06-2387 (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: P10n
V'
06-00002387
60179 HONEYSUCKLE ST
764-270-999-137 -300233-
POOL - RESIDENTIAL
MEDIUM HIGH DENSITY RES
10000
Tiht 4 4'Q"
Architect or Engineer:
N IAS
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisio f Chapter 9 (commencing with
Section 7000) of Division 3 of the B ,Qjpiesshr�als Mal License is in full force and effect.
License Class: A B C20 /J /J1 se 723
-"'— WNER-BUILDER DECLARATION
I hereby affirm uncle natty of p r' that I am exempt from the Contractor's State License Law for the
following reason 1 . 7031.5, B siness 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 contractors) 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:
LQPERA11T
i�v
Owner:
SUE RASMUSSEN
60-179 HONEYSUCKLE
LA QUINTA, CA 92253
Contractor:
TIM GILBERT, INC.
43501 TORPHIN HILL PL
INDIO, CA 92201
(760)835-5959
LiC. No.: 617723
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/14/06
r
JUN 19 2006
CITY OF LA QUINTA
------------------
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
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 beco a subject to the workers' compensation laws of California,
and agree that ' bec bject t e workers' compensation provisions of Section
3700 oft abor C ly ith thos si ns
' Datef� plicanti
WARNING: FAILU TO CURE RS' PENSATION C IS UNLAWFUL, AND SHALL
SUBJECT AN EMPIIER TO CRI A P LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0 0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
s �
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 is corr I agree o comp)with all
city and county ordinances and state law ing to bui ' g co e , and h a e (h dFtativ
of this county to enter upon the abov entioned property tion pur
Dater % —lY . - Signature (Ap icant or Agent):
L
Application Number .
. . 06-00002387
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
117.00 Plan Check Fee
76.05
Issue Date . . . .
Valuation . . .
. 10000
Expiration Date
12/11/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
8.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
72.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
12/11/06
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
12/11/06
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
12/11/06
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
3.00
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
C
Application Number . . . . . 06-00002387
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 240
Expiration Date 12/11/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SPA/15LFX4FT EQUIPMENT WALL CITY
STANDARD ALARM/BARRIERS SHALL BE IN
PLACE AT PRE-PLASTER INSPECTION.
Fee summary Charged Paid
----------- - - - - -
Credited
Due
----- - - - - ------ - - -
Permit Fee Total 236.00
- ------ - - -
.0;
- ----
.00
-- - - - - --
236.00
Plan Check Total 102.05
.00
.00
102.05
Grand Total. 338.05
.00
..00
338.05
LQPERMIT -,
I� Y'2
I/CITY OF LA QUINTA SUB-CONTRACTOR LIST
:JOB ADDRESS �
IT NUMBER G(o, 2.3S7 OWNER BUILDER
This form shall be posted on the job with the B
nn Inspection Card at all times in a conspicuous place. Only 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 trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
i
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Company Name
Classification
Licensee Number
Exp. Date
Carrier Name
Policy Number
Exp. Date
Licensea Number
. Date
Exp.
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A RE-INSPECTIOIN FEE OF $30 —'t -41e, xe f�
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON (,0177
THE SITE FOR A SCHEDULED
INSPECTION. 7-P1Y ,
NO EXCEPTIONS!
CITY OFF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVED
FO C NSTRUCTION
DA ► V �BY �'/l
R
A)
or
Bin #
Cityof La Qui ht'a
Building 8T Safety Division
P.O: Box 1504, 78-495 Calle Tampico.
l a Quinta, CA 92253 - (760) 777-7012
- Building Permit Application and Tracking Sheet
Permit•#
^
Project Address: -
G `
Owner's Name: --
A P. Number.
Address:
Legal Description:City,
Contractor:
Address: `J? l L
ST, Zip:
Telephone:
Project Description: s
City, ST, Zip:o
Telephone:
Ms_4
State Lie. # .: 2,
City Lica #:
Arch., Engn, Designer:
Address:.
City, ST, Zip:
Telephone:
Construction. Type:\'LAccupancy:
State Lic. #:
Project type (circle one): ew Add'n Alter . Repair Demo
Name of Contact Person:
Sq. Ft.: /C)
# Stories:
# Units:
Telephone # of. Contact Person:
Estimated Value of Project: .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIQNG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans Picked .uP
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
20 Review, ready for corrections/issue
Electrical
Subeontactor.List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
HOA. Approval '
Plans resubmitted
Grading
IN HOUSE:
'`' Review, ready for correctionsrssue
Developer"'Impact Fee.
Planning Approval
Called Contact Person
A.LP.P.
Pub: Wks. Appr
Date of permit issue
School Fees
Total Permit Fees