05-2936 (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:
05-00002936
81735 BROWN DEER PARK
767-540-010- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
a/v,,C4 -10 r<
Tt-tyl 4 4 Q"
Architect or Engineer:POOLS &
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
M
r_a
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-713
Date: 7/14/05
Owner:
CA COVE COMMUNITIES
JUL 18 2005 NTYRE STATE FUNDAS,
C: 1769111 01/01/06
UZU NTA CS 614611 09/30/05
cmr
--------------------------------------------------
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 Clas License No.:
Date � � Contractor: e`dL � S � i4
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 isnot 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 contractorls) 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:
LQPER111IT
INC.
-----------------------------------------------
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 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' comp e ation provisions of Section
3700 of the Labor Code, 1 s501 forthw' comply with those pr, Bions.
Dste: Applicant/ / a�-
WARNING: FAILURE TO SECURE WORK 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES 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.
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 rela2nt)�O�
construction, and hereby auth ize repr entatives
of thi ounty enter upon the above-mentior insp tion purposes.
r
Date: Signature (Applicant or A✓
Application Number . . . . . 05-00002936 .
Permit
. . . BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 207.00
Plan Check
Fee
134.55
Issue Date
. . . .
Valuation
. . .
. 20000
Expiration
Date 1/10/06
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 1/10/06
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 1/10/06
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 1/10/06
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 . . . . . 05-00002936
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
LQPERAIIT
wD
Bina City Of La Quintd.. M
Building &r Safety Division �QVe
P.O. Box 1504, 78-495 Calle Tampico 60y'kMor4-oPermit {F
La Quints, CA 92253 • (760) 777-7012
d S- 213 �0 Building Permit Application and Tracking Sheet �-
Project Address:gs Namc. ^
A. P. Number:4ZIo Address: tJ
Legal Description: City, ST, Zip: y�v
Contractor: Tele h ne. — '` :• ?>'>.''<'
Address:Project Description:
City, ST, Zip:
Planning Approval Called Contact Person A.LP.P.
Pub. \'ks. Appr Date of permit -issue
e.
Telephone:
School Fees
ic. # : f''
Engr., Designer:
City Lic.
rAddrtss.
T, Zip:
o c:
n
Lis
Name of Contact Person: �Zz_G'J_
cu ancv:
C n ti T• c: o struc on Type: O c P
r
f
dd'n Alter r tc sir Demo
Peci le one l : c A
oProJeethStale
.
- -Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO'NOT WRITE BELOW THIS LINE
# Submittal Rtq'd
Rec'd TRACKING
PERMIT VEF.S
Pian Sets
Plan Check submitted `y
Item Amount -
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
TJ uss Calcs.Called
Contact Person
Plan Chr:ek Balance
Title 24 talcs.
Plans picked'up
Construction
Flood plain plan
Plans resubmitted
titechanical
Grading plan
2"' Rtview, ready for corrections/issue
Metrical
Subcontaetor List -
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.l•i.l.
II.O.A. Approval
Plans.resubmi'Md
Grading
IN [,OUSE:- '"' Rcvicw , eady for correctionslissue' Developer Impact Fee
Planning Approval Called Contact Person A.LP.P.
Pub. \'ks. Appr Date of permit -issue
School Fees
Total Permit Fees