RPL (10-0766)54970 Avenida Madero
10-0766
PQ. BOX 1504 VOICE (760) 777-7012
78X495 CALLE TAMPICO FAX (760)'777-7011
LA QUINTA, CALIFORNIA 92253, BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT „
Date: 8/16/10
Application Number. 10-00000766 Owner:
Property Address: 54970 AVENIDA MADERO PHIL DUAMARELL.
APN: 774-265-011-14 -000000- 54=970 AVENIDA MADERO
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL -rTLD,Application valuation: 17250Contractor: 1Yi;1 1 20
Applicant:'. Architect or Engineer: COMPETITIVE WEST POOL CON--- {
PO .BOX 5865
LA QUINTA, CA 92248,
A)A 760)625-2512 -
Lic. No.: 916827
• 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 C ss: 53 License No.: 916827 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,
issued.
ate C ctor. 1 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
WNER-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 PRAETORIAN INS Policy Number 302628300
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_ I 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 a700 of the Labor Code, I shall with comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by p-
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ,,0 Ite: l _ f*, plicant:
1 _ 1 1, 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' COIQSATION 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 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 1 am exempt under Sec. , B.&P.C. for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all,
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction,. and hereby authorize representatives
;W;;iu ,
pon the above-mentioned property for in io urposes.
Lender's Name: Lender's Address: -ture (Applicant or Agen 1:
LQPERMIT
Application Number
10-00000766
Permit
BLDG POOL PERMIT
Additional desc
Permit Fee ".
- 189.00 Plan Check Fee.-
122.85"
Issue Date . . . .."
Valuation
17250 "
Expiration Date
2/12/11
- Qty Unit Charge
Per
Extension
BASE FEE
45.00..:
- 16.00, 9.0000.THOU
BLDG 2,001-25,000
144.00
- Permit . . . ..MECH
POOL
Additional desc
Permit Fee
26.00 Plan Check Fee :.
6.50
Issue Date
Valuation
0
Expiration Date.
2/12/1.1
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 .
2/12/11 :.
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0.0000
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
2/12/11
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
Special Notes and Comments
• POOL/SPA. ALARMS/BARRIERS
SHALL BE IN
LQPERMIT
Application Number
10 -00000766
-------
Special Notes and
-------------
Comments
PLACE AT PRE=PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
CODES.
--------------------------------------------------------
Other Fees
. . . . . . BLDG STDS ADMIN-(SB1473)_
--------
1.00
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
293.00
00
.00
293.00
Plan Check Total
148.85
00
.00
148.85
Other Fee Total
1.00
.00
.00'..
1.00
Grand Total
442.85
.00
.00
442'.85
Bin #
Permit #
10'
lf
Project Address: 5 .
A. P. Number:
Contractor: 60M PL --aa&-
Address: Q Si3t6:
City, ST, Zip: L4
Telephone: f Z s- o"l5i 2—
State Lic. #: W69,;).
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: CI+ I,
Telephone # of Contact Person: GI
'd
Plan Sets
Structural Calcs:
Truss Cales.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
1/Q''`' dme Owner's Name: P%L DVAW%PA--R
Address: f y? 7 /0 4vc40 jq A44aefx
.City, ST, Zip: L4 gZ3
dd ( /✓ Telephone: -0—
Project
yProject Description:
NW
Lic. #: /04/f 03
Construction Type:
Project type (circle one):New
t Sq. Ft.:
--To Stories:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
F:70..-
TRACIONG
Ch
Occupancy:
Add'n Alter . Repair Demo# Units:
PERMIT FEES
Total Permit Fees
Amount
eck submitted
Reviewed, ready for corrections
1
Item .
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"" Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
3N Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue „
Total Permit Fees
Amount
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