07-2810 (SOTB)rr",
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tity/ °F 4 Q"
Application Number: 07-00002810
Property Address: 61188 CACTUS SPRING DR
APN: 764-280-999-21 -300235-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 5100
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury tha licens under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s and P le i .Is CA and my License is in full force and effect.
License Class: C53 Li No.: 890670
Date:- `�. 01 Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of erjury tha I am exempt from the Contractor's State License Caw for the
following reason (Sec. 7031 .5, usiness.a d Professions Code: Any city or county that requires a permit to
construct, alter, improve, demo sh, or rep it any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement at he she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commenci ith 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).:
(_) 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.).
am exempt under Sec. , BAP.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:
LEWIS SPIVAK
61188 CACTUS
LA QUINTA, CA
Contractor:
PLATINUM POOL
77564 COUNTRY
PALM DESERT,
(760)772-4274
Lic. No.: 890
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/25/07
SPRING DR.
92253
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 STATE FUND Policy Number 1863573-07
I certify that, in the performance of tOle
for which this permit is issued, I shall not employ any
person in any manner so as to becbje�,�fIthe workers' compensation laws of California,
and agree that, if I shoulf bAc tc/th,s workers' compensation provisions of Section
3700 of the Labor Code, I s 11 fo co ly with those provisions.
WARNING: FAILURE TO �ICURE WOR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYERRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. INITION THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LCOD , 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 staAbuildi
rmat' n correc I agree to comply with all
city and county ordinances and state laws relaticti , a d hereb uthorize representativesofthis co/u�nty,[o entfer upon the above-mentiontin pu oses.
Date] 1/1> � /Signature.(Applicant or Ag
Application Number .
. . . . 07-00002810
.Permit . . . BUILDING PERMIT
Additional desc
-
Permit Fee
81.00 Plan Check Fee
52.65
Issue Date . . . .
Valuation . . .
. 5100
Expiration Date . .
4/22/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
4.00 9.0000
-------------7---------------------------7----------------------------------
THOU BLDG 2,001-25,000
36.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
17.25 Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
4/22/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 .7500
----------------------------------------
PER. ELEC DEVICE/FIXTURE-1ST 20
------------------------------------
2.25
Permit . .
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date
Valuation
0
Expiration Date
4/22/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
--------------------------------------------------- -------------------
Special Notes and Comments
BBQ & FIREPIT PER APPROVED PLAN ONLY
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
116.25. .00 .00
116.25
Plan Check Total
61.46 .00 .00
61.46
Grand Total
177.71 .00 .00
177.71
LQPERMIT
Bin # T
City of La Quinta e
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit
n� I
G
Project' Address:' (gyp • , J CC,Nnl(^ i�t2•
Owner's Name: LL tots i x
A. P. Number:.
Address:
Legal Description:
City, ST, Zip: L P, CkJ I CJS SZZS�
Contractor: L�pr t Nv NA
Telephone:-
.
Address: spy to CGLOS ",),Z. t,-6
Project Description:
City, ST, Zip: ✓I� CA szl `
Telephone:��
State Lic. # : Off. ,--.,
City Lic. #:
Arch., Engr., Designer:'
Address:
City, ST, Zip:
Telephone: €��` k �✓
State Lic. #: a s- ._;
Name of Contact Person: off �
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
—T
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: (pQ. T7fi • '-1-;G
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
2
b 'l. 7
Item
Amount
Structural Cates. ,
Reviewed, tsa
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
�TU
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrections/issue
Electrical3
Fix LS
Subcontactor List
Called Contact Person
Plumbing 6A5
(_G f carr ZS
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
to of permit issue
School Fees
ITY OF LA 01 jjNj
LDING & SAFETY DEPT.
Total Permit Fees
L�-� "J"O I NUUTION
DATE�_BY
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RA15ED 5EA7IN6 AREA V'IITH PAVER
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RA15ED BOND )SEAM AT +Ib" ^;TH
C.CNC,RETE GAF' AKV 5TONE FACE_
DP+RDEOVE AREA AT +6" NITH PAVER
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POOL. DE30 BA5E TO 13Iw 57UGGOI-P TO
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BJASIN5 AND UPLISRT5. Hl--!16HT ANP
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BOULDeR TO HE 5ELI -O= BY
HO1�JEOJ" NER.
"BED SPA AT +16' V4IT+4 AEGIS
GAF'', STONIEr F=AGE, AND 57A6P
5rONE SPILLAAY TO POOL
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CONCRETE VEC.,KI` &1 GDLOR TO 5L
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LATE DRANN SYI
10-4-47 'OHN
5PLA 3Y-
JOHN
CHFFT
Platinum Pools
77-564 Country Club ❑r.:#108
Pala Desert, CA, 92211
Ph. 7 0-77 4274
90670 Fax. 760-772-4264