RPL (09-0019)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA. 92253
Application. Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
09-00000019---
50035 MONTELOMA CT
777-250-017- - - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
15000
Td-�v 4 4Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT.
LICENSED CONTRA OR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed unde provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business nd Professio als ode, and my License is in full force and effect.
License Class: C53 Lic se No.: 866518
ate: C actor: .
O ER -BUILD DECLARATION -
I hereby affirm under penalty of per�tatm. empt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Pr9ressions 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 70001 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, 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 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 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: /
LQPERMIT
Owner:
RECONE
50035 MONTELOMA CT
LA QUINTA, CA 92253
Contractor: .
GARY & SONS
67621 CACTUS APPLE
DESERT HOT SPRINGS,
(760)251-8945
Lic. No.: 866518
VOICE (760) 777-7012
FAX. (760) 777-7011
.INSPECTIONS (760) 777-7153
6t�t
0 0.209
Date: 1/08/09
CITY 0s LA QUJt4l
L
WORKER'S COMPENSATION DECLARATION
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 performanceofthe 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 DELOS INS CO Policy Number 02D 220010101
I certify that, in the performance of the work for which this trmit is issued, I shall not employ any
person in any manner so as toibecome subject to the kers' compensation laws of California,
/nd agree that, if I should b me subject to the orkcompensation provisions of Section
/3700 of the Labor Coc[Q, I h II forthwith com/y with/hose provisions.
WARNING/ FAILURE TO SEEt1RE-WORKERS' COMP ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTI A D CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE 96ST 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 ant hold harmless the City
of LaQuinta, its officers, agents and employees for any act or omission rel ed 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 ork is not commenced
within 180 days from date of issuance of such permit, or cLns
f ork for 180 days will subject
permit to cancellation. - -
I certify that I have read this application and state that the above informar ct. I agree to comply with all
city and co ty o finances and state laws relating to building constructioby authorize representatives
of this court'. toter upon terve-mentioned prop)rrtylor inspection.
(Applicant or Agent):
s
Application Number 09-00000019
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Pee 162.00 Plan Check Fee
105.30
Issue Date, Valuation . . .
. 15000
Expiration Date 7/07/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
.13.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------
117.00
Permit MECH POOL
Additional desc .
Permit Fee . . 26.00 Plan Check Fee
6.50
Issue Date . . Valuation .
. 0
Expiration Date 7/07/09
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.. 7/07/09,
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 27.00 Plan Check Fee
6.75
Issue Date Valuation
0.
Expiration.Date 7/07/09
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
SPOOL. ALARMS/BARRIERS SHALL BE IN PLACE
LQPERMIT ..
Application Number . . . . .
09-00000019
--------------------------------------------------------------------
Special Notes and Comments
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED.
------------ -- ----------------------------------------------------------
Other Fees
BLDG STDS ADMIN
(SB1473)•
1.00
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 260.00
.00
---------- -----.-
.00
260.00
Plan Check Total 129.80
.00
.00
129.80
Other Fee Total 1.00
.00
-.00
1.00
Grand Total 390.80
.00-
00
390.80
LQPERMIT
- - -
RECONS RE5IDENCE
50035 MONTELOMA COURT
MOUNTAIN VIEW COUNTRY CLUB
DATE: 12/16/01
Bin #
City of La Quints
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 # n
l"l
0
Project Address:��
Owner's Name:
A. P. Number:
Address: '-
3J T
Legal Description:
City, ST, Zip:
t/7
Contractor:
Telephone:
Address:&�, (J e
Project Description: I&A10
City, ST, Zip: I)-{ W-C(
Telephon :
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: P � �-'�
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
P Y:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: L4 I LS (-Q
Estimated Value of Project: bo
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 Cates.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Zed 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:-
''d 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