RPL (05-2638)51080 Marbella Ct
05-2638
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
r
05-00002638
51080 MARBELLA CT
772-250-998-39 -31349 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
Tiht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S -DECLARATION
I hereby affirm under penalty of perjury that I am Iicens - "'r provisions of Chapter 9 (commence g with
Section 7000) of Div' pn Business and Profe s nals de, and my/r tc a in I r/J '(pnd effect.
L icense Clss: Li nse No.: tC yU
Date: ontractor:
OW -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 ofthe 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 proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
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:
LQPERAM
VOICE (760) 777-7012
FAX (760) 777 -7011 -
INSPECTIONS (760) 777-7153
Date: 6/28/05
Owner:
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200
SCOTTSDALE, AZ 85258
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
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' comAAen ation
insurance carrier and policy number are: ,r/// / / %/ (/
Carrier C8 C27 C29 C53 Number o
I certify that, in the performance the w rk for which t is permit is issued, I shall not employ any
person in any manner so as to ome ubject to the workers' compensation laws of California,
and gree that, if I sho Id bec me u act to the workers' compensation provisions of Section
7 3 0 of the Labor I sh 1 fo ith co y with those provisions.
plica
WARNING: FAILURE TO SECURE ORKERS' 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 as 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 ce of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above informat n i or act. I agree to comply with all
city and county ordi ances and state laws relating to build' onstruction and eby authorize representatives
of thi ou yy to a er n the above-mentioned prope for nspe tion p rpo
11. Z ignature (Applicant or Agent):
Application Number . . . . . 05-00002638
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
-189.00 Plan Check Fee
122.85
Issue Date . . . .
Valuation . . .
. 17920
Expiration Date
12/25/05
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
12/25/05
Qty Unit Charge
Per
Extension
y
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
12/25/05
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
12/25/05
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
. . . . . . WALL/FENCE PERMIT
LQPERBIIT
J
LQPERniIT
Application Number . . . . . 05-00002638
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 15.00 Plan Check Fee. .00
Issue Date . . . . Valuation . . . . 80
Expiration Date 12/25/05
Qty Unit Charge Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA & WATER FEATURE. 5 L.F.
4'
BLOCK WALL, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE
PRIOR
TO PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED IN PERMIT.
Fee summary Charged
-------------------------------------
Paid
Credited
-------------•-------
Due
Permit Fee Total 308.00
.00
.00
308.00
Plan Check Total 148.85
.00
.00
148.85
Grand Total 456.85
.00
.00
456.85
Bin #
p s_ 268
City Of La Quinta
Building &I Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perm i #
Project Address: _ '
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: C L ODLS
Telephone:h
o
ne. S
Address:
.....................::::::::::::::::::::::::
Project Description:
City, ST, Zip: 6 e—to 30
Dont
Telephone: hone: 3p
f
.............................:.::::::::::::::::::::::
State Lic. #
City Lic. #;
Arch., Engr., Designer:
Address:
5'fl% W/
City, ST, Zip:
Construction o struc
tion T Y P e: Occupancy:
P Y•
Telephone: hone:
State Lic. #:
Project type (circle one): Add' n Alter Repair Demo
o
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:.2Estimated
Value of Project: L.
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
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n° 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:-
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
O O
l,l g
0