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10-0679 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000679 Property Address: 53710 AVENIDA CARRANZA APN: 774-121-010-15 -000000- Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 15000 Applicant: . (r� �- 4 4a Q" Architect or Engineer: a /a BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION - .. r.. 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: C53 License No.: 930999 ate: 1• Z:�'�tintractor: 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.). (_) 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 7/26/10 Owner: LACROIX ROGER 53710 AVENIDA CAR LA QUINTA, CA 922531 O e yup 2s 20to _Contractor:_. LEFT COAST POOL CONC 74478 HIGHWAY 111, ST PALM DESERT, CA 92260 (760)567-9007 Lic. No.: 930999 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' compensation insurance carrier and policy number are: Carrier EXEMPT Policy Number EXEMPT 1.i I certify that, in the performance of the work for which this permit is issued, I shall not employ any V� person in any manner so as to beco a subject to the work ' compensation laws of California, and agree that, if I should bec m s bje s compensation provisions of Section 3700 of the Lab or Cade I sh I wit o ly with those provisions. /� r ate: L' cant: WARNING: FAIL RE 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 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 infor ation isE,,e a ee tocomply with all city and county ordinances and state laws relating to building constr c on, andauthorize representatives of thi counnty to 1enntter upon the above-mentioned propert for 'n e i purpo ate: ! r1* "0 S ature (Applicant or Agent): v LQPERMIT Application Number . . . . . 10-00000679 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation. . . . . . 15000 Expiration Date 1/22/11 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 1/22/11 Qty Unit Charge: Per Extension BASE FEE 15.00 1.00 11.0000iEA 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 1/22/11 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 1/22/11 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 ----------------------------------------------------------------------------- Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN Application Number 10-00000679 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2007. CODES. Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ------------------------------------- Paid Credited -------------------- Due Permit Fee Total 266.00 .00 .00 266.00 Plan Check Total 131.30 .00 .00 131.30 Other Fee Total 1.00 .00 .00 1.00 Grand -Total-- 398 73-0 R . 0'0 —'". 00 ":'"- '398": 30'- _._._........__...__._....__._..._............. . . i LQPER IIT H F � �• S spa UA�\ Raised bond beam ® I A 22 f1. FP 0 0 � Q I � •Plit1A � Q Roger aktd civide Lacroix s3 -,%so,4✓ewida Carravlza La i2uinta, CAJ22,5.3 CITY OF LA QU!NTA BUILDING & SAFETY DEPT. _„ .. ... Left Coast Pooh Concepts, Inc. APPROVED Lic•93o999-Tel.760•567.9007 FOR CONSTRUCTION j . www. L cFtCoastFoolConccpts.com The rusion of Art, Design and Water DATE .% "AO BY PAGE DEPT. DESIGNER REV Mario M Horvath �+ SCALE SHEET 1 OF 1 Bin # City of LA Quin LCI Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 10 ' Project Address: 3 f] �V� - CAI2 AJ 2-4 Owner's Name: A. P. Number: Address: /Q AUE 1124 Legal Description: City, ST, Zip: j Contractor: C, — } i' Telephone: Address:c1,i`?9 Ht A) l f f *Z-79 Project Description: .P .o City, ST, Zip: Z) Telephone: -10 State Lic: # . City Lic. C Arch., _Engr., Designer: • QS:-1)J 0--- Address: ^ I City., ST, Zip: k r iJA CA2 U 0� Telephone:�I p t 4v. '� .�: ro ti State Lic. #: �5 ?` :^'•.,;/y, '.:' Name of Contact Persona .1 Construction Type:Occupancy: Project type (circle one): a Add'n Alter Repair Demo Sq. Ft :# Stories: #Units: Telephone # of Contact Person: Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 1-240 Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Truss Coles. Called Contact Person Pian Check Balance. Title 24 Coles. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 20° Review, ready for correctionstissue Electrical Subcontactor. List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd 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 CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESSS3110 „IVY CAR24412A PERMIT NUMBER OWNER — BUILDER U ►= f C �.t ��i�1- UIYLCav This form shall be posted on the job with the Building Inspection Card at all times in a conspicuousplace. Only person appearing on this list or their employees are authorized to wor 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 voidanc of building permit. For each applicable trade. all information reauested below must be comoleted by annlicant_ "On File' is not an accentable response. / Classification Con ant to'sLkettse . .. :N::. ks... ,:71 QraTrade 't . Bu License" :• nsat%ti;insw . Gr sines Company Name Classification (e.g. A. B, C-8) License Number (xxxxxx► r Exp. Date �xx/xx/xx) Carrier Name (e.g. State Fund, CaK;omp) Poky Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp, Date Ixx/xx/xxl EARTHWORK (C.12) — n •'�jJ' ll — T Jl s�� 3 CONCRETE (C-8)' - R ?75 FRAMING (C-5) STRUC?:'STEEL (C=51) - MASONRY (C-29) _10 PLUMBING (C-36) tt i,11�� aa �.✓a' I i C J\pi�� 1���•�Z� '�1�lli �p L'� '1J+'�� LATH-- PLASTER (C-35) DRYWALL (C-9) . HVAC (C-20) ELECTRICAL.(C=po):. f�l 5 r � �5�� o'l l SiA J1ti� 1�3�`d ZS ( - I� ('7t RQQRNG' f C=39) SHEET -METAL (C--43) ) FL O RING K,--`15). GLAZING (C-17) MISULATIOOIC72) SEWAGE DISPt (C.2) PAINTING (C-33) . CERAMIC TILE (C-54) ' CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) POOL (C-53)