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08-1293 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 Q" Application Number: c-08$ ..0001293`l Property Address: 61830 MESA CT APN: 764-280-999-61 -300237- Application description: POOL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 25000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: (( Contractor: 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.).' (_) 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 contract or the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). - (_ 1 I am exempt under Sec. , B.&P.C. for this reason 1/atDe: 10 q110 k caner: F�e .�. �1/ , A e i .. 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: iP( LQPERMIT Owner: BEN SMITH 61830 MESA COURT LA QUINTA, CA 92253 Contractor: Owner �J VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/12/08 _ WORKER'S COMPENSATION DECLARATI 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' compensation insurance carrier and policy number are: Carrier Policy N I certify that, in the performance of the, for hich this permit is issued, I shall not employ any person in any manner so as to become subje to the workers' compensation laws of California, and agree that, if I should become/subject td the workers' compensation provisions of Section 37_90 of the LabgL.0�, I shall forthwith jfomply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 becomes null id if work is not commenced within 180 days from date of issuance of such permit, or cessatio of work for 180 days will subject permit to cancellation. certify that I have read this application and state that the above information ' correct. I agree to comply with all city and cou ty ordinances and state laws relating to building construction, d hereby authorize representatives Of this y to nt r upon eabove-mentioned pr for in �pection rposes. ate: l� / �% nature (Applicant or Agent): j Application Number . . . . . 08-00001293 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 252.00 Plan Check Fee 163.80 Issue Date . . . . Valuation . . . . 24825 Expiration Date 5/11/09 Qty Unit Charge Per. Extension BASE FEE 45.00 23.00 .9.0000 - -----------------------------------7---------------------------------------- THOU BLDG 2,001-25,000 207.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . 0 Expiration Date 5/11/09 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 5/11/09 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 5/11/09 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 . . . . . 08-00001293 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 175 Expiration Date 5/11/09 Qty -Unit Charge Per Extension BASE FEE 15.00 -------------------------------------------7-------------------------------- Special Notes and Comments POOL/SPA, 7 L.F. 6' EQUIPMENT WALL, CITY STANDARD, GAS STUB -OUTS FOR FUTURE APPROVED AND PERMITTED APPLIANCES. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited ------------------------------------=-------------------- Due Permit Fee Total 371.00 .00 .00 371.00 Plan Check Total 189.80 .00 .00 189.80 Grand Total 560.80 .00 .00 560.80 LQPERMIT J AA` Ur�✓r�l /V j, z E LN 0 Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico U Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 3 0 Ii% Owner's Name:, A. P. Number: Address: "C630 / A 154 Legal Description: City, ST, Zip: U! 117A ! Z ZS^3 Telephone: /- i G o- li 9 4 - 3--74-o Contractor: O's t�-e Address: Project Description.5�A s City, ST, Zip: Telephone: State L State ic. # : City Lic. #: Arch., Engr., Designer:50 Address: R, City, ST, Zip: Telephone: State Lic. #: Construction Type: 61c*ccupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: ��K L ��— Sq. Ft.: 1 # Stories: # Units: Telephone # of Contact Person: 7? 1 7 Estimated Value of Project: 1is00 t7 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Plan Sets Req'd Rec'd TRACIONG Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2id 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:- 1. 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 X, IM Q CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS (a1'3 -'ND A964 6oar PERMIT NUMBER OWNER ',&-_/J BUILDER F-'-_-� This form shall be posted_on the job with the Building Inspection Card at all times in a conspicuous 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 applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade Classification Tr / as Contractor ::..:: . .:::..:::..77 ::::<';:: <:<>S..Contractor's tate.license - . .:........;>. Wo�ke�s Com en.sation _Insurance.' : ;.:. City Business License: . . Company Name Classification (e.g. A, B, C-8) License NumberEExp. (xxxxxx) 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)fJEpti% t✓ ^ 5 g/ ZEA H CONCRETE (C-8) FRAMING (C-5) STRUCT. STEEL JC=51) MASONRY (C-29) PLUMBING (C-36) ' [„ ��'J� L ` S /� � S gf /D SC�l9,t � 0' Z 90 < LATH, PLASTER (C-35) DRYWALL (C-9) HVAC IC -20) ELECTRICAL (C-10) : .. 0 Lo ROOFING (6-391.:: SHEET METAL (C43) FLOORING (C=15): GLAZING (C-17). INSULATION (C-2) . SEWAGE DISP. (C-42) PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) ' POOL (C-53) 6-0-60 C'?au1/• fc-G- rj 3 % t ,3 073f /o 4160447,JG6 G 20036-3 60Z.