05-2064 (RPL)P.O. BOX 1504-
78-495
504-78-495 CALLE TAMPICO
LA QUIN. TA, CALIFORNIA 92253
Application Number: 05-00002064
Property Address:
APNc 81914 COUPLES CT
Application description: 764=060 -008 -
Property Zoning: POOL - RESIDENTIAL
Application valuation: LOW DENSIT
Applicant:
Ta!t 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING. PERMIT
Owner:
SULLIVAN
81-914 COUPLES COURT
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
or Engineer: --------------------------------
MCINTYRE POOLS & SPAS, INC.
WCC: STATE FUND
WC: 1769111 01/01/06
Lic. No.:---------------
---------p��.- -----------------------
�I�IA CONTRACTOR'S DECLARATION
hereby affirm under ryury that l am licensed under provisions of C epter 9• (commencing with
Section.7000) of fvi t Bu rofessionak Code, and m ce s i, 'nlfull f r e and:effect.
License CI - License No.: - -
Date, Contractor•. impS - -
���(((���///lll OWNER49JILDER 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 thet requires' a. permit to
construct, atter; improve, demolish; or repair any structure, prior to its issuance;_ also requires'the applicant for the
permitto 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 penahyof not more than five hundred dollars (8500).:
L_) I, as owner of the property, or myemployees with wages as:theirsolwcompansation, 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 at completion, the owner -builder will have the burden of proving that he or she did not build or
improve forthe-purpose of sale.).
I,_) 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:).
(_) I am exempt under Sec. , B.&P:C: for this reason.
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 hereby affirm•under penalty of perjury that there is a construction lending agency for the performanoe'of the
work for which this permit is issued (Sec. 3097, Civ._CJ.
Lender's Name: _
Lender's Address:
LQPERMLT
Date: 5/27/05
--------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of -the following declarations:
_ I have and'will'maiFKain 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:ind will maintain workers' compensation insurance, as required by'Section 3700 of the Labor
Code, for the performance of the work for which this permitis.issued. My workers' compensation
insurance cariarand policy number are:
Carrier. 614611 09/30/09olicy Number C53
I. certify that, in the:peformanoe: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, 0 1 should become subject to the.workers' compensation provisions of, Section
3700 of the. Labor Cods all forthwith co�m�pllyy�wthose provisions.
/Co
Applicanty ► \
WARNING: FAILURE TO SECURE WORKERS_' COMPENSATION COVERAGE.IS UNLAWFUL; AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,000). IN.ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED'.FOR,IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGMENT
IMPORTANT Application is hereby made to the Director of Building anxfSafetyfor 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, indemnifyand hold harmless the City
of La Quinta, its officers, agents and,employeas-for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a.resultof this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or ceasation of work for 180 days will subject
permit to cancellation.
I certify that I have;read this application end state that the above information is -correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of thi n to enter upon the above-mentioned o i apectionpurpoosse%s.�
et Signature (Applicant or° ant): Pel
Application Number . . . . . 05-00002064
Permit BLDG POOL PERMIT
Additional desc . .
Permit.Fee . . . 207.00 Plan Check Fee 134.5.5
Issue Date . . . . Valuation 20000
Expiration Date . 11/23/05
Qty Unit Charge Per Extension
BASE FEE 45.00
18.00 9.000.0 THOU BLDG 2,001-25,0.00 16.2.00
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . 26.00 Plan Check Fee 6.5.0
Issue Date . . . Valuation 0
.Expiration Date . . 11/23/0:5
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.000.0 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 11/23/05
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 . . .11/23/05
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
------ ------- I --------
POOL &
SPA ONLY. ALARMS/BARRIERS SHALL
LQrEVtrr
Application Number . . 05-00002.064
---------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER -
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged
Permit Fee Total 311.00
Plan Check Total 160.55
Grand Total 471.55
LQPERMT
Paid Credited Due
_00 .00 311.00
.00 .00 160.55
.00 .00 471..55
STONE
TTLE,
BOULDERS,
DECK COLOR
CONTROLLER
PEBBLE
PLASTER
DAM WALL
EQ WALL
�V 1510N5
�Y
POOL & 5PA 5P�C5
POOL SIZE �O' X 27'-6''
POOL S.A. 5-78 50Fr:
POOL PER. Mr
DEPTHS 35`0' TO °5
POOL PUMP i15 HIP.
HEATER 400,000 m '
FILTER ccr 420
LIGHTS 2-000 Warr
CONTROLLER
SPA SIZE 17- x 8'
SPA PER. 3a 5Q, Fr.
SPA S.A. 85 50, Fr,
SPA DEPTH
JETS
JET PUMP 5 H�
DECK AREA Spa 5Q, vr,
` ATERFEATURE 145Q.Ff,,
W.F. 60 L, fr,
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SCALE:
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JOB:
SULLIVAN
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