.
License Cla s: 11mol
ate: Contr tor: I
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 foi a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 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.).
(_) 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_) 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 (760) 777-7153
Date: 9/13/05
I
u
SEP 5 2005
09/3 /0 '
06/ 0/06 CITyOF
FINgN c F%—_ _
A
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 C53 Policy Number - - - - - - - - - - - - - --
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,
nd agree that, ' shout ome subject to the workers' compensation provisions of Section
700 of the Labo Code, I sha forthwith coLyw,h those o ns.
Date: -Applicant:`7-1
WARNING: F 'LURE TO SECURE WOR S' COMPENS ON CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER PENALTIES AN IL 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 Ouinta, its officers, agents and employees for any act or omissionrelated 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 1 have read this application and state a information is correct. agree to comply with all
city and cow ty or finances and state laws relating t wilding co ruction, and hereby thorize represen rive
of this co / o ter upon the above-mentioned prop y for insp tion purposes.
Dat ( Signature (Applicant or Agent
Application Number .
. . . . 05-00003978
•7
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check Fee
134.55
Issue Date . . .
Valuation . . .
. 20000
Expiration Date
3/12/06
Qty Unit Charge
Per
Extension
BASE FEE
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
3/12/06
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
3/12/06
- Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.000O.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
3/12/06
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 ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number . . . . 05-00003978
----------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE
PRIOR TO PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT
INCLUDED IN
PERMIT.
Fee summary.
-----------------
Charged Paid
--------------------
Credited
Due
Permit Fee
Total 311.00 .00
--------------------
.00
311.00
Plan Check'Total
160.55 .00
.00
160.55
Grand Total
471.55 .00
.00
471.55
LQPERMIT
I -Bin
Permit #
vs- 3 9 7
Project Address:
A. P. Number:
Contractor: x Hl L J&)
Address: )( t,6946 Ta --1W4
-City. ST, Zip:
Telephone:
X
State Lic.#:)C._81112_0
Arch.. Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic.
Name Of ContactPerson:
Telephone # of Contact Person: y,'
$0 Submittal
2, Plan Sets
I Structural Calcs;
Truss Cafes.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building ff Safety Division .
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: Y
ZV/4jq UA &Z_IW64,
Address:
City. ST. . Zip: 4A oulta'A
Telephone: X46?aO,
Project Description:
4('76A `Wi TANNI'tw 50YC_LF
Q
r M LA57 DW 6F
City Lic.-#:Z5 RRY 1' --ft
4r13 I - I — k I I
I Total Permit Fees
Type:
I . Occupancy:
:ME=Construction
Project type (circle one):
New Add'n -Alter Repair Demo
11 4 —
Sq. Ft.:,x,#
Stories:
4 Units:
(06ZZ
,8 5 1
-7 ,
Estimated Value of Project: y,
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd
TRACKING
PERMIT FEES
Plan Check submitted
fte
Item
—
Amount
_v: d d
ie w: r 3, for correction
Reviewed, ready- for correction
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
Review, ready for corrections/issue
Electrical
Called Contact Person
Plum . bing
Plans picked up
SAIJ.
Plans resubmitted
Grading
Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
AJ.P.P.
Datcof permit issue
1_ _
I Total Permit Fees
MD4
-raL4\
O
LI
cam;
to
-7r
CITY OF LA QUINTA , r
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION I V
4c)( ,E F-x ,T/Ne
9-1
a H P 01 wj,4-r iI
CITY OF LA QUINTA SUB -CONT CTO LIST I
JOB ADDRESS i'"LC7C PERMIT NUMBER 05-- 3 °f It OWNER AK Cszf r BUILDER C[b
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. my 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
nf huildina permit. For each applicable trade, all information requested below must be completed by
Trade /Classification
Contractor
State.: Contractbr's License
Company Name
Classification
(e.g. A, B, C-81
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK 16-121
CONCRETE (C-8)
FRAMING'(C-51
UCT: STEEL jC-51)
MASONRY (C-29)
>
LUMBING (C-36)
ATH; PLASTER (C-35)
645655
6
446
DRYWALL (C-9) .:.
I IEL C
HVAC. (C-20)'.
.: ..
ELECTRICAL. (C-10)' :....
Y6 v
N
RQOFING`IC7,391'.:`
SHEET METAL (C-43)
FLOORING (C=:15);
GLAZING (C-17)'.'
INSULATION'.(C-21.
SEWAGE DISP; (C-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (C-27.) ".
POOL (C-53)
` ii