05-4832 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: [`05-00004832
Property Address: x..79913 -BARCELONA DR
APN: 609-380-999-56 -293234-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Tay/ 4 4 Q"
Applicant: Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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, d my License is in full force and effect.
License Class: License.
ate:` _ Contractor
OW R- UILDER DECLARATION
I hereby affirm under penalty of perj that I am ex pt rom the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Profes ions ode: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any st uct -e, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is li d 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).:
(_ I 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 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:
GOODWIN
79-913 BARCELONA
LA QUINTA, CA
LA QUINTA, CA 9
Contractor:
ALPINE -SERVICES
WCC: STATE
WC: 229002
CSLB: 786324
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/31/05
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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 C53 Policy Number - - - - - - - - - - - - - - -
I certify that, in the performance of the work for which this per it is issued, I shall not employ any
person in any manner so as to become subject to the work s' compensation laws of California,
and agree that, if I should become subject to workers' ompensation provisions of Section
� 3700 of the Lab"PENNAL
comply wi t e provisions.
Da � 02.0 Applicant:
WARNING: FAILURE TO SECUTI COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CNOS
FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($1'00,000). IN ADDOMPENSATION, 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 1 0 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I a e to comply with all
city and county ordinances and state laws relating to building constructio eidfiereby out ize representatives
of this c%o �ty to enter upon the above-mentioned prrpeor inspect purposes.
Date: k or.e/ Signature (Applicant or Agent): _ e,�_
1�
Application Number . . . 05-00004832
Permit . . . BLDG POOL PERMIT
Additional desc
"
Permit Fee . . . . 162.00 Plan Check Fee
105.30
Issue Date Valuation . . .
. 15000
Expiration Date 4/29/06
Qty Unit Charge Pet
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 4/29/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >10'OK
----------------------------------------------------------------------------
11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee
11.25
Issue Date Valuation
0
Expiration Date 4/29/06
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 4/29/06
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
------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application'Number . . . . . 05-00004832
----------------------------------------------------------------------------
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 266.00 .00 .00 266.00
Plan Check Total 131.30 .00 .00 131.30
Grand Total 397.30 .00 .00 397.30
LQPERMIT
Bin #
City of La Quinta
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: / 7 Lr w y�
Owner'sName:
A. P. Number: 4—
Address: `� 1 ( iF6►CE(�lSlv✓{
Legal Description:
Contractor:
City, ST, Zip: [ iN n e,4 4o7aS
Telephone:
Address: Lkqe1—')- f� Vwtowt'�Le et(5
Project Description: 60 !i
City, ST, Zip: P'4 4> cI(o6n "6't 7�oZ
Telephone: LI 3 5-0
,
State Lic. #
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
#" s
Construction Type: I/&Lj Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: IO A w
Sq. Ft.:
# Stories: -T-
# Units:
Telephone # of Contact Person: .Lin — % b -z((.
Estimated Value of Project: '$21d0
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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
2" 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:-
Jrd 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
I
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Areal 441 Sq.lt, +-
Peri rneter : 91'4'
Ffmsn: pebble
CQ4or: TB5
WateMine: tole
Color: TINS - -
Deck r
Area: 785 sq,ft.
Finish: cobred salt y
C410r: TBS j
E,4uioment
1andy 2.0 )et Gump ' Alpine Poul5 And 5pv�
}andy 1.0 ors. puml7
36ndy 340 sq_1t. filter
799K 56 / Phase 1 R
3mr* 400,000 9TU heater k, 2 a
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11 ' 6 " Ta pesby 0 EMbnadir
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12'9'
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