04-7411 (RPL)1. n __
_ a-
YY 1 Y Y
UfBUILDING & SAFETY DEPARTMENT
�,.Box 1504 (760).777-7012
_78--49 " CALLE TAMPICO FAX (760) 777-7011
TLA U
CEpEpg QJ NTA, CALIFORNIA 92253 . INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number
Property Address . . . .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
04=0=0007411
81815_B'ROWN DEER PARK
767-540-018- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
15000
Date 11/23/04
Owner Contractor
CALIFORNIA COVE COMMUNITIES MCINTYRE POOLS & SPAS, INC.
81795 BROWN DEER PARK P.O. BOX 1791
LA QUINTA CA 92253 LA QUINTA CA 92253
(760) 342-3612
WCC: HRH INS
WC: 176911104 01/01/05
CSLB: 614611 09/30/05
CCG: C53
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Permit . . . BLDG POOL PERMIT
Additional desc
Permit Fee . . . . 162.00 Plan Check Fee 105.30
Issue Date . . . . Valuation . . . . 15000
Qty Unit Charge Per Extension
BASE FEE 45.00
13.00 9.0000 THOU BLDG 2,001-25,000. 117.00
------------------------------------------------7---------------------------
Permit . . . . . . MECH POOL
Additional desc
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9:00
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Permit . . . . . . ELEC POOL PERMIT -RES
Additional desc
Permit Fee 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.000.0 EA ELEC PRIVATE SWIMMING POOL 30.00
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Permit . . . . . . PLUMBING
Additional desc
Permit Fee 33.00 Plan Check Fee 8.25
P.O. Box 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO Tdf 4 4 a"FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 044- 'Ll (( Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
A i j,4�t��
LI/rp
Architect or Engineer's Address:
�,4
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 Licens in f ce and effect.
nst!
cee Classes cense No. 1 (p
ateontractor ��ljM 1
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C, for this reason
Date Owner
WORKERS' 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
Lof the work for which this permit is issued.
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
iss d.` o er ' compensation i rance carrier a�jp c m r a
artier olicy Number l L v ] 1-1
_ 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 3700 of the Labor Code, I shall
forthwith comply with those provisions.
✓ Date 1 pplicant SI— V 'C o t 7� c,^,&C�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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.
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
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 relating to building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
to Si ure (Applicant or Agent): 4111-1Aa�r—
M
Page 2
Application Number . . . . . 04-00007411
Date 11/23/04
Issue Date . . . . Valuation . .
. . 0
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
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Special Notes and Comments
POOL/SPA, BBQ (#3020914).
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited
-----------------
Due
------------------------------
Permit Fee total 264.00 .00 .00
----------
264.00
Plan Check Total 130.80 .00 .00
130.80
Grand Total .394.80 .00 .00
394.80
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Walidesign
Incorporated
DRYWALL * INSULATION * PAINT * PLASTER * CONTRACTOR
Lot 18
La Quinta
Street Address
City
Riverside
Calif Cove Comm
Las Ventanas 18
County
Builder
Project Lot
Description of Insulation :
Thickness
R -Value
Exterior Walls
Insulation Type: Batts
6 1/4
19
Flat Ceilings
Insulation Type: Batts
12
38
Cathedral Ceilings
Insulation Type: Batts
0
Garage Ceilings
Insulation Type: Batts
0
Interior Walls
Insulation Type: Batts
0
Interm Ceilings
Insulation Type: Batts
0
Garage Walls
Insulation Type: Batts
0
Slab on Grade
Insulation Type: Batts
.0
Blown Ceilings
Insulation Type: Cellulose
0
Blown Ceilings
Insulation Type: Insulsafe 0
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Energy Efficient Standards for residential buildings (Title 24, Part 6, California Code of Regulations)
as indicated on the Certificate of Compliance, where applicable.
449739 c..J�.� Walldesign, Inc.
License Number Signature Date Insulation
Subcontractor