RPL (10-0423)Application Number: 10-00000423
Property Address: 61218 LIVING STONE DR
10-0423
APN: 764 -280 -999 -199 -300236 -
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 34800
Applicant:
T41�v 414 Q"
Architect or Engineer:
�1a
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT a
LICENSED CONT CTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a icen under provisions of Chapter 9 (commencing with
Section 000) of Division 3 of the Business and ssionals Code, and my License is in full force and effect.
Lice lass: Cf5`3 LicenseNo.: 658996
Da v tractor:
0ER-BUILDER DECLARATION
hereby affirm under penalty of perjury that I am ex mpt from the Contractor's State License Law for the -
following reason (Sec. 7031 .5, Business and Profes ns 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.). -
(_) 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.).
1-1 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
Owner:
DONNA MABBOTT
61218 LIVING STONE DR3
LA QUINTA, CA 92253
Contractor:
FAMILY POOLS CONSTRUCT
P O BOX 283
LA QUINTA, CA 92247
(760)564-3655
Lic. No.: 658996
VOICE (760) 777-7012
FAX (760) 777-7011
-INSPECTIONS (760) 777-7153
Date:
5/17/10
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 STATE FUND Policy Number 1344032-2009
I certify that, in the perform ce of the ork for which this permit is issued, I shall not employ any
person in any manner so to b me subject to the workers' compensation laws of California,
d agree that, if I sho Id c subject to the workers' compensation provisions of Section
0 of the Labor C II forthwith comply with those provisions.
lica
�ate:
ING:AIL E TO SECURE WORK PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P NALTI AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. IN ADDITION TO E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, IN REST, 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 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.
I certif that I have read this application and state that the b information is correct. I agree to comply with all
city court ordinances and state laws relating to buil construction, and hereby authorize representatives
of i unty .enter upon he above-mentioned p :f in ection purposes.
a 4 nature (Applicant or Agent):
Application Number, .
. . . . 10-00000423
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
317.00 Plan Check Fee
206.05
Issue Date . . . .
Valuation . . .
. 34800
Expiration Date
11/13/10 "
Qty Unit.Charge:
Per
Extension
BASE FEE
252.00
•10.00 6.5000
THOU BLDG 25,001-50,000
65.00-
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50 "
Issue Date
Valuation
0
Expiration Date
11/13/10
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
11/13/10
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
11/13/10
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
LQPERMIT
Application,Number . . . . . 10-00000423
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
346
Expiration Date 11/13/•10
Qty Unit Charge. Per
Extension
BASE FEE
15.00
--------
Special Notes and Comments
POOL/SPA 16 L.F. 416" EQUIPMENT WALL,
CITY STANDARD,.GAS & ELECTRIC FOR
FIREPIT, BBQ $ FOUNTAIN. ALARMS/BARRIERS
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. 2007 CODES.
--------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged PaidCredited
---------- ----
Due
•-----------------
Permit Fee Total 436.00 .00
.00
436.00
Plan Check Total, 232.05 .00
.00
232.05
Other Fee Total 2.00 .00
.00
2.00
Grand Total 670.05 .00
.00
670.05
Bin #
City of La Quint'a
Building 8T Safety Division
Permit #P.O.
a'
Box 1504, 78-495 Calle Tampico
1 O . L �
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:�U��
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: L' s:.
Telephone:
�',
Address:
Project Description:
City, ST, Zip:
� t
Telephone: d
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.,. \r},r:>i:}�:;:�Y.; :ill
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State Lie. # :
City Lie. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
+NTelephone::}:::;'i;:::°„,•'?}.;.i}i:i}Si•}i}:y i”}>:,v<:>:-x:.}y-::
070
�.v:r . :4l }••.:: }. rJ-en' k`Wr`.;i;:.v;ij}ii}j Construction Type: Occupancy:
:� \�c:C.+acct<:c;f.�:Y;t:...}YS}'•4:..:.
State Lie. #:
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f" '>::.'tib}'}'•}: ;li:�ji:?-i}}}};: i{...5}:
{ Y:.�`:<•.,: r:« rY<};<::<:::.<.:>:::a<>< Project type (circle one): New
:::.�.:::?r,,:<.:rN..::�:::.u•<,:YYY:::»}:.»::}�,;}x'. ) Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
9 # Stori # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACING
PERMIT FEES
Plan Sets
Plan Check submitted
�
Item
Amount'
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs•
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
tad 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:
hd Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P. .
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
GOLF COURSE
DONNA MABBOTT
61 21 E3 LIVIN13STONE DRIVE
.�TRILOGY COUNTRY CLUE3 LA QUINTA
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR
C OF
DING
'7
BU A
I�
' A
T
AFQIDEPT.
U
U
APPROVED CONSTRUCTION'
E
R
DATE' 7
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