05-4173 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-0.0004173
Property Address:
81628 CHARISMATIC WY
APN:
767-200'-999-38 -31202-1-
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Applicant: Architect.or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING& SAFETY DEPARTMENT
BUILDING PERMIT
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 License is in full force and effect.
License Class: License No.:
,/Date
con Va L r S fro A
O W NER-BUILDER' DECLARATION
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 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 Businessand 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 (8500)•:
(_ 1 1, as owner of the property, or my employees with wagss.as their sola 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 improvementislsokf 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'vt 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 Lew does notapply 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.).
(_) I em exempt under Sec. , B.&P.C: for thisreason
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: CJ.
Lender's Name:
Lender's Address:
Owner:
BRANDA.
81-628 CHARISMATIC
LA QUINTA, CA 92253
(
Contractor:
MCINTYRE
WCC:
WC:
CSLB:
POOLS &
STATE FU
1769111
614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777=7153
Date: 9/19/05
WAY
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,mself-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
�j issued.
I have -arid will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T Code, for<the performance of the work'for which this permit is issued. My workers' compensation
Insurance carrier and policy'nwmber 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 to as to become subject to the workers' compensation laws of California,
and agree that,'if'l should become subject to a workers' compensation, provisions of Section
3700 of the Labor Code, I shall forthwith ply with those evislons. .
y/%yi�� Applicant.
WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS,UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (6100;000). IN ADDITION TO THE COST OF COMPENSATION, 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 parmit.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 aril for
whose benefit work is performed under: or pursuant to any permit issued as a result'of this:appiication,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of L&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 resuit,of this application becomesnull.and void if work;is not -commenced
within 180 days from date of issuance of,such'permit, or cessation of workfor 180 days will subject
permit to cancellation.
1 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, pW hereby aLith rize representatives
of this county to -enter upon the:above-mentioned property for i actio rposes.
Signature (Applicant or Agent), ♦� /t Z_
Application Number . . . . . 05-00004173
Permit
. . . BLDG POOL PERMIT
Additional
desc ,
Permit Fee
. . . . 207.00 Plan Check Fee
134.55
Issue Date
. . . Valuation . . .
. 20.000
Expiration
Date 3/18/06
Qty Unit Charge Per
Extension-
xtensionBASE
BASEFEE
45.00
18.00
9.6000 THOU BLDG 2,001-25,000
162.00
.Permit
. . . MECH POOL
Additional
desc .
Permit Fee
. . . . 26._0.0 Plan Check Fee
6.50
Issue Date
Valuation . . .
. 6
Expiration
Date 3./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 3/18/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00
-------------------------------------------------------------------------------------
3.0.0000 EA ELEC PRIVATE SWIMMING POOL
30.00
PermitPLUMBING
Additional
desc .. .
Permit Fee
. . . . 33.00 Plan Check Fee
8.25
Issue Date
. . . . Valuation
0
Expiration
Date 3/18/06
Qty Unit Charge Per
Extension
BASE_ FEE
15.00
2.00
6.0000 EA PLB FIXTURE
12.00
1.00
3.0006 EA PLB WATER INST/ALT/REP
3. OD
1.00
------------------------------------------------------------
3.0000 EA. PLB GAS PIPE.1-4 OUTLETS
3.00
-------------
Special Notes and Comments
POOL & SPA
ONLY. ALARMS/BARRIERS. SHALL
Application Number . . . . . 05-000041.73
---------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE-PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid
Credited
Due
Permit Fee Total 311.00 .00
.00
311..00
Plan Check Total 160.55 .00
.00
160.55
Grand Total 471.55 .00
.00
471.55
LQ
Bin
City of La QuInt'4.
Building 8i' Safety'Division
Per mit.IY
!72✓
P.O. Box 1504, 78.495 Calle Tampico
La Quints, CA 92253
- (760) 777.7012
Building Perm Application and Tracking Sheet
Project Address: �
�
'
f140
Owner's Name:
A. P. Number.
Address:
le t ./
Legal Description:
Contractor:
City, ST, Ztp w
A
Telephone: / =
/
Address _
. !
n7 A
U •
Project D Proj
J escciption:
City, ST, Zip:
��
Telephone;
�Z
f
State Lic. # :
Citytic. #: s
Arch.,
rch., Engr., Designer:
rCAddress;
ity..ST, Zip:
Telephone:
StatcL'ic: #•
Constriction Type: Occupancy:
"
Name of Contact Person: '
Project type (circle one)• ear Add'n Alter------
lter. Rcpur. Demo
.Sq.
Telephone 9 of Contact Person:
Ft.: �
#Stories:
#Units;,
w
Estimated Value of Project: Q
APPLICANT:
DO'N0T WRITI•BELOW THIS LINE
It
Submittal.
Req'd
Recd.
TRACKING
Plan Sets
PERMITE'EFS
i
Plan Check submitted
9 QS
Item
Structural Cates.
Reviewed, ready for carrections
Amount. .
TtussCdc;.
Plan Check Deposit
••
.Called Contact Person
Plan Check Balance
71de 24 Cales
Plant pieketl'up
Flood plain plan
Construction
'
Plans resubmitted
-
11Ycchanleal
Grading plan
•
20' Re0ew•, ready for correctionsrssue
I:leelrlcal
SubeoutsctorUst
Called Contact Person
Grant Deed
Plumbing
Plans picked up
S.IIt.I.
II.O.A. Approval
Plans:resubmilted
IN I[OUSE:-
eview eady for correctionstIssue'
b
Grading
Developer Impact Fee
Planning Approval
Called Contact PC'rfOn
Pub. Wks. Appr
Date of permit. issue
A.t.P.P.
School Fees
Total Permit Fe,
AI
m�
I
� Qn 01
1
I
I
I
b
13Y
POOL SIZES x i
POOL S.A. �50 sa, Fr
POOL PER. 82 Fr
DEPTHS -�' -O' TO y -�
POOL PUMP �.5 H.P.
HEATER 400,000 r3ru
MTER CT -420
i-100 Warr
LIGHTS 2-100 WArr
CONTROLLER
SPA SIZE i, pia
SPA PER. 22' LFr,
SPA S.A. �8' 50, Fr,
SPA DEPTH 36''
JETS 5
JET PUMP 15 Hp
DECK AREA 4« 50, Fr,
PAVER AREA
cm
go
�.r
°
�'
ol■
tid
;
I�
Q
W
-
ca
c
a
v
1.
c=
40o
d
v
�
DATE: 0 9 / 0 8 /US
SCALE: 1 /8 "=1
DRAWN BY: 1) T
JOB: BRANDA
SHEET
OF SHEETS
3
...��`'