11-0889 (RPL)53885 Avenida Martinez
11-0889
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000889
Property Address: 53885 AVENIDA MARTINEZ
APN: 774-171-019-7 -000000-
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 12000
Tiht 4 4 Q"
Applicant: Architect or Engineer: -
aha
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LICENSED CO ACTO D LARATION
I hereby affirm under penalty o riury th I am literd under p visio of Chapter 9 (commencing with
Section 7000) of Division 3 of t e usine and Profonals C e, an my License is in full force and effect.
Lice Class: IB Licens N 727199
ate:— ( `l/ trac
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).:
(_ 1 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 I, 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. , BAP.C. for this reason
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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
Owner:
3 BOULDERS
42760 MADIO STREET
INDIO, CA 92201
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/18/11
Contractor:
CORONEL ENTERPRISES
42760 MADIO STREET
INDIO, CA 92201 20,11
(760)775-1234
Lic. No.. 727199
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
1 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,
K.r I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
---TTT Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1948 2011
I certify that, int erformance of the work hich thi permit ' issued, I shall not employ any
person in any an r so as becomes ject; o the orkers' ompensation laws of California,
and agree that, if I s ould b me subje t to the wor cers' c pensation provisions of Section
3700 of the r C de, I s II forthwi comply wi [h a provisions.
ate: i5 licent:
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 beco ull and v id if work is not commenced
within 180 days from date of issuance of such per tUabove
or cessati ark for 18 s will subject
permit to cancellation.
I certify that I have read this application and state thation corre t. agree to omply with all
city an county ordinances an state laws relating toon, d here y uthorize epresentatives
ft ' county to enter upo he above-mentioned prn pu oses.
D te: I, -S' nature (Applicant or Agent):
- 1 r
LQPERMIT
Application Number . . . . . 11-00000889
Permit .
. . BLDG POOL PERMIT
Extension
Additional desc
. .
15.00
1.00 30.0000'EA
----------------------------------------------------------------------------
Permit Fee . .
. . 135.00
Plan Check Fee
87.75
Issue Date . .
. .
Valuation
12000
Expiration Date
. . 2/14/12
6.75
Issue Date . . . .
Qty Unit
Charge Per
Expiration Date
Extension
BASE
FEE
45.00
10.00
----------------------------------------------------------------------------
9.0000 THOU BLDG
2,001-25,000
90.00
Permit .
. . ELEC POOL PERMIT -RES
1.00 3.0000
Additional desc
.
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
Permit Fee . .
. . 45.00
Plan Check Fee
11.25
Issue Date . .
. .
Valuation . . .
. 0
Expiration Date . . 2/14/12
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 . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/14/12
Qty' Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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 ONLY, NO HEATER.
ALARMS/BARRIERS.
SHALL BE IN PLACE AT
PRE -PLASTER
INSPECTION. EQUIPMENT
ENCLOSURE NOT
INCLUDED. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total
207.00 .00 .00
207.00
Plan Check Total
105.75 .00 .00
105.75
Other Fee Total
1.00 .00 .00
1.00
Application Number . . . . . 11-00000889
Grand Total 313.75 .00 .00 313.75
LQPERMIT
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city ® LaQuinLQ
Building..& Safety Division -.
P.O. Box 1504, 78=495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012'
Building Permit Application and Tracking Sheet
Permit #
l
Project Address;S _ JS yr w
Owner's Name:
A. P. Number: '1 'j 4 - —1 1 _,olq
Address:
Legal Description:
City, ST, Zip: 'v U . aa.a
Convector:U
--T
Telephone: '.;w M".
Address: 1 ,_ Q , ` •„
Project Description:
City, ST, , `\'vZ'a0
Telephone: %S -3,-)
P • O ' 7.i ' •Y,fir:.::;
)a
:.isz;::;;.'.ra.'.:ec:»r>x.;.v',•.ti;.i^
:<;:> <;:. .::,.. '::.:>.H
State Lic. # : `]
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #::*? ;c<:<.<::i;:.;>':':" • i»i
Name of Contact Person: ✓ / /Sq.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: C10,07
a
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
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 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
2"" 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