RPL (11-0095)50610 Mandarina
11-0095
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: lc - 11''200000095._,} -
Property Address: 50610 MANDARINA
APN: 776-200-003- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000
Applicant:
"`&t v 4 4v,QMkr6j,
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CITRUS 18 GROUP, LLC
30875 DATE PALM DRIVE, STE. C
CATHEDRAL CITY, CA 92234
Contractor: I a
HENRY'S ENGINEERING 4
2
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/25/11
e
i
JA► i 2 2011 iu
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: r
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 b mg truc ion, and hereby authorize representatives
of is cou y to nter upon the above-mentioned pro artr nsp c on purposes.
Date: nature (Applicant or Agent):
P.O.. BOX 10 90
INDIO, CA 92202'
(760)393-7636 CITyOF AiIUWTA
Lic. No.: 859859 Ft?¢4± ti^Ut T•
-------------------------------------------------------------------------------------------------
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 Busines,§ and Professionals Code, and my License is in full force and effect.
_ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: A License No.: 859859
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
DMate:')
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
,ontractorjr
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 pI am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1932825
following reason (Sec. 7031.5, Bd 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
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
and agree that, if I sh uld ec a subject to the workers' compensation provisions of Section
70:;f/the Labor o a, s I forthwith 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.:
1
ate: Z ( pplicant: .
(_) 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 WO ERS' 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 CRIMI 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 ADDITI 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 C E, 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 I 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
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: r
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 b mg truc ion, and hereby authorize representatives
of is cou y to nter upon the above-mentioned pro artr nsp c on purposes.
Date: nature (Applicant or Agent):
Application Number
11-00000095
Permit . . . . . . .
BLDG POOL PERMIT INV FEE
Additional desc
Permit Fee . . . .
414.00 Plan Check Fee
134.55
Issue Date . . . .
Valuation
20000
Expiration Date
7/24/11
Qty Unit Charge
Per
Extension
BASE FEE
90.00
18.00 18.0000
-----------------------------------------------
THOU BLDG 2,001-25,000
w -----------------------------
324.00
Permit . . . . . .
MECH POOL
Additional desc
Permit Fee
26.00 Plan Check Fee..
6.50
Issue Date . . . .
Valuation.
0
Expiration Date
7/24/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00'
1.00 11.000.0
------------ -------------------------
EA MECH FURNACE >100K
77-7 -------------------
11.*00
--------------- -
Permit . . . . .
ELEC POOLIPERMIT-RES
Additional desc
Permit Fee
45.00 Plan Check Fee
11.25
Issue Date
Valuation . .
. . 0
Expiration Date
71/24/11
Qty• 'Unit Charge
Per
Extension
BASE FEE
J 15.00
1.00. 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . . . . . .
PLUMBING
Additional desc . .
I -
Permit Fee . . . .
33.00 Plan Check Fee
8.25
Issue Date
Valuation . .
. . 0
Expiration Date
7/24/11,
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
LQPERMIT
Application Number . . . 11-00000095
-------------------------------------------------------------
Special Notes and Comments
--------------
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
INVESTIGATION FEE ASSESSED PER 1997
UNIFORM ADMINISTRATIVE CODE §304.5 FOR
,'. WORK BEGUN WITHOUT BUILDING PERMIT.2010
CODES.
- -------------------_-------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
------ ---
Credited
Due
----------------- ----------
Fee Total 518.00 .00'
.00
518.00
_Permit
Plan Check Total 160.55 .00
.00
160.55
Other Fee Total 1.00 .00
.00
1.00
Grand Total ,679.55 .00
.00
679.55
LQPERMIT
Bin #
Penult J
k
Project Address: S() -'(0k0
A. P. Number:
City of La Quinta
Bid1ding & Safety DJvidon
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
hQ I Owner's Name:
Address: 5 0- G 10 1AAIQ D Q t o
City, ST, Zip:
'c
Contractor: i4stJp- (:JlJf l t ISI -M
Address: 0 10 2-q
City, ST. Zip: T7PJDt0 CA q9 -2 -02 -
Telephone: -7bo.-7
2202-
Telephone:`7bo,-7 6., IN
State Lic. # : S City Lic. #;
Arch., Engr., Designer: ( a POr--7LTLc-
Address: -7--7-72-5 Ct i ri I✓Lo -;a (2J o
City, ST, Zip: A)A s5G9 7(CA
Tel hone: 7f— 2
Project Description:
5Wlrim, 4- q
6A5 L &I C
7 y ( Construction Type: Occupancy:
State Lic. #: 3 q (p Project type (circle one): New Add'n Alta Repair Demo
Name of Contact Person: CJFP-1S I I {rs bwAi J Sq. FL: # Stories: #Units:
Telephone # of Contact Person: W. 2-7 5. q T? J EstimatedVal f Pro ? 0 tD Ci 0
a Submittal
Plan Sets
Structural Ca1cs.
Truss Cales.
T itie 24 Cales.
Flood plain plan
Grading plan Li
Subcontactor st
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
ue o sect.
APPLICANT: DO NOT WRITE BELOW THIS UNE
'd
Recd
TRACMG
PERMIT FEES
Plan Check submitted S
Item Amount
Reviewed, ready for rnatcetlona
Plan Check Deposit
Called Contact Person
Plan Check Balance
Pians picked up
Construction
Plans resubmitted
Mechanical
2" Review, ready for correctionslissue
Electrical
Plumbing
S.M.L
Called Contact Person
Plans picked up
Plans resubmitted
Grading
Review, ready for cormctions/issue
Developer Impact Fee
Called Contact Person
A.LP.P.
Date of permit Issue
Total Permit Fees
r
PROPERTY LINE 5' BLOCK WALL
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l0'6
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SPA,
X
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BENCH