06-2202 (RPL) �� IIIIIIIIIIIIIIIIIIIIIIIII 61
ihtP.O. BOX 1504 IE -- -, 4 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
Date: 5/30/06
Application Number: 06-00002202 Owner:
Property Address: 80849 CALLE AZUL CHAVIS
APN: 762-240-003-50 -300962- 80-849 CALLE AZUL
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM DENSITY RES n
Application valuation: 20000 D [�
Contractor: JUN
O� 2006
Applicant: Architect or Engineer: FAMILY POOL CONSTRUCTIO JUN
P 0 BOX 283
LA QUINTA, CA 92247 CITY OF LA QUINTA
/� (760)564-3655 FINANCE DEPT.
I►" ' Lic. No. : 658996
------- - - - - - ----- - - - ---- - - --- - -- --- --- - - - ---- - ------ --- - --- - ---- ----- -- --- - -- - - - ----- -----
�thdl'S�'Ilicc�nss'oee,�f
TRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7 00) f Division 3 of the Busrofessionals 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
LicenseC s: 5 , License No.: 658996 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
ate: O Contractor: _ 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-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1344032-06
following reason(Sec.7031.5,Business and ofessions Code: Any city or county that requires a permit to _ I certify that,in the perf rmance 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 manne s' as to become ject 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 s I ecoma sub' ct 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 - 700 of the Labor I shall f rth ith 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 �
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).: Date. -Applicant:
(_) 1,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: FAILURE TO SECURE 0 ERS'C PENSATION 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 CRIMINA ENALTI SAND 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 0100,000). IN ADDITION T 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
(_) 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 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 issuan o this pe�ve
i�information
Date: Owner: 2. Any permit issued as a result of this pylic tion void if work is not commenced
within 180 days from date of issu ce of ch ion 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 certif that I have read this application and state that th is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city co my ordinances and state laws relating o ing construction,and hereby authorize representatives
of t is yJ6 enter upon the above-mentioned p for inspection purposes.
Lender's Name:
ate. IISignature(Applicant o nt
Lender's Address: _
LQPERMIT
Application Number . . . . . 06-00002202
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 207..00 Plan Check Fee 134.55
Issue Date . . . Valuation . . . . 20000
Expiration Date 11/26/06
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 . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0 .
Expiration Date 11/26/06
Qty Unit Charge 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 11.25
Issue Date . . Valuation . . . 0
Expiration Date 11/26/06
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 . . 11/26/06
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
SPA & FOUNTAIN ONLY
LQPERAIIT
Application Number . . . . . 06-00002202
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ---------- '
Permit .Fee Total 309.00 .00 .00 309.00
Plan Check Total 160.05 00 .00 160.05
Grand Total 469.05 .00 .00 469.05
LQPERWIT .
i
------------
Cid OF LA Q
UINTA
BUILDING & SAFETY DEFT.
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Lic, #658996
Bin# City of La Quinta .
0 Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit# La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: Owner's Name:
k6 DAW
IV
A.P.Number: Address: "
Legal Description: City,ST,Zip:
Contractor: M Telephone:
Address: Project Description:
City,ST,Zip: i -
Telephone:. 14 "'
State Lic.#: City Lic.#:
Arch.,Engr.,Designer:
Address:
City,ST,Zip: ly
Telephone: Construction Type: Occupancy:
F-Name
ic.#: Project type(circle'one): New Add'n Alter Repair Demo
f Contact Person: Sq.Ft.: #Stori s: #Units:
one#of Contact Person: a— Estimated Value of Project: "
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
Flood plain plan Plans resubmitted Mechanical K 1,,
Grading plan 2""Review,ready for correctionsliissue Electrical 5"VA 6
Subcontactor List
Called Contact Person PlumbingD OnP5 asZ
Grant Deed Plans picked up S.M.I.
H.O.A.Approval Plans resubmitted Grading
IN HOUSE: 3'Review,ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub.Wks.Appr Date of permit issue
r
School Fees
i
Total Permit Fees