07-1221 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
�Applicatio_n Number:, _07-0000122'1___.'.1
c&t�v 4 4 Q"
Property Address: 81625 HIDDEN LINKS DR
.APN: 767-200-999-27 -312022-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application.valuation: 15000
Applicant: Architect or Engineer:
--------- - - - - --
(CEN
I hereby aff m u er penalty of pe
Section 70 0) of Division 3 of the
Lice CI ss:
Date:' Contractor:
of
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
.r 9 Ic mmencing with
ull force and effect.
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 employe ,provided that the
improvements are not intended or offered for sate. If, however, the buil in or improvement is sold within
one year of completion, the owner -builder w' ave the burden of proving at he or she did not build or
improve for the purpose of sate.).
(_) I, as owner of the property, am exclusivel contracts g i sed contra ors to cons c the project (Sec.
70 ,Business and Professions Co The Con tors'
St.
License aw does a ly to an owner of
pro erty who builds or improves th reon, and w contracts r the pr jects wi a co tractor(s) licensed
pu uant to t e Contractors' State scene Law .
(_) I am empt unler Sec. , B. P.C. for th' reason
S
Date: �
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 .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/20/07
Owner:
HOWARD RESIDENCE
81-625 HIDDEN LINKS
LA QUINTA, CA 92253
--------------------LCIMAY
------
Contractor:
Owner 1 7 2007
TY OF LA QUI ----------------------�r► A
-----------------------------------------------
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 Sectio 3700 of the Labor
Code, for the performance of [ rk fo ich is permit i; issued. wo ers' compensation
insurance carrier and policy umber
Carrier - Poli Number
certify that, in the perfor ante of th ork for whi /hismrimikKissued, shall not employ any
7t 5person in any manner o as to be a subject to hees'mpion laws of California,
acid a ree that, if Isould becom ubject to the orc pensati provisions of Section
70 of the Labor ode, I shall thwithcomp wi provisi s.
Date plicant
�_ -. /
WARNING:. FAI URE TO SECURE WORKER COMPENS ION COVER GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES 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 applicati
the owner, and the applicant, each agrees to, and shall defend . m . harmless the.- y
of La Quinta, its officers, agents and employees for any or omi on related to the ork bei
performed under or following issuance of this permit.
2. Any permit issued as a result of this application be mes null an oid if work is not omm ced
within 180 days from date of issuance of such rmit, or cess on of work for 1 day wills bjeci
permit to cancellation.
I certify th t 1 have read this application and state that t .above informat is corre . I a ee��to om ith all
city and c my or inances and state laws relating to b ding constructs , nd here y au oriie epr a tatives
of thi co/nty toTn/er upon the above-mentioned prop rty for inspecti p poses.
Date: / V �I Signature (Applicant or Agentl' ~�
Application Number . . . . . 07-00001221
Permit . . .
BLDG POOL PERMIT•
Additional desc .
Permit Fee . . . .
162.00 Plan Check Fee
105.30
Issue Date . . . .
Valuation . . .
. 15000
Expiration Date
10/17/07
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
10/17/07
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
10/17/07
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 . . . .
33.00 :Plan Check Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
10/17/07 .
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 3.00.00
=
EA •PLB GAS PIPE 1-4,OUTLETS
-
3.00
------------------------------------------------------------
-Special Notes and Comments
--------------
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
LQPERA4[T
Application Number . . 07-00001221
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION. 30"
COURTESY RETAINING BLOCK WALL. GAS STUB
FOR FUTURE APPLIANCES PERMITTED BY
SEPARATE PERMIT ONLY.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 266..00 .00 .00 266.00
Plan•Check Total 131.30 .00 .00 131.30
Grand Total 397.30 .00 .00 397.30
LQPERNIIT
Bin #
City of. La Quin'ta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �. �-�� l � ��
Owner's Name:. j
A. P. Number:
Address:
Legal Description:
Contractor: 6 b lu L..,2 �� � ��2
City, ST, Zip:
Telephone:
Address: / . Z 1, N k,>
Project Description:
City, ST, Zip: &(Amjj
Telephone:L4-09.
4 -09.G
q
NJ ✓�NC7< Ott -30
State Lic. # :
#:4A,,VIA
I L,pU/ (.,,:j p L(._
Arch., Engr., Designer:
4 0rS JYu 0 d viZ 4yl\, i�.?,.,,
Address:.P
City, ST, Zip:
Telephone: J
State Lic. #:
Name of Contact Person: (J 1rf-'
Construction Type: Occupancy:
Project type (circle one):' New 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 submittedItem
Amount
Structural Cates.
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
2"d 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
c1- L CITY OF LA QUINTA SUB=CONTRAC` LIST
JOB ADDRESS �I "Z� l`���I�e^/ /'►�"l� S PERMIT NUMBER %/a. ,/ OWNER BUILDER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. On 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 tirade, 611 information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade CI sifica'
/ as tion
:.
Contracto . :::: :.:.....:.
r
..:.:....:... .. ....:.:..:.. .
:. :.... ..
::. ::.:..:.::
a"
tata..Contractor.s. License... :.:...:::.
;::: ;:r :.:.:::..::::::;:..:.:...:.; :.::.::: ;:::.>:;:.:::::;::>:; . :
:.. :.:..::.. ;;V{iorkers.Com ertsation;InsuranCe:° .:`'::: ':;:.:. :-
City. Bus ne. s
Company Name
Classification
(e.g. A, B, -C-8)
License Number �
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State: Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date.
(xic/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (c-12)
C, /
9-79N
O
CONCRETE
FRAMING :4C
STRUCT::STEEL.(C-S1)
�- C'k CLA-0-er I'-)
MASONRY (C-29) ;.
PLUMBING (C-36)
LATH, PLASTER(C-35)
%��-. Q'� (l�S /!
l� S
7/04P��
g 31 / ��
(�
! 8 28'.33
I p
I -7q 3Gi
NCO
6�
DRYWALL (C-9)..
HVAC.IC-201':.: %... ">
ELECTRICAL.(C=10) ::' • ,
.. ..
Cc�r�z-c � c�v�-1 e.
C: f D
2$101 � Gl. ..
Ski
r2r�Jsuie_
�ura.�tceC��e
l�vu�!/vo/s�oo1
/- / -0 8
2Z�°i
j Z
r'�t
RQ00ING'.(C.=39)
SHEET METAL (C'-431
.FLOORING
GLAZING (C-17) ...
INSULATION'(C-2) . . ;.::.
SEWAGE DISP (Q-42)-
G-42)
PAINTING
PAINTING (C-'33)'-:
CERAMIC TILE (C-54)
CABINETS IG -6)
FENCING (CA3)
LANDSCAPING (C=27)
11 POOL (C-53)