05-2907 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: _
OS -00002907 '
Property Address:
81705 BROWN DEER PARK
APN:
767-540-007- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Applicant: Architect or Engineer:
0.&tTr"6,U-10K
r
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
D
JUL 14 2005
CITY OF LA ®UINTA
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) o Divisio 3 of the Business and Professionals Code, and my Licens is in full force and effect.
License Class License No.: /! Gz
t06e: 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 _ 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 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner: .
SWC NORMAN 39
C/O DAVID.PEERY
7161 INDIANA AVE
RIVERSIDE, CA 92504
Contractor:
MCINTYRE POOLS & SPAS,
WCC: STATE FUND
WC: 1769111
CSLB: 614611
VOICE (760) 777-7012
FAX (760) 777-7011 _
INSPECTIONS (760) 777-7153
INC.
01/01/06
09/30/05
Date: ' 7/13/05
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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
1/ issued.
h 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 permit is issued, 1 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' co pensation provisions of Section
3700 of the Labor Code, I shall forthwi comply with tho provi ' S.
t39 e:� Applicant: vA ' -
WARNING: FAILURE TO SECURE WORKS' COMPENSATI 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 correct. I agr to com ly with all
city and co m- Ordinances and state laws relating to building construction, and hereby auth ' e repr entatives
of this c my to enter upon the above-mentioned propert or ins ion poses.
Date: % Signature (Applicant or Agent): ,
Application Number . . . . . 05-00002907
Permit
. . . BLDG POOL PERMIT
Additional
desc . .
Permit Fee
. . . . 207.00
Plan Check
Fee
134.55
Issue Date
Valuation
. . . .
20000
Expiration
Date 1/09/06
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 1/09/06
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 1/09/06
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 1/09/06
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
LQPERAIIT
Application Number . . . . . 05-00002907
-----------------------------------------------------
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 311.00 .00
.00
311.00
Plan Check
Total 160.55 .00
.00
160.55
Grand Total
471.55 .00
.00
471.55
LQPERMIT
• 1 Bin ! � • • •
,
Permit M
OS- 2 9o7
Project Address:
A. P. Number.
X Contractor:
Address: tr f
X City, ST, Zip:Iry Ck jb- r(�
Telephone:,2 u(a
State Lic. q : 14 G
Arch.. Engr., Designer:
Address:
City. ST. Zip:
Telephone:
State Lic. #: _
F% Name of Contact Person:
X I Teleahone # of Contact Person:
If Submittal Rtq'd
Plan Sets
Structural Cala.
Truss Cates.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks Appr
School Fees
City of La Qulnta
Building 8 Safety Division
P.O. Box 1504, 78-495 011e Tampico
La Quinu, G 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
AIA C"_r vil L ON-ler's Name: 1,,-e
City Lic. ak:
Cin•, ST. Zip: ( :a,-
Description:
iz-W'�r. C!A
Construction Type:
Project type (circle one): liw
Sq. Ft.:�J',�S'�' N Stories:
g l — % Estimated Value of Proiec
ArrLIvANT: DO -NOT-WRITE BELOW THIS LINE
I
TRACKING
heck submitteded. ready for corrections
Contact Person
picked up
resubmitted
view, ready for eorrectionsfissut
d Contact Person
Plans picked up
Plans resubmitted
Review, ready for correctionsfissue
Called Contact Person
Date of permit issue
Item
Occupancy:
Add'n Alter Repair Demo
N Units:
PERMIT FEES
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer impact Fee
A.I.P.P.
Total Permit Fees
Amount
P/I
7/L
/L