06-0345 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00000345'
80105 CEDAR CREST
762-060-001- -
POOL - RESIDENTIAL
LOW DENSITY RESIDENT
20000
Architect
A—la-1
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thatAm licensed under provisions of Chapter 9 (commencing with
Section 7000 of Division 3 of the Busines a d Pr ssionals Code, and my License is in full force and effect.
License Clais : C 3 License No.: 658996
;�act
-ate: Co or:
v
AER -BUILDER DECLARATION
I hereby affirm under penalty of. perjulat 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 (5500).:
1 _ 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 _ 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:
MILLER EDWARD A
80-105 CEDAR CREST
LA QUINTA, CA 92253
Contractor:
FAMILY POOL, CONSTRUCTION
P O BOX 283
LA QUINTA, CA 92247
(760)564-3655
Lic- No.: 658996
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/23/06
------------------------------------------------
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
v 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 STATE FUND Policy Number 1344032-2005
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so a to beco subject to the workers' compensation laws of California,
and agree that, if I should a subject to the the
compensation provisions of Section
�0 of the Labor s all forthwith comply with those provisions.
ate: Applica t:
WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA ENALTIES 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 actor omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becom null and void ' ork is not commenced
within 180 days from date of issuance of such perm' , r cess ' of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab o rmation is correct. I agree to comply with all
city and aunty ordinances and state laws relating to build' s uction, and hereby authorize representatives
of this my to enter upon the above-mentioned grope y ction purposes.
Signature (Applicant or Agent):
7)
Application Number . . . . . 06-00000345
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. . .
. 20000
Expiration Date
7/22/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date . .
7/22/06
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
7/22/06
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 . .
7/22/06
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
m
3.00
------------------------------------------
Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number . . . . 06-00000345
----------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
----------------- ----------- ---------- ---------- ----------
Permit Fee Total 311.00 .00 .00 311.00
Plan Check Total 160.55 .00 .00 160.55
Grand Total 471.55 .00 .00 471.55
LQPERMIT
FA
'"
- City of La Quints
<'
W Balding et Safety Wvislon
P.O Box 1504, 78-495 Cale Tampico
Pamdt #
V Qiefita, CA 92233 - (760) 777.7012
Building Permit Application and Tracking Sheet
j lti Owner's Name: 1—�v i uui=--
Project A&Ihm:
A. P. Numbs:
Address: 70 I 1�tx• T
Legal
City, ST, Zip: Z25 3
Contractor:,c� L -E'
Telephone:
Addteas: , V
Project Deseaiption: to L
city, ST, Zip: Cpr 2. 57
Telephone:
State Lia #: City Lia #;
Arch.. Eng.. Designer.
Address:
City. ST, Zip: t
';'elephone:
Construction Type: Occupancy:
StMe Lia C
Project type (circle one): New Add'n After Repair Demo
Name of Confect Paaoa: Drs
Sq. Ft.: # Stories: # Units:
.Tekphone # of Comic t Person: Estimated Value of Prof �Q�
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Snbakw
gwd
Ra'd
TRACIMG
PERMTP FEES
Pdaa Sew
Play Ckeet a bsitted i2,b
Item Amount
8truWrU
Reviewed, ready for corree8ona
Por Chee!<Deposit
Tti CUs.
Caped Contact Person
Plan Coe& Balance.
IM Z/ (Me&
Pian Arcked u
Construction
Flood Aida on
Plana rembmitted
Meehaninl
Gradiq plan
v Review, ready for correcti momoe
EleeMed
&*mmcm Lin
Cadkd CoataetPerson
mummm
Gnat Aad
Plan picked up
S.KL
X" Appr"d
Plana resubmitted
Grading
IN ROUSdi:-
Revlew, rally for eorrecdoedism
Devdoper Impact Fee
Plaaaias ApprovU
Cured Coataet Pawn
Pub. Win. Aper
Aute of permit chase
&iodl Fees
Totd Permit Few
140
2
C50/f Gout -,-5e
ai y r
exl--Onq Deck
Gray
I
i
ed-,tlr4 Plock Wall
t
I'lluxe HO Mir
80/05 Gedar Greet
PGA WeSf
Golf Gour9e
Acce�" Woad i
i 00
CITY OF !A QUINTA y
BUILDING & SAFETY DEPT.
APPROVED
I
FOR
CONSTRUCTION
DATE1 BY t9'
Gommarcia/ 5wir7m raq
Ool Area
Construction
Poo/ -.,5 �pa� Fountain .
C�GO>5G4-3655
A
4M4 ;V"&
CONSTRUCTION
P.O. BOX 283
LA QUINTA, CA 92247
(760) 564-3655
LICENSE NO. 658996 January 26, 2007
Mr. Greg Butler
Building & Safety Manager
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
RE: PERMIT APPLICATION #06-00000345 CANCELLATION
Dear Mr. Butler:
Our company purchased this permit on January 27, 2006 for the construction of a
pool/spa located at 80105 Cedar Crest. There has been no construction from our
company performed at this address.
Please cancel this permit as we will not be doing any work there. Please call me at
(760)902-5346 (m) or (760)564-3655 (o) if you have any questions.
Thank you.
Don Early, Uwner
Family Fools Construction
Hand Delivered to City Hall