BLCK (07-0535) + RPL (14490)78785 Lowe Dr
07-0535
14490
a
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit!t44Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: License No.:
Date: Contractor:
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).:
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 provirig 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 thiproject (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 ) I am exempt under Sec. , B.&P.C. for this reason
I—&-
I
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:
MATT JAM
78785 LOWE DR
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/21/07
----------------------10-1---FEB 21 2007
Contractor: CITY OF LA QUINTA
Owner I FINANCE DEPT
M
-----------------------------------------------
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 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
rrrrrr''' 111111 ' 3700 of the Labor Code, I shall forthwith comply with those provisions.
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 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.
1 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 upon the above-mentioned property for inspection purposes.
VQ: _ - _a 1Sign atu nt or Agent): rC
Application Number:
07=00"0005`3-5
Property Address:
7-87-85—L-OWE—DR
APN:,'
604-233-004-173 -23268
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
i
2725
Tit!t44Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: License No.:
Date: Contractor:
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).:
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 provirig 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 thiproject (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 ) I am exempt under Sec. , B.&P.C. for this reason
I—&-
I
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:
MATT JAM
78785 LOWE DR
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/21/07
----------------------10-1---FEB 21 2007
Contractor: CITY OF LA QUINTA
Owner I FINANCE DEPT
M
-----------------------------------------------
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 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
rrrrrr''' 111111 ' 3700 of the Labor Code, I shall forthwith comply with those provisions.
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 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.
1 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 upon the above-mentioned property for inspection purposes.
VQ: _ - _a 1Sign atu nt or Agent): rC
Application Number 07-00000535
Permit . . . WALL/FENCE.PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 2725
Expiration Date 8/20/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 9.0000 THOU BLDG
2,001-25,000
9.00
-----------------------------------------------
Special Notes and Comments
------------------------------
109 LF 6' BLOCK WALL TO FORM FRONT
COURTYARD. CITY STANDARD.
Fee summary Charged
---------- ---------- ----------
Paid Credited
----------
----------
Due
------------------
Permit Fee Total 54.00
.00
.00
54.00
Plan Check Total .00
.00
.00
.00
Grand Total 54.00
.00
.00
54.00
rr
<4
LQPERMIT
Bin #
Permit #
Project Address:'
A. P. Number:
Contractor: Q/r
Address:
City, ST, Zip:
Telephone:
State Lie. #
Arch., Engr., Designer. '
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
!t Submittal 1
Plan Sets
Structural Cales.
Truss Cafes.
Enetgy Cale.
Flood plain plan
Grading.plan-
Subcotitactor List .
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quints
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
Owner's Name: /Y!—
Address: % $ 7 $ LoH/e' AV
City, ST, Zip: 1-- A Et w O'k CA -17-2-5-3
Telepho:e.
74'p 9 `i 7— '7 f s, $
PrOjed escription:
r
V
Total Permit Fees
Construction Type:
Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:
#Stories:
# Units:
Estimated Value of Project:
APPUCANT:
DO NOT WRITE BELOW
THIS UNE
Reed
TRACIMG ,
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Pfau Check Deposit
Called Contact Person
Plan Check Balance
Plans bicked.up
Construction
Plans resubmitted
Mechanical
2" Review, ready for correctio"'ssue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.L .
Plans resubmitted
Grading
Review, ready for.corrections/tssue
Developer Impact Fee'
Called Contact Person
A.I.P.P.
.Date of permit issue
V
Total Permit Fees
)J,y 115
Building '87785 LoWeDr.
Address
Owner
BreezeLand
Addresgs 42335 Washington St. F310
PaIrA Desert, G zlp
P 92211
Contractor
V A P Specialties
Address
73-373 Country Club Dr.
fglr Desert, Z'p 92261
State Lic.
& Classif. D 1675422
Arch., Engr.,
Designer
Address
City lZip
4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tel.
340-5557
#701
Tjl l9) 346--4393
City
Lic. # 2934 .
Tel.
State
Lic. #
t4
LICENSED CONTRACTOR'S DECLARATION ..
I hereby affirm that I am licensed under provislons of Chapter 9 (commencing with Section
1100) of Division` 3 of the Business and Professions Code, and my license is in full force and
ffect. b",
" C / 4-1-
/11 /
SIGNATURE
/. DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires- a
permit to construct, alter, iniarove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section .7000) of
Division '3 of the Business and Professions Code, or that. he 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). .
O 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,-Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees, -
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044. Business and.Professlons Code: The Contractor's License Law
does not apply to an, owner of property who builds or Improves thereon, and who contracts for
such projects with a contractor(s) #caned pursuant to the Contractor's License Law:)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof.•(Sec. 3800, Labor Code.)
Polly No#O' Company
Rpy.is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit Is for one hundred dollars ($100) valuation
or less.)
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
Date • Owner
NOTICE TO APPUCANT: d, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you 'must forthwith
comply with such provisions or this permit shall be deemed revoked. -
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 ($110,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR -CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 160 days.
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 city to enter the above-.
mentioned property for inspection purposes. `
Signature of applicant Date
Mailing Address
City, State, Zip
No. 14490
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description Pool and Spa
281
-1.f. of 6* high blocs gall
Sq. Ft. No. No. Dw.
Size. Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
-Investigation fee Charged for starting
work without: a permit.
Pawl/Spa $8,000.00
Estimated Valuation Mall 7,025.00
PERMIT ` AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 64.35
Const. 99.00/99.99
Mech. 24.00
Electrical 45.00
Plumbing 27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL _358.3.5
REMARKS
Investigation fee 99.00
?57.35
ZONE: BY: -
Min imum
Y:Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback fromn er Lim ne
Side Setback from Prop y ine
FINAL DATE INSPE R
Issued by: - Date
Validated by: 19.7n " /
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW%3 FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
COLL. AREA
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
STORAGE TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
ROCK STORAGE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
WATER SYSTEM
SO.FT.GAR ® 3/4c
HOUSE SEWER
GRADING
cu. yd.
$ -Plus-x$-=$
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING J\ ELECTRICAL ' 11 HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC A K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
IY
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Sao SQ Fr 0f }CCOL`DECK.
* 280..SQ FT-,,OF:KCCL DEC'{ PATIO It
1 S L-
4 -ria st rQ A0
properly Line 1Z" Rai
IL
'.' 30'—
RV0"
r
7' FI
i^ 0
CF t
.
Pik.
sw
oi
_INE
SteQ
..* •.;
.
3 E .: SCO
3TRI LE'%':L SEA
27
VAD
JSPI_ WA? SIZE
SP1L_Wti
OPEN X C
DEPTH 3' TO G'
SPA RUN 51'
P-yOL RUN 18'
I
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''.
•
,',
—.''trip' r
r'V7_
qtr'. '-• .
i
oS l
,
'i
v
I
ontractor
Owner
C = TY O F LA QU I NTA
7 1 Address
Job Address
This form shall be posted on the job with the Building Inspection Card at all times in a
conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder
to monitor the sub -contractors that are on this list are the same persons performing the
work. Any changes of this list must be approved by the City of La Quinta Department of
Building and Safety prior to work being performed by a changed sub -contractor. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
TRADE
SUB -CONTRACTOR NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE
CITY BUSINESS
LICENSE NO.
GRADE/
EXCAVATE
' S 4 K L
Z `t -7 5
S 7
PIPELINES
Z ,S f (0t-ka
CEMENT/
FOUNDATIONS
\
b a,,s e_MA
CEMENT/WALKS
& DRIVES
ASPHALT
FRAMING
STEEL/
STRUCTURAL
V R •P
3
MASONRY
PLUMBING
LATHING
DRYWALL
¢
4' Yv., A P=te, AL<,
HVAC
ELECTRICAL
ROOFING
SHEET METAL
FLOORS
GLASS/
GLAZING
INSULATION
SEWAGE DISP
PAINTING/
DECORATING
TILE
CABINETS/
INSTALLATION
ORNAMENTAL
METAL
FENCES/
BLOCK WALLS
LANDSCAPING
OTHERS