RPL (05-4854)60410 Living Stone Dr
05-4854
78-495 CALLE TAMPICO (60) 777-7 0 2
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/03/05
Application Number: 05-00004854 Owner:
Property Address: 60410 LIVING STONE DR T RUSSEL
APN: 764-270=999-52300233- fes; !� 60-410 LIVING STONE
Application description: POOL..- RESIDENTIAL �"1 LA QUINTA, CA 92253 '
Property Zoning:. MEDIUM HIGH DENSITY RES p� -1'n35
Application .valuation: 800.0 i`ev 0 ! 2 31Y3
CITY 0_ �`, =4':rt Contractor:
Applicant: Architect or Engineer: FINANCE 11. MCRAE POOL & SPAS
WCC: EXEMPT
_.�. /� % WC: EXEMPT 09/30/06 .
& .KJ CSLB: 823017 08/31/07 '
-_y---- - --div- " -- ►'- -------`-'--�1
LICENSED CONTRACTOR'S DECLARATION
' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter, 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass: License No.:
Cldte: C tractor:
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 for a permit subjects the applicant to a -civil penalty of not more than five hundred dollars (9500).:
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.).
(_ 1 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 far the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury oneof 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 -C27 Policy Number - - - = - - - - - - - - - --
_ I certify that, in the performance of the work for which this permit is issued, I shall novemploy any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Co e, I shall forthwith comply with those provisions.
ate: Applican .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 Quints, its officers, agents and employees for any act of 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 cou ordinances and state laws relating to y��,�,,,•r��ffding construction, and hereby authorize representatives
of this c ty to enter upon the above-mentioned pr arty for Inspection purposes.
Date:. .Signature (Applicant or Agent):
P.O. BOX 1504 ^�
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
/05-00004854
'Property Address:
6041 0—LIVING STONE DR
APN:
764-270-999-52 -300233-
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
8000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: j^ L'ccee
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 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 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.).
(_ 1 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 contractors) 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: ' 11/03/05
Owner:
RUSSEL
60-410 LIVING STONE
LA QUINTA, CA 92253
Contractor:
MCRAE POOL & SPAS
WCC: EXEMPT
WC: EXEMPT 09/30/06
CSLB: 823017 08/31/07
-----------7-----------------------------------
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 -C27 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,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
4ale Of—.pplican-t.
-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 Directoi 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 Quinta, its officers, agents and employees for any act of 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. -
I 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 relating7ilding
construction, and hereby authorize representatives
of this c tyttto enter upon the above-mentioned ty for inspection purposes.
Date:-i-A—Signature (Applicant or Agent):
LQPERMIT
Application Number
. . . . O5-00004854
Permit . . .
BLDG POOL PERMIT_.
Additional desc
Permit Fee
99.00 Plan Check Fee.
64.35
Issue Date . . .
Valuation
7824
Expiration Date
5/02/06
Qty Unit Charge
Per
Extension .
BASE FEE
45.00
6.00 9.0000
THOU BLDG 2,001-25,000
54.00
Permit
MECH POOL
Additional desc .
Permit Fee . . ."
26.00 Plan Check' Fee -.
6.50
Issue Date
Valuation
0
Expiration Date
5/02/06 -
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
-5/02/06
Qty Unit Charge
Per
Extension,
_BASE FEE
15.00
1.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . •PLUMBING.
Additional deso•.
Permit Fee . . . .
27.00 Plan Check Fee
7.50
Issue Date . . . .
Valuation
0
Expiration Date
5/02/06
Qty -Unit Charge
Per
Extension
BASE FEE
15.00,
1.00 6.0000
EA PLB FIXTURE
6.00
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 .. . . . . 05-00004854 .
:Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 15.00
Plan Check
Fee
.00
Issue Date:
Valuation
. . .
. 176
_ Expiration Date 5/02/06
Qty Unit Charge Per
Extension
BASE FEE.
15.`00
-----------------------------------
Special Notes and Comments
--------
- ------------
-------------
--------------
SPA ONLY. 11 L.F. 4' EQUIPMENT BLOCK
WALL,.CITY STANDARD. ALARMS/BARRIERS
SHALL BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION: .
' Fee summary Charged Paid
-------------- ---------- --- -----
Credited
------
Due
Permit Fee Total 212.00
.00
.00
212.00
Plan Check Total 89.60
.00
.00
89.60
Grand'Total 301.60
.00
.00
301:60
LQPERWT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �d — �� L ` ' S' ' A� ,
Owner's Name: 0
A. P. Number: 44 qu)'% CA
Address:`
GCS -iia L►(/iwGS �c
Legal Description:
Contractor: 114 C�� /S
City, ST, Zip: 4. u1'1,iM G4 of Z2S —
Telephone: 60 —
Project Description:' A
Address: ` Cl- ! 2 S Cr
City, ST, Zip: v„i
'3
Telephone:760 . Dyqb
r
State Lic. # : �.
City Lie. #:tT
,
Arch., Engr., Designer:
3 0
Address:
A
City, ST, Zip:
Telephone:
_ s
State Lie. #: t
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:
Estimated Value of Project: P OOD
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
p 3�/
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°” 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 Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
JOB ADDRESS 60 .�10 L-►'(�irlr. CITY OF LA QUINTA SUB -CONTRACTOR I IST _
C�fD�C' PERMIT NUMBER OWNER _S5 (0',l �
,,..S;S 1;..�_ BUILDER _rVl CJ2r9 C° 00 (S '•_
This form shall be posted on the job with the B ilding Inspection Card at all times in a' conspicuousplace. Only persons appearing on this list or their employees are authorized�to �ivork
on this job. Any changes to this list must be approved by the Building Division prior *to commencement of work. Fail a to Com
ply will result in a_ stoppage of work and/or the voidance
, ly - .ten_...
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade / Classification Contractor
State Contractor's Licens
j Company Name Classification.
License Number
1 (e.g. A, B, C=8) (xxxxxx)
ARTHWORK IC -12)
CONCRETE (C-8)
FRAMING (C-5)
TRUCT. STEEL (C-51)
MASONRY (C-29)
UMBING (C-36)
ATN, PLASTER (C-35)
DRYWALL (C-9)
HVAC (C-20)
KEtEPTRICAL (C-10)
ROOFING (C-39)
SHEET METAL (C-43)
FLOORING (C-15)
GLAZING (C-17).
INSULATION (C-2)
SEWAGE DISP. (0-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (C-27)
OOL (C-531
e..
.Workers Compensation Insurance
City Business License
Exp. Date
4xxh(x/xx)
Carrier Name
(e:g. State Fund, CalComp)
Policy Number
(Format -Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
12.0-0.S
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