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04-6044 (RPL)
BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760),777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-00006044 D`:b 8/25/04° -- Property Addres.s . . . . . . 47620 CALEO BAY APN: 643-230-002- - - AUG Application description POOL - RESIDENTIAL 2 ZQQ�y Property Zoning . . . . . . . MEDIUM DENSITY RES CiTyOnpc CJ Application valuation . . . . 25900 Owner Contractor ------------------------ --------------------- 7 -- ANDREW VARTANI MC CALLUM POOLS PO BOX 3586 46576 VIA CELESTE LA QUINTA CA 92253 INDIO CA 92201 (760) 775-5685 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB: 818835 04/30/05 CCC: C53 ---------------------------------------------------------------------------- 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 ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee 258.50 Plan Check Fee 168.03 Issue Date . . . . Valuation . . . . 25900 Qty Unit Charge Per Extension BASE FEE 252.00 1.00 6.5000 THOU BLDG 25,001-50,000 6.50 7 ---------------------------------------------------------------------- .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 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 P.O. Box 1504ICE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: © Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: 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 Licen is in1�u11 force and effect. 7 License Class�� S License No.s lee Date r/ b ' q Contractor (Y\ \ 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. , B.8 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 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 Policy Number 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 becomes ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with lh Bions Date 'I; "' Applicant WARNING: FAILURE TO SECURE W ERS' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 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 itp all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this count to enter upon ove-mentioned pro ert for inspection purposes. Date '�� Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006044 Date 8/25/04 ---------------------------------------------------------------------------- Permit PLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 5.25 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 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited ------------------ Due ------------------------------- Permit Fee Total 360.50 .00 .00 ---------- 360.50 Plan Check Total 190.5.3 .00 .00 190.53 Grand Total .551.03 .00 .00 551.03 Rug 11 04 05:39p Joseph mccallum 7607755685 p.2 o e ZVm� 3 Y W! t f• _____________ _______..-___- -1 o por—H 1 1 1 LAA �D-� —_, 1_ _ _ _ _ _ _ XIS \COVERD PATIO\ L & SAFETY DEP OVED ONSTR� ifCl+y cone Rc,,6-.tvI✓t h U01" EXISTING RESIDENCE Lc% e Aq'7.. 00 Lco t-cl0 ` Aug 12 04.04:30p Joseph mccallum 1 q S_ N i = - am U W ? Y U fi W • W Z I ol z oSe! O■ '� i _ t _____--- ---_ =--------_ _ BUILDING & SAIF Y C EPT.xisnNc covERo,PAno� APROV FOR CONS DATE r/ �,' 7 BY _�l 7607755685 p.2 A RE -INSPECTION FEE 0 $30 WILL BE CHARGED IF THE I PPROVED EXISTING RESIDENCE PLANS AND JOB CARD A NOT ON THE SITE FOR A SCI ED . LED INSPECTION. NO EXCEPTIONS CITY OF LA QUINTA SUB -CONTRACTOR LIST (f Q JOB ADDRESS &)o o-,4 PERMIT NUMBER (,,o,41 OWNER BUILDER_ h_ C' This form shall be posted on the job with the Bu If ding Inspection Card at all times in a' conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work Faille t^ o cpm Icy will result in a�stoppage of work and/or the voidance of hiiildina hermit. For each applicable trade, all information reauested below must be completed by aoolicant. ("On File" is not an acceptable response 4, Trade /Classification Contractor State Contractor's License 17Vorkers Com ensation Insurance City Business License Company Name Classification. le.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xxlxx/xx) Carrier Name (e.g. State Fund, CalComlp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) 1 11 A A <90 3 5 SC) 5: }-e T, 2:4 0 CONCRETE (C-8) �.(✓ C 7 -LY Ll 19�5�-(� j?j� �,4 1 2 1 0-Dool Da5 FRAMING (C-5) ' STRUCT. STEEL (C-51) P� R " �� cc c9 3S -SO _-131 9 OU1'-14 2 -1 -03 I -3ro MASONRY (C-29) PLUMBING (C-36) (� �'1J�) t �C� A S0 ,3S,SO- 3-3) -ou -t �., aG 0 0 2 4 -7 7 ( 7 LATH, PLASTER (C-35) e2�o� Wit` C =>3 (�l. Ci 7D '/o •3i -o.S 5 u+ e �,,,��_ea I 9b acoy (0-1-0s DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) 1 -eJ A\_ <go3 SSC) 3 31-O C9 ",•� 22Gr-602`Ny�% -%' ROOFING (C-39) SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) SEWAGE DISP. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) POOL (C-53) VylaCA I L, c5 p O I gg y 30'OS &xf A 0d