09-0288 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-000002.88
Property Address: 81676 CHARISMATIC WY
APN: 767-630-035- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 23000
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ROHDE
81676 CHARISMATIC WAY
LA QUINTA, CA 92253
(
Contractor:
Applicant: Architect or Engineer: MCINTYRE POOLS &
83695 AVENUE 45
INDIO, CA 922'01
(760) 612
Lie'. No.:
6'.14611
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O'S DC
RELARATION
I herebyaffirm under penalty of perjury that I am I) naed u provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P ession I Code and my. License is in full force and effect.
License Class: - C53- cense No,: 614611
J�jtate:ntractor:
WNER-aUILDER DECLARATION
I hereby affirm under penalty of perjury. at 1 examptfromthe Contractor's State'. License Law for the
following reason (Sec. 7031.5, Business nd rofessions Code: Any city or county that requires a permit to
construCt,.alter, improve, demolish OC rep ny ,.Mr.,
ucture pnor to its ISSuance:'�aIso.requires the applicant for the
permit to file,a signed statement that he or she is licensed pursuantto the, provisions of the,Contractors State
Ucense;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).:
(_) I, as owner of the property, or my employees with wages:as their sole will do thework„and
thestructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Lew does not apply town owner of property who builds or improves -thereon,
and who does the work himself or herself, through his or her own amployees, 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 orshe.did not°build or
improve forthe purpose of sale.).
I, as owner of the property, em exclusively contracting with licensed contractors to construcCthe project (Sec.
7044, Business andProfessionsCode: The Contractors' 'State License. Lawdoes 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 Lawd.
1 _,) I am exemptunder Sec. , B.&P.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:.
LQPERMrr
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
SPAS, INC'
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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 3700r 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 MZLOS INS CO Policy Number 02DKRM12000.1870
I certify that,, in the performan of`eject
ork for which this permit is issued, I shall not employ any
person in'eny,manner so, - besubject to.the workers' compensation laws of:California,
and -agree that,
if I'should�p��cj/J�{c',omto the workers' eompensation,provisiona of Section
3700 of'the Labor Code, //shall fith comply with those provisions.
WARNING:. FAILURE TO SECU E WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC IMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100;000). IN ADDIVOF TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN
SECTION 37061 THE LABOR C . _E, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to,the Director of Building,end Safety for a.permit,subject tothe
conditions and restrictions set forth on this application:
1. Each person upon whose behalf this application ismade, each person at whoserequestand 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 Quints, 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 )Id void if work is not commenced
within 180 days from date of issuance of such peryn
,on
of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the ab is correct. I agree to comply with all
city and county ordinances and state laws relating to building d here by authorize representatives
of this county to enter upon jhe above-mentioned property f- inoses..
- I / EiAhature.lApplicantor
09
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iQrE�r
Application Number . . . . . 09-00000288
Permit BLDG POOL PERMIT
Additional desc . .
Permit Fee . . 234.0.0 Plan Check Fee 152.10
Issue Date Valuation . . . 2300.0
Expiration Date 9/26/09
Qty Unit. Charge Per Extension
BASE FEE 45.00
21.0'0 9.0000.THOU BLDG 2,001-25,000. 189.00
Permit . . . MECH POOL
Additional desc .
Permit Fee 26.00
Issue Date . . .
Expiration Date . . 9/26/09
Plan Chock Fee 6.50
Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1..00 11..0000 EA, MECH FURNACE >100K- -11.0.0
Permit . . . EL_EC POOL_ PERMIT -RES_
Additional desc . .
Permit Fee . . . . 45•:.00_ Plan Check Fee 11..25
Issue Date Valuation . . . . 0
Expiration Date 9,/26/0.9
Qty Unit Charge Per Extension
BASE FEE 15.0.0
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
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Permit. . . . PLUMBING.
Additional desc .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date -9/26/09
Qty Unit. Charge Per Extension
BASE FEE 15.00
2.00 6.0000 EA PLB FIXTURE 1.2.00
1..00 3.0.000 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. ALARMS/BARRIERS SHALL BE IN.
Application Number . .. . 09-00000288
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Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
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Other.Fees . . . . . .. . .BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged
Permit Fee Total 338.00
Plan Check_ Total 178.10
Other Fee Total 1.00
Grand Total 517.10
LQrERMrr
Paid Credited Due
.00 .00 338.00
.00 .00 178.10
.00 .00 1.00
.00 .00 517.10
Bin #
CIV of La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La. Quanta, CA 92253 - (760) 777-70.12
Building Permit Application and Tracking Sheet
Permit #
o-
Project Address: �j l 6 c Owner's Name: 5
A. P. Number: Address: _ 7 6 r
Legal Description: City, ST, Zip: La 2ze,"
Contractor: e CSS Telephone:
Address: Project Description: IS 00
City, ST, Zip: o Z
Telephone: 3 4 Z- 36
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction`Type: Occupancy:
State Lic. #:Proj]No bet type (circle one): New Add'n Alter Repair Demo
Name, of Contact Person- YY Sq. Ft: #Stories: #Units:.
Telephone # of Contact Person: 2,;-0 - G Z 9 Estimated Value of. Project: rb
APPLICANT: DO NOTMRITE. BELOW THIS LINE
#
Submittal
Req'd
Reed- -. -
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item 'Amount
Structural Calcs.
Reviewed, ready for corrections. Plan Check -Deposit
Truss Cases.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"a Review, ready for correctionstissue Electrical
Subcontactor List
Called ContactPerson Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE-
3" Review, ready for correctionstissue Developer Impact Fee.
Planning Approval.
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees