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12-0240 (RPL) IIIIIIIIVIIIIIIVIIIIIII 46 ' P.O. BOX 1504 --�E 4- - ��^��N^� VOICE(760)777-7012 78-495 CALLE TAMPICO FAX(760)777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT --� Dated 3/19/12 Application Number: 12—.:00000 4242 0� Owner. Property Address: G'80920 CALLE AZUL ROGER GOODWIN APN: 762-240-003-31 -300961- 80920 CALLE AZUL Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 ;, t ;.:'; A .� 2012 V Property Zoning: MEDIUM DENSITY RES Application valuation: 18000 ?.:O�iJBPdaA Contractor: E Applicant: Architect or Engineer: MCRAE POOL & SPAS 791. 05 DESERT STREAM DR / LA QUINTA, CA 92253 I (760)774-6343 ` Lic. No. : 823017 -- ------ --------------------- ---------- - - ------- -------- ------- ------------- --------- -------- - --- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions 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 have and will maintain a certificate of consent to self-insure for workers'compensation,as provided ' License Class: C53-C27 License No.: 823017 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is Q �— issued. ate: �� / ' g tractor: .� ✓ Y 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 OWNER.BUI ER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1950505 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the performance of the work for which this permit is issued,I shall not employ any construct,alter,improve,demolish,or repair any structure,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 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should become subject to the workers'compensation provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3 00 of the Labor Code,I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ell 9//7/ 1-1 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).: Date: v �•//� can ( 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 WARNING: FAIVdRE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 or she did not build or improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT 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 this application. 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_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 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. Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city d county ordinances and ate laws relating to building construction,and hereby authorize representatives of is county t en�si on a above-mentioned property for inspection purposes. Lender's Name: // Date:3 � 2ature(Applicant or Agent). Lender's Address: LQPERMIT Application Number . . . . . 12-00000240 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 9/15/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 ---------------------------------------------------------------------------- Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . . . Valuation . . 18000 Expiration Date 9/15/12 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 THOU BLDG 2, 001-25,000 144.00 ---------------------------------------------------------------------------- Permit . . . ELEC POOL PERMIT-RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/15/12 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 9/15/12 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 ---------------------------------------------------------------------------- Permit . . . . . WALL/FENCE .PERMIT LQPERMIT Application Number . . . . . 12-00000240 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 96 Expiration Date 9/15/12 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, STUB-OUTS FOR FUTURE BBQ & FIREPLACE, 6 L.F. 4 ' EQUIPMENT ENCLOSURE. ALARMS%BARRIERS SHALL BE IN PLACE AT PRE-PLASTER INSPECTION. 2010 CODES. -=-------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 308.00 .00 .00 308.00 Plan Check Total 148.85 .00 .00 148.85 Other Fee Total 1.00 .00 .00 1.00 Grand Total 457.85 .00 .00 457.85 LQPERMIT Bin.# Cjtj/ 0f !:d C�Who r Buil ing 8L.Safety Division Permit# P.O.Box 1504,78-495 Calle Tampico. ' La.Quinta,CA 92253-:(760)777-7012 Building Permit Application and Tracking Sheet Project Address: .Ro WE Owner's Name:. A.P.Number Address: Legal Description: City,ST,Zip: ) 7 Contractor. C Telephone: . 3 Address: 7 —/ - Project Description: Q/ SOA cvdU City,ST,Zip: r t 7'- 4 Telephone• / q' IL i • f7 C, 4 State Lia# City Lia#; Arch.,Engr.,Designer. Address: City.,ST,Zip: Telephone: �2 Construction Type: Occupancy State Lia#: �• =� Project type(circle one): New Add'n Alger Repair Demo Name of Contact Person: Sq.Ft.: #Stories: #Units: Telephone#of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WF1TE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Calcs. Reviewed,ready for corrections Plan Check Deposit. . Truss Cala. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan 2''Review,ready for correctionsfcssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Pians picked up S.M.I. H.O.A.Approval Plans resubmitted Grading IN HOUSE.- '^'Review,ready for correctionAssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub.Wks.Appr Date of permit issue School Fees Total Permit Fees CITY OF LA QUINTA BUILDING &SAFETY DEPT. APPROVED FOR C NSTRUCTiON ,< Zs -� DAT y 160-TT2-2440 Q U N Z W N NIFW Oa) -CON-CRETE CLM z Q PROPOSE s W WAL _ BBQ NEW CONCRETE0 CJ) NEW CONCRETE .A. S P00 EQUIP ENT 'p`C � � w RESIDENCE J MIT TANNING ,� Z 3 » SHELF —9 - _31 � Cly ® w ( �� J 5' z O +001 to p v POOL w BENCH SPA 5'X7° ' -- r-6" —5 f +6„ 0 -- 17'-7" ODW J U H W W 0 N �O SCALE: 1/8" = T-O"