RPL (09-1238)61605 Living Stone Dr
09-1238
09-00001238
,61605 LIVING STONE DR
764"-280-999-18 -300236-
POOL.- RESIDENTIAL
MEDIUM HIGH DENSITY RES
9500
Architect or Engineer:
Owner:;
BOB SULLIV f
61605 LIVING STO
LA QUINTA, CA 92253
1a.. I,_
✓`v�jf�
Contractor:
MCRAE POOL & SPAS
79105 DESERT STREAM DR
LA QUINTA, CA 92253
(760)772-2440
Lic. No.: 823017—
VOICE (760) 777-7012
FAX (760) 777-7011
E NS (760) 777-7153
Date:. 12/03/09
f
-----------------------------------------------
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
issued.
Date: l'& , 4/-# V ntractor:
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 am exempt from the Contractor's State License Law for the
Carrier EXEMPT . Policy Number EXEMPT
following reason ISec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
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
3700 of the Labor Code, hall forthwith
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of .Section 7031.5 by
#1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: 7 pplicant:
(_ 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: FAILURE 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 1, 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,
. ( I 1 am exempt under Sec. , S.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
r
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
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 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 relating to building construction, and hereby authorize representatives
of this county to enter upo he above-mentioned property for inspection purposes.
T"' L / gnature (Applicant or Agent):
Application Number
09-00001238
Permit
BLDG.POOL PERMIT
Additional desc .
Permit Fee . . .
117.00 Plan Check
Fee
76.05
Issue Date . . . .
Valuation
9500
Expiration Date
6/01/10
Qty_, Unit Charge
Per
Extension
BASE FEE
45.00
8.00 9.0000
THOU BLDG 2,001-25,000
72.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . .
Valuation
0
Expiration Date
6/01/10
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
6/01/10
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 . . . .
27.00 Plan Check
Fee
6.75
Issue Date . . .
Valuation
0
Expiration Date
6/01/10,
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
a
3.00
------------------------------------------
Notes and Comments
SPOOL & 14 L.F. 4' EQUIPMENT
LQPERMIT
Application Number . . .
09-00001238
Special Notes and Comments
ENCLOSURE,CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE
AT
PRE -PLASTER INSPECTION. 2007
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid
Credited
Due
---------------------------
Permit Fee Total 215.00
-----------
.00
--------------------
.0`0-
215.00
Plan Check,Total 100.55
.00
.00
100.55
Other Fee Total 1.00
.00
.00
1.00
Grand Total. 316.55
.,00
.00
316.55
LQPERMIT
EXHIBIT A PAGE 3
TRILOGY AT LA QUINTA MAINTENANCE ASSOCIATION
DESIGN REVIEW COADUTTEE APPLICATION
(Do Not Write Below Line.* This is to Be Completed By Design Review Cop,
.................................................................................................................................
Received by the Design Rev . iew Committee: L4
Date
Homeowner
The attached Application has been reviewed by the
F-1 APPROVED (Initials & Date)
[_71 Incomplete Submittal
F-] Require Additional Information
El othie
Address
Review Committee and
Notes oift
conditions
V
O -Z
acti6,!.--*
ROVAL'r'(Witihis & Date)
)roval check list
Date: Signature:
For the Design Review Committee
Final Inspection: 11 Approved as submitted El Disapproved (refer to attached comments)
Date: Signature:
For the Design Review Committee
In the event plans and specifications submitted to the DRC are disapproved, Owner may appeal to the Board
of Directors by submitting a written request for appeal, The written request shall be submitted to the Board
not more than thirty (30) days following the final decision of the DRC.
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 -
Building Permit Application and Tracking Sheet
,41*41
Permit # ^
Project Address: �S' 1 f� AtS'
Owner's Name: LL
A. P. Number:
Address: — O� /'At 6ST�i✓t�
Legal
Legal Description:
City, ST, Zip: 1Vyi Z Z.X
r
Contractor: S _S J •
C
^�
Telephone:
P / �o
Address: �, 6 '�
Project Description:
City, ST, Zip: L7 f 2a
0' S7Avc.,v eFPoo C
Telephone: «z:<:>'
State Lic. #: City Lic. #.:
1/
Arch., Engr., Designer:
v,fN�
Address:
City, ST, Zip:
Si>:i.Y.'r'• C i i >a .Y•kF4 W42vX!'
Telephone: `.�>;> �a>:„>;:»:�?»:::;>,;u.,J• r..�
State Lic. ai2`:i>y ti;i2.;#_r;%;r;^)h •`,;::;<o:r:'•:a"''k
..
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: `?7Y- 63
Estimated Value of Project: o
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
Tide 24 Calcs.
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-.
'`a 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
CITY- OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS 61-60S L"In/6S-hwgF PERMIT NUMBER OWNER BC8 Stiar�LAN BUILDER.ZDCRAE 260 S
This form shall be posted on the job with the Building Inspection Card- at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to worts
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 voidanc(
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
..:.....:.. .
:Contracto:..:s.:. L... ce.:n:
..s..0::
..... ... Bus e it ConTrada /Classi katon tractor .s License:
Company Name. Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp, Date
(e.g. A, B, C-8) (xxxxxx) Ixx/xx/xx1 (e.g. State Furid, CalComp)(Format Varies) Ixx/xx/xx) (xxxx) (xx/xx/xx)
EARTHWORK IC -12t L 0 { .� q833 '3
CONCRETE
FRAMING :(G-51
STRUCT:STEEL-(C-51) • O
MASONRY -(C-29)
PLUMBING (C-36) !
LATK PLASTER (C-35 t7 '� i0
DRYWALL (C-9)
HVAC. (C -20)" -
'ELECTRICAL (C-40 -;'.. .go 9
ROOFlNG`IC.=391::::.::
SHEET -METAL (C-43)
FLOORING
r .
GLAZING (C-17): ' S
INSULATION'(C-21:
SEWAGE DISP (6421
PAINTING (6=33)
CERAMIC TILE (C-54)
'CABINETS (C-6)
FENCING IC -13)
LANDSCAPING I0-27) ? .
11
30.1
0
D
01.40
R1
�,_
peclacapes a Dc aloes
760-7-2440
Uc Ps +p,230 h?
73CAMP WIYPAf! NO. 166A•16X240V9?s , ,
.# Devious
ISO -M-2440
. 823017
CITY OF LAQUINTA
BUILDING
®&[�SAFETY DEPT
APPROVED
i O V E®
FOR CONSTRUCTION
DATE A ••Z • OT BY ST
'DRAWN
Y
CHECKED
DATE
-6-09
SCALE
Ile /"
JOB NO.
//;VA, pi
SHEET
OF SHEETS