06-3821 (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:
06-00003821
81673 HIDDEN LINKS DR
767-200-999-30 -312022-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
T4ht 4 4 Q"
Architect� or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED 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 Professionals Code, and my License is in full force and effect.
License Class: C53 License No.: 614611'
mate: Contractor:
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 dohs 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.).
( 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:
KOFF
81673 HIDDEN LINKS
LA QUINTA, CA 92110 (
Contractor:
MCINTYRE POOLS
83695 AVENUE 4
INDIO, CA 9220
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
U
,S ,QrNC 2 71006
CI FO � QiJIN
Date: 10/25/06
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
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 HRH INS Policy Number 020060333601
_ 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 as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensa ' n provisions of Section
3700 of the Labor Code,Ishall forOGith comply with ose prov' ons.
Date: �' 2 Applicant-
WARN( E TO SECURE W <ERS' COMPENSATI N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND VIL 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 orrect. I agree to comply with all
city and county ordinances and state laws relating to building construction, d hereby aut ooze reprep ntatives
of this co�un/ty t enter upon the above-mentioned property for iinnspactio urpos`es. 01
Date re (Applicant or Agent): f / /
Application Number . . . . . 06-00003821
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.00 Plan Check Fee
134.55
Issue Date
Valuation . . . .
20000
Expiration Date
4/23/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00 ,
18.00 9.0000
------------------------------------------------------------
THOU BLDG 2,001-25,000
-----------
162.00
-----
Permit . . .
M
MECH POOL
Additional.desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . . .
0
Expiration Date
4/23/07
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
4/23/07
-
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
33.00 Plan Check Fee
8.25
Issue Date
Valuation
.0
Expiration Date
4/23/07-
/23/07Qty
QtyUnit 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
--------------------------------------------------r-------------------------
Special Notes and Comments
POOL, SPA ALARMS, BARRIERS SHALL BE IN
LQPERMIT -
Application Number . . . . 06-00003821
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION. FUTURE
STUB FOR BBQ ONLY PER APPROVED PLAN.
EQUIPMENT ENCLOSURE NOT INCLUDED.
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 - "
Bin >Y
.
City of La Quillit'4.
Building 8C Safety Division
�`
W
'
La Quinta, CA 92253 - (760) 777.7012
Buiiding Permit Application and Tracking Sheet
Project Address:
A. P. Number:
Owner's Name:
Address:,
Legal Description:
City, ST, Zip: `
Contractor:
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Address: _/
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Telephone:
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Project Description:
City, ST, Zip: ��O
Telephone:
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State Lic. # : L
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City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
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Telephone:
---------------Construction
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State L•ic.#:
af. <.r!;i :,.:>`} ,:>:•;Occupancy:
Type:
'
•
Name of Contact Person:
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'7'.'"+.u:i� • xf.•Y.�ry:i::Cil%}:f> ;,> rh ;,sh
Project type (circle one cW Add'n Alter
Repair Demo
Telephone # of Contact Person:
'
Sq. Ft.:
# Stories:
#Units;
�•�
Estimated Value of Project: �Q
APPLICANT: DO 'NOT WRITE BELOW
I,
Submittal
THIS LINE
Req'd
Recd
TRACI:INC
clan secs
' •
PERMIT }'EFS
.
Plan Check submilled
1
'
Structural Cales.
Reviewed, ready for
D
tem
Amount
TrUSS'Clics.
corrections
Plan Check Deposit
.Called Contact Person
Title T4 Cales:
Plan Check Balance
Plans Picked 'up
Flood plain plan
Construction
Plans resubmitted
Grading, plan
Mechanical
Subcontactor List
2•' Review, ready for corrections/issue
Electrical
Called Contact Person
Grant Deed
Plumbing
Plans picked up
-----
II.O.A. Approval
S.M.I.
Plans. resubmilted
1N HOUSE:-
Grading
PlanningA
Approval
Review " eady for correctionsfissue'
Developer Impact Fee
Called Contact Person
Pub. wks. Appr
Date of perms( issue
School Fees
Total Permit Fees