08-1500 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: � 08-00001500
Property Address:
80992 BELLERIVE
APN:
775-350-002- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
40000
T,iht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
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 �
a's`s: �C,�27-053 License No.: 859417
,_16ate: � C ractor:
I OWNER-BUILR ATION
I hereby affirm under penalty of perjury that I am exempt fromractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Codty or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prssuance, 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 (5500).:
(_ 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.).
(_) 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. , 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:
LQPERMST
Owner:
JIM & LESLIE WARD
80992 BELLERIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/02/08
D
Contractor: )
AMERICAN LANSCAPE/P,; L OFS 042008
!
85265 DAMASCUS AVE E i
COACHELLA, CA 92236 CITY OF
(760) 880-1173 ��f"Ja�d:1 AQU11eEpr
Lic. No.: 859417
------------------
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 per of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1890134-07
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
J 3700 of the La e, I sh Orth ' omply with those provisions.
/� Appt:
WARNING: FAIL11;10 RE WORKERS' COMPENSATION COVER 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 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the above information is correct. I agree to comply with all
city an oug��te laws relating to building construction, and hereby authorize representatives
of scou tOve-mentioned pro rty insp tion purpose .Daterplicant or Agent):
Application Number . . . . . 08-00001500
Permit . . . BLDG POOL -PERMIT
Additional desc .
Permit Fee . . . . 349.50 Plan Check Fee 227.18
Issue Date . . . . Valuation . . . . 40000
Expiration Date 3/01/09
Qty Unit Charge Per Extension
BASE FEE 252.00
15.00 6.5000 THOU BLDG 25,001-50,000 97.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/01/09
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 3/01/09
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
----------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc 2
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation 0
Expiration Date . . 3/01/09
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. ALARMS/BARRIERS SHALL BE IN
LQPERMIT
x.
Application Number . . . . . 08-00001500
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 453.50 .00 .00 453.50
Plan Check Total 253.18 .00 .00 253.18
Grand Total 706.68 .00 .00 706.68
LQPERMIT
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84992 BELLE RWE
LA QUINTA, CA.
CITYOF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DAT &-j�-Q BY
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Bin # City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit #b6)
La Quinta, CA 92253 - (760) 777-7012
&' Building Permit Application and Tracking Sheet
Project Address: git3 e I ? Owner's Name: J 1VVA Jr L-Er5 L 1
A. P. Number:
Address: Qj
Legal Description:
City, ST, Zip:
Contractor: ,j
Telephone: % -
Address: $$ 2GS�q-5 LKS R J E
Project Description: O�
City, ST, Zip: GOA �ry 224 16
Telephone: A 6-M ( 1 -704
State Lic. # : J/
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: V-0�-
S-R�'e 1.� C{�-C Z
Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: p 9-8-O 117 -5
1 Estimated Value of Project:
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted S
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
2"4 Review, ready for correctionsfissue 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 correctionsrissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees