05-3151 (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:
05-00003151
81755 BROWN DEER PARK
767-540-012- -
POOL - RESIDENT
LOW DENSITY RES
20000
Ti'ht 4 stP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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�theBusiness and rofessionals Code, and my License is in full force and effect.
License Class: License No.:
Contrac .� J /aa
$ OWNER-BUILER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following ieason (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 (5500).:
(_ 1 1, 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:
LQPERMrT
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: 7/22/05
WORKER'S COMPENSATION DECLARATION
1 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 worke compensation laws of California,
and agree that, if I should become s t to the workers' mpensa ' n provisions of Section
!`RIG
3700 of the Labor de 11 fort ith comply with se prov' ons.
Ap: FAILURE TO SECURE WOR S' COMPENSAT N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND VIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF OMPENSATION, 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 ab infor tion is correct agree to comply with all
city and county ordinances and state laws relating to bull g�Tnsir coon,and here authora representatives
ofth/isjcunty to enter upon the above-mentioned pro y fcoon purposes
DMe: % Signature (Applicant or Ag
Application Number . . . . . 05-00003151
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 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 . . . . . 05-00003151
----------------------------------------------------------------------------
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 Due
---------- ---------- ----------
.00 .00 311.00
.00 .00 160.55
.00 .00 471.55
Permit #
05-361
Project Address: J�<
• A. P. Number:
Legal
-Description:
Contractor: G
Address:
City, ST, Zip-
i
Telephone: 6
State Lic. # : L
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: 10,011,
Telephone # of Contact Pers
# Submittal
Plan Sets
i
( Structural Calcs.
I�
Truss'Calcs.
Title 14 Calcs:
Flood plaiin plan
Grading plan
Subcontactor List
Grant Deed
II.O.A. Approval
IN IIOUSE:
Planning Approval
Pub. A%Ts. Appr
School Fees
1Z
City Of is Quill��?
Building &r Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheer
City Lic. #:
APPLICANT:
Req'd Recd
Plan Chcct
Reviewed,
Called Con
Plans picks
Plans resul
2•' Review,
Called Con
Plans pkki
Plans. resul
Revien•i
Called Con
Date of pct
Owner's Name:
' Address: '
City, ST, Zip:
v
�1 '
�►
Telephone: G
Project Description:
r>' ; Construction Type:
Occupancy:
»>' Project type (circle one
nv Add'n Alter Re air Demo
P
' Sq. # Stories: # Units:
�� Estimated Value of Project:
vv
DO NOT WRITE. BELOW THIS LINE
TRACKING'
PERMIT VEFS
submitted
71241,29-
Item
.
Amount
eady for corrections
Plan Check Deposit
fact Person
Plan Cheek Balance
d'up
---------------
Construction
muted
1ltechanical
ready for correctionstiissue
-------------
Electrical
[act Person
Plumbing
d up
S.)\I.l.
milted
Grading
ready for correctionslissue�
Developer Impact Fee
tact Person-------------
mil-issue
Total Permit Fees