RPL (12-0892)78045 Lost Elk Tr
12-0892
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,.CALIFORNIA 92253
Application Number: 12-00000-892
Property Address: 78045 LOST ELK TR
APN: 623-520-007- - -
Application description:' POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 38000
Tiht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LEO STEIDLMAYER
78045 LOST ELK TRAIL
LA'QUINTA, CA 92253
FFD
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/12
7
AUG 14 2012 t ,
Applicant: Architect or Engineer:
PALOMAR POOLS
69676 PLEASANT GROVE i Cfff5FLAQUINTA
CATHEDRAL CITY, CA 922 1 i ltii iIAF
(760)774-7624
PIP
/
Lic. No.: 912619
----------------------------------------------------------------------------------------------
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
Li ense Class: C53 License No.: 912619
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued:
Daterontracto
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 -BU ECLARATION
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 (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
is permit is issued, I shall not employ any
I certify that, in the performance of the woLthe
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 coorkers' 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 shouldorae subjers' 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 LaboZode hall forthwithose 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 ($500)•:
UU,,,///
ate. plicant:
( ) 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 S RE 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 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 _ ) I am exempt under Sec. , BAP.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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 th the above i rmation is correct. I agree to comply with all
city and county ordinances and state laws relating t wilding co If ction, and hereby authorize representatives
oI thi county to enter upon the above•mentione roperty for in p tion purposes.
at - 1 ' 1 ' nature (Applicant A
Application Number ... . . 12-00000892
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
336.50 Plan Check Fee
218.73
Issue Date
Valuation
38000
'Expiration Date
2/05/13
Qty Unit Charge
Per
Extension
BASE FEE
252.00
13.00 6.5000
------------------------------------=---------------------------------------
THOU BLDG 25,001-50,000
84.50
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/05/13
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
2/05/13
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
2/05/13
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
Application Number . . . . . 12-00000892
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 31.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1299
Expiration Date 2/05/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
8.00 2.0000 HND BLDG 501-2,000
----------------------------------------------------------------------------
16.00
Special Notes and Comments
POOL/SPA, 60 L.F. 5' GARDEN WALL & - 40
L.F. 18" WALL, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged Paid Credited
=--------------------------
Due
--------------------
Permit Fee Total 471.50 .00
----------
.00
471.50.
Plan Check Total 244•.73 .00
.00.
244.73
Other Fee Total 2.00 .00
.00
2.00
Grand Total 718.23 .00
.00
718.23
1
LQPERMIT
CITY OF LA QUINTA' SUB -CONTRACTOR LIST
JOB ADDRESS PERMIT NUMBER OWNER BUILDER .
This form shall be posted on the job with the Building Inspection Card at all times in a donspicuous place. Only persons appearing on this list or their employees are authorized to work
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 voidance
of building. permit. For each aDDlicable trade. all information reouested below must be comDleted by aDDlicant. "On File" is not an acceptable response.
Trade Classification
T / n
Contractor
:::..::.: :.......Contract
State or s License
:..:..::...
Workers Compensatio
City. Business License: `• .::
Company Name
Classification
(e.g. A. B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/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)
EARTHWORK (C-12)
✓bC,
6q- ," %1
AN n
' d b 2
V `t
_
CONCRETE (C-81
FRAMING'(C-5) ..
STRUCT. STEEL•(C-51)
q 0
, C
roqjisEieyl
7629
MASONRY (C-29)
PLUMBING (C-36)
f
-
g 2 6 tel w
r_ li JZA
p
( O
p
0' (-
LATH; PLASTER (Cw35)
ffW1_
Q
— OQ
-
QB -7
DRYWALL (C-9)
HVAC. (C-20) .: ,.. ` ..
ELECTRICAL. (ClG
D .c 1 I
/74(
j_1
ROOFING -'(C.=39)
SHEET METAL (0=43)
FLOORING (C`:15):."
GLAZING (C-17)
INSULATION`(C-2) .:
.SEWAGE DIS P (C-421
PAINTING (C=33)
CERAMIC TILE (C-54)
a Nt l '
C
203.3
/
9J(
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (CG27) ?:
POOL (C-53)
I I
,_. _...
_.. ---
---- _ --- _- _ _ :_ . _- - - r i
t3in.#
City Of, la Quitlta
Building 8i Safety Division
P.O. Box 1504,78-49S Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1T
Project Address:
00
Owner's Name:. . ✓
A P. Number.
Address: —0 S f
Legal Description:
Contractor.
01)
City, ST, Zip:
u 1 - C 4
FX..
Telephone: 0 40 1
Address:
Project Description:
City, ST, Zip:
Telephone: r . s
State Lic. #Q City Lic. #;
0
Arefi., Engr., Designer:
14
r
Address:
_ r
City, ST; Zip:
ti
Telephone:Construction
State Lic. #:
Name of Contact Person:
Type: Occu an
p cy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories:
# Units.
Telephone # of Contact Person:
Estimated Value of Project: 0 a
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Rec'd
TRACIUNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
'buss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Cates.Plans
picked up
Construction
Flood plain plan
Plans resubmitted
Mechaeical
Grading plan
r4 Review, ready for correctionstiissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
7n° Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees