08-0577 (RPL)W
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00000577
Property Address:
81808 CONTENTO -
APN:
767-200-011-4 -318742-
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
25000
Iii M- - - <
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CLARK RESIDENCE
81808 CONTENTO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Applicant: Architect or Engineer: FAMILY POOLS CONSTRU
P O BOX 283
LA QUINTA, CA 92247 (�
(760)564-3655 f
Lic. No.: 658996P r
^I R 1-02008
CITY OF I.A QUINTA
LICENSID CO ACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am i sed under provisions of Chapter 9 (commencing with
Section 70 ,PSI of Division 3 of the Business &rsson�ls Code, and my License is in full force and effect.
License CI ss: �(53j License No.: 658996
Date: / ✓ Contractor:
f 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 a6 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 _ 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, 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. , 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
Date: 4/08/08
-- v�)t'e�
--------------------- -
-- - - - - --
WORKER'S COMPENSATION DEC pr
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 STATE FUND /�olicyNqmber 1344032-8
I certify that, in the performance
person in any manner so a
A-FAILURE
agree that, if I should
0 of the Labor Code, I
Date: Applicant:
WARNTO SECURE WORKER
SUBJECT AN EMPLOYER TO CRIMINAL P
DOLLARS ($100,000). IN ADDITION TO TjH
SECTION 3706 OF THE LABOR CODE, IN EI
ark for which this permit is issued, I shall not employ any
subject to the workers' compensation laws of California,
act to the workers' compensation provisions of Section
ith comply with those provisions.
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
:ST. 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 nuloid if work is not commenced
within '180 days from date of issuance of such permit, essationl vof work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above o ation is correct. 1 agree to comply with all
city and c unt ordinances and state laws relating to building con tr tion, and hereby authorize representatives
of this my o ter upon the above-mentioned property for in fe t pulp - •es.
Date: Iv Signature (Applicant or Agent):
Application Number . . . . . 08-00000577
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
252.00 Plan Check
Fee
163.80
Issue Date . . . .
Valuation
. . .
. 25000
Expiration Date
10/05/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
23.00 9.0000
-'---------------------------------------------------------------------------
THOU BLDG•2,001-25,000
207.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
10/05/08
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
10/05/08
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
10/05/08
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/BARRIER
SHALL BE IN
LQPERMIT
Application Number . . . . . 08-00000577
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 356.00 .00 .00 356.00
Plan. Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 .00 545.80
LQPERAI IT
Bin #
City of La Quints
Btdtdmg 8t Safety DIMon
P.O. Box 1504, 78-495 Calle Tampico
[a Qtdnta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
Permit #
1
Project Address:Owner's
Name:
A. P. Number.
Address: O d
Legal Description:
City, ST, Zip: ZZSS'
Contractor: j 0
a:
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephone: (y 3•
State Lic. # : City Lie. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lie. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft:#Stories: # Units:
Telephone # of Contact Person: 412 —
Estimated Value of Project: d , 60
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Wd
Reed
TRACKING A
PERMIT FEES
Plan Seta
Plan Check submitted
Item
Amount
Structural Was.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Cala.
GRed Contact Person
Plan Check Balance.
Title U Cala.
Pion picked up
Construction
Flood plain pin
Plana resubmitted
Mechanical
Grading pin
21! Review, ready for eorrectiowAssue
Electrical
Sabeontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked op
S.M.L
H.OA. Approval
Plana resubmitted
Grading
IN HOUSE:-
k+ Review, ready for cormetions/ieeae
Developer Impact Fee
Planning App mvO
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
d�