10-0032 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TdAt- 4 4 Q" -
Application Number:
—10-00006.032'
Property Address:
81469 RUSTIC CANYON DR -
APN:
764-280-999-49. -30.0236- '
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
20000
Applicant:
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 -C27 LLice'nseNo.: 823017
ate: �Qntractor:
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.- , BAP.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:
CALKINS
81469 RUSTIC'CANYON DRIVE
LA QUINTA, CA '92253
Contractor:
MCRAE POOL-& SPAS
79105 DESERT STREAM DR
LA-QUINTA, CA 92253
(760)772-2440
Lic. No.: 823017
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/13/10
JkiJ 13 2103419 iL
CITY OF LA 6?UINTA
---------------------7-------------------------
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 become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
13"i7J00 of the Labor Code,
IIls�hall forthwith comply wiittthn thiols/P,� provisions.
V A scant: -'0 "�-
WARNING: FAILU TSE RE 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 daysfrom 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 correct. I agree to comply with all
city and county ordinances and state laws relating to buildin nett-snd-hET2by"fiTftK6riie representatives
of thi ounty too enter upon the above-ment' or inspects
a1 i Si ature (Applicant or A
Application Number .
. . . 10-00000032.
Permit . .
BLDG POOL PERMIT
Additional desc..
Permit Fee . . .
207.00 Plan Check
Fee
134.55
Issue Date
Valuation
20000
Expiration Date
7/12/10
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
7/12/10'
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
7/12/10
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
7/12/10
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
Application Number . . . . . 10-00000032
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 15.00
Plan Check
Fee
.00
Issue Date . . .
Valuation
. . .
80
Expiration Date 7/12/10'
Qty Unit Charge Per,
Extension
BASE FEE
15.00
-.-----------------------------
Special Notes and Comments
----- -
POOL/SPA, FIFE PIT, 5 L.F. 11 SCREEN
WALL, CITY STANDARD. ALARMS/BARRIERS
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. 2007 CODES.
--------------------------------------
--------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
Credited
Due
Permit Fee Total 326.00
.00
.00
326.00
Plan Check Total 160.55
.00
.00
160.55
Other Fee Total 1.00
.00
.00
1.00
Grand Total 487.55
.00
.00
487.55
Bin #
Qty of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico -
La Qtiinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
O , O
Project Address: 8 _
•
Owner's Name: I
A. P. Number:
Address: ). 6 R
I
Legal Description:
Contractor.A C PA & PM19
City, ST, Zip: 44 ft'C 3
Telephone:<: <<:<•�aa s'>w :::"
Address:Project
Description: C
City, ST, Zip: A44`
2 -A
F,*� i
Telephone:
hs'%:se's.`"< z `:' a`:w:~s`.>:''.
" s
State Lic. # : 0
Arch., Engr., Designer:
City Lie. #;
Address:
City., ST, Zip:
Telephone:
P
>,.:...,�:.�S;M::x:Y :.s...:.,..�p::..«::>:>•::•:
'`"..'.;
Construction Type: Occupancy:
State Lic. #:
ProJect type circle one): New Add'n Alter Repair
Demo
Name of Contact Person:,
Sq. FL:
# Stories:
# Units:
Telephone # of Contact Person: 740 .22
Y 63 y3
Estimated Value of Project: Q, QQ
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Tide 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' 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
11 1, -
I
I..
Al,
DRAWN
CHECKED
DATE
1.30
SCALE
JOB NO.
SHEET
OF SHEETS
LU
Zoo zo
uj
u > 5
v
0
cl) cr
zU)
U-ACL®
0
Zcr
®LL <
-j LL
LLJ
m
I
I..
Al,
DRAWN
CHECKED
DATE
1.30
SCALE
JOB NO.
SHEET
OF SHEETS
1
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS lCt1s CAYPERMIT NUMBER OWNER. �/L C41k, N -C' 13U1L�ER_,/1?Cy S
This form shall be posted on the job with the Building Inspection Card. at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to worl
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 requested below must be completed by applicant. 'On File' is not an acceptable response.
Trade / Classification
...:
contractor" :.
v....Y:. w .... .:...
.....:.::::..::::. StaftE.ContractW's Lkelue ..: .......,.
:: W4tkers at%ti:l usneo::::.::..: ,;<:.:..:' ::...
.. . 'City Business
Company Name
Classification
(e.g. A. B, C-8)
License Number
(xxxxxx)
Exp. Date
Ixxlxxlxx)
Carrier Name
(e.g. State Fund. CalComp)
Policy Number
(Format Varies)
m
Exp. Date
(xxlxxlxx1
License Number
(xxxxl
Exp, Date
Ixx/xx/xx)
EARTHWORK (C-12}::.
11
i
31•
0'7
3
CONCRETE (C-8) '
If
FRAMING .(0-51
A-4
STRUCT: STEEL IC=511
Se r
J
•��.
.3
7
MASONRY W -29Y
{
PLUMBING IC -361
//
/I
LATWt PLASTER �e-351
DRYWALL (C-9) ..:.
,,,
y g3,
vet
- 3 D q )
`1 •
3 13
11 -30 -IC
HVAC. (C-20)`
I
ELECTRICAL.(C=10).,-`:
Cma. 61 /Y N
as -9 g. !
'.3atl
S340
9 3 1 9P2,S7
/
•`•
/
(9%
'•'!�
R .gFING'(11:09) "'
SHEEf.Mf TAL 0-431
FLO RING
GLAZING (0-17)`.
INSULATION (C-2).
,
SEWAGE DISP 1G-421
PAINTING (C=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING IC=271.'.:
f/ 12 Z.7'
POOL (C-53)
h
rT/ r