RPL (07-1863)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
07-00001863
58425 MIJAS
764-200-999-53 -316812-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Tav/4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
al"
--------------------------------------------------
LICENS D 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 Irofessionals Code, and my License is in full force and effect.
LicenseClass: C8 C27 C29 License No.: 656128
Date: �7ontractor:
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).:
(_) 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.).
(_ ), k; 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 I am exempt under Sec. , B.&P.C. for this reason
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:
LQPERN11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/07
Owner:
CORAL OPTION I
79295 RANCHO LA QUINTA DR
LA QUINTA, CA 9,;Z53
Contractor:
P.O. BOX 128 JUN % 2007
COACHELLA, C 22-, I
(760) 398-922QF
Lic. No.: 656128 1VCgDFo�Nrq
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 SEABRIGHT Policy Number BB1070510
I certify that, in the performance of the work for which this permitisissued, I shall not employ any
person in any manner so as to becoesubject to the workers' compensation laws of California,
and agree that, if I should become bject to the workers' compensation provisions of Section
3700 of the Labor Code with comply with those provisions.
Date: 79plicant:
WARNING: FAILURE TO SECURE WOR ERS' 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 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 building co struction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop o on purposes.
Date: && y¢nature (Applicant or Agent) . /
Application Number . . . . . 07-00001863
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date
Valuation
25000
Expiration Date
12/23/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
23.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
207.00
Permit
MECH POOL
Additional desc .
Permit Fee
26.0.0 Plan Check Fee
6.50
Issue Date . . .
Valuation . . .
. 0
Expiration Date
.12/23/07
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
12/23/07
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 . . . .
39.00 Plan Check Fee
9.75
Issue Date
Valuation . . .
. 0
Expiration Date
12/23/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 6.0000
EA PLB FIXTURE
18.00
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 & WATER FEATURE ONLY. PERMIT
LQPE%NIIT
Application Number
07-00001863
-------------=------------------------------
Special Notes and Comments
--------------------------------
DOES NOT INCLUDE EQUIP WALL.
Fee summary Charged
----------------- --------
Paid
----------
Credited
---------- ----------
Due
7-
Permit Fee Total 362.00
.00
.00
362..00
Plan Check Total 191.30
.00
.0"0
191.30
Grand Total 553.30
.00
.00
553.30
LQPERDIIT
� - --I _ 'L _ __ _ -- _ _ --- - _ -- _ _-
_ _ _._
_ __.._..
pp
Bin #
*ty of La Quinta
Building 81 Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
Jl0 (D 2 La Quinta, CA 92253 - (760) 777-7012
(�J Building Permit Application and Tracking Sheet
Project Address: _ \
ZSOwner's Name:
A. P_ Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: ' _
Telephone:
Address:
� e '
l�� Project Description:
City, ST, Zip:GO,__ CJ ! u�
Telephone: -2-/ Z Z L
State Lic. # S6l Z City Lic. #.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
C—�0 Sq. Ft.:
;Eitories: #Units:
Telephone #1 of Contact Person: 7_ �s-o _ Z E
# Submittal
Plan Sets
Structural Calcs,
Truss Calcs.
Energy Calcs_
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H_O.A. Approval
fN HOUSE: -
Planning Approval
Pub. \V ks. A ppr
School -Fees
Total Permit Fees
V
sttmated value of Project
APPLICANT:
DO NOT WRITE BELOW THIS LINE
Recd
TRACKING .
PERMIT FEES
Plan Check submitted rj�f/ Item Amount
Reviewed, ready for corrections 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
Plans resubmitted
Grading
Review, ready for correctionslissue
Developer Impact Fee
Called Contact Person
A.i.P.P.
Date of permit issue
Total Permit Fees
V