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05-3152 (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: � �Ll�✓tet! 05-00003152 81745 BROWN DEER PARK 767-540-011- - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 20000 Architect or BUILDING & SAFETY DEPARTMENT BUILDINGTERMIT 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: License No.: /e:Az_-z Contractor: C P ffJP 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.). (_ 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: 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-..I FAX (760) 777-7011 INSPECTIONS (760) 777-7153 INC. 01/01/06 09/30/05 Date: 7/22/05 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 7� 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 ubject to a work s' compensation laws of California, and agree that, if I should becomes ject to th orker compensation provisions of Section 3700 of the Labor Code, I f hwith cc ly wit those provisions. Applicant:/ WARNFAILURE TO SECURE �/0ERS"C0?h4 ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMW S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). IN ADDITIN TO THE CT 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. certify that I have read this application and state �thatth 'above informatio 's correct. I greet comply with all city an county ordinances and state laws relatingildingcontio ;and hereby thori representatives of thi count o enter upon the above-mentioned ertXo' ecY purposes. Date: Signature (Applicant or Agentl: Application Number . . . . . 05-00003152 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date 1/18/06 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 . . 1/18/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 -----------------------------------------------------------------7---------- 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 . . 1/18/06 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 1/18/06 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 . . 05-00003152 ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ----------------- ---------- Permit Fee Total 311.00 Plan Check Total 160.55 Grand Total, 471.55 LQPERMIT Paid Credited 00 .00 00 .00 00 .00 Due 311.00 160.55 471.55 Bin, # Permit # p 3� Sz Project Address: 7� A. P. Number: i Legal -Description: Contractor: Address: City, ST, Zip: i Telephone: i ` State Lic. # : L Arch., Engr., Designer: . Address! City, ST, Zip: Telephone: --------------- $tate I:ic. #: Name of Contact Person: City Of La QUintj Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheer E eJ 7 l/ v Telephone # of Contact Person: —,.e3 q Submittal Plan Sets t Structural Calcs. 1 Truss'Calcs. Title V Cales: Flood plain plan Grading plan Subcontactor hist Grant Deed II.O.A. Approval IN I[OUSE:- Planning Approval { Pub.11'ks. Appr if School Fees APPLICANT: D Req'd Recd Plan Check s Reviewed, rei Called Conta Plans picked Plans resubm 2" Review, n Called Conta Plans picked Plans.resubm s°' Revie Called Conta Date of perni Owner's Name: Address: .O VIA City, ST, Zip: Telephone: C Project Description: y f Construction Type: Occupant:': Projecttype (circle one) ew Add Alter Repair Demo Sq. Fl.: L st�. # Stories.# Units;. Estimated Value of Project:�%� 0 NOT WRITE BELOW THIS LINE TRACKING' PERMIT FEES : ibmitted 2J Item Amount dy for corrections Plan Check Deposit A Person Plan Check Balance 1p Construction fitted h4chanical ady for correctionsfissue Electrical I Person Plumbing ap S.11I.1. ' fitted Grading tdy for corrections/issue Developer lmpAcl Fee :l Person 4issuc Total Permit Fees