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06-4195 (RPL)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 06-00004195 Owner: Property Address: 81874 COUPLES CT DAVID DOW APN: 764-060-010- - - 81874 COUPLES COURT Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 28000 Applicant: Architect or Engineer: Contractor: MCRAE POOL & SPAS 79105 DESERT STREAM DR LA QUINTA, CA 92253 (760)772-2440 Lic. No.: 823017 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/05/06 DE Oe' _ Date: Owner:, CONSTRUCTION': LENDING AGENCY I hereby affirm under penaltyof perjury that there is,a construction lending agency for the performance of the work for which this.permit isissued(Sec. 3097, Civ. Ct). Lender's Name:. Lender's Address: LQPERMIT 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 and void if work is not commenced within ISO 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 with all city and county ordinances and state laws:relating to building construction, and .hereby authorize representatives of thi cou y t/ear/tjier upon above-mentioned property)Vspection purposes. date : V`� 'nature (Applicant or Agent) !!/_ ,., LICENSED CONTRACTOR'S DECLARATION WORKERIS COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9. (commencing with I hereby affirm under penalty of perjury, one of the following declarations: Section 7000) of Division'3 of"the Business and Professionals Code, and my License is in full force and effect. _ I have, ,and will maintain a certificate of consent,to self -insure for workers' compensation, as provided ClC53-C27 License.No.: 823017 _ Li��Covdctor: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �� issued. _ 1 have and will maintain workers' compensation insurence,.as required by Section 3700 of the Labor Code, for the performance of the'work for which this permitis,issued. My workers' compensation OWNE $UILDER ECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that am•exempt from the Contracior's^State License Law for the Carrier EXEMPT Policy Number .EXEMPT following reason (Sec`. 7031:5, Business and Professions Code: Any city or county that requires a permit to I certify that,:in the performanceiof the work for which,this permit is issued,.lshall not employ any construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as.to become!subject,to the workers' compensation laws. of California, permit to file a signed statement that he or she'is licensed pursuant to;the provisions: of the Contractor's :State and agree that, if l should become subject to the workers' compensation provisions'of Section License Law (Chapter 9 (commencing with Section,7000) of Division 3 of the Business and Professions Code) or of the Labor Code, I shall fort ly with those provisions. that he(or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 09 any applicant fora permit subjects'the�applicant to e:civil penalty,of not more than five hundred dollars,($500).: ate: Ica_ n : - (_ 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State.License. Law does, not apply to an owner of property "who builds or improves,thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO'ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own ernployeesi,provided that the DOLLARS (8100;000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If; however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES_. 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.). APPLICANT ACKNOWLEDGEMENT 1 _ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec,. IMPORTANT Application is hereby made to the Directorof Building and Safety for a permit subject to the 7044„Business and Professions Code: The Contractors' State License Law does not apply to an owner of, conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each, person at whose request and for ” pursuant to the Contractors' State License Lew.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I em exempt under Sec. B.&P:C., for this, reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City Date: Owner:, CONSTRUCTION': LENDING AGENCY I hereby affirm under penaltyof perjury that there is,a construction lending agency for the performance of the work for which this.permit isissued(Sec. 3097, Civ. Ct). Lender's Name:. Lender's Address: LQPERMIT 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 and void if work is not commenced within ISO 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 with all city and county ordinances and state laws:relating to building construction, and .hereby authorize representatives of thi cou y t/ear/tjier upon above-mentioned property)Vspection purposes. date : V`� 'nature (Applicant or Agent) !!/_ Application Number . . . . . 06-00004195 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 271.50 Plan Check Fee 176.48 Issue Date . . . Valuation . . . . 28000_ Expiration Date 6/03/07 Qty Unit Charge Per Extension BASE FEE 252.00 3..00 6.5000 THOU BLDG 25,001-50,000 19.50 Permit . . . MECH POOL _ Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date . . 6/03/07 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 . . 6/03/07 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 . . 6./03/07 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 LQreRMff Application Number . . . . . 06-00004195 --------- - - - ---------------------- - - - - ---- - - - - - - Special Notes and Comments PLACE AT PRE -PLASTER INSPECTIONS. EQUIPMENT ENCLOSURE NOT INCLUDED Fee ,summary Charged Paid Credited Due ------------------------------------------ ----- --- Permit Fee Total 375.50 .00• .00 375.50 Plan Check Total 202.4.8 .00 .00 202.48 ' Grand Total 577.98 .00 .00 577.98 LQPERMIT B`" # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (7G0) 777-7012 Building Permit Application and Tracking Sheet Permit # ��a Project Address:' Ownes'sName: �) A. P. Number: Address: I — (b u Legal Description: City, ST, Zip: Contractor: "� - Telephone: Address: ��f - �© Project Description:] City,, ST, Zip:- V ' Telephone: Q State Lic. #: ( City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State.Lic. #: Projecttype (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd •. Ree'd TRACEING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Coutact Person Pian Check Balance Energy Calcs. Plana ticked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcoutactor List Called Contact Person Plumbing Grant,Deed Plans picked up S.M.L ILO.A. Approval Plans resubmitted Grading IN ROUSE:- m'Review,.ready for cormetionwInue Developer Impact Fee Planning Approval Called Contact Person AXP.P. Pub. Wks. Appr Date of,permitIssue School Fees Total Permit Fees ' - CITY OF LA QUINTA SUB -CONTRACTOR LIST -1• -JOB ADDRE: ;S, $-87y Cov jSG?— �_ PERMIT NUMBER OWNER-16~-,_Oi4 IJILDER _[}S' D-�1,� �A S . •. This o sal a os o lob Bit Ca a a i s a o o s c .Only persons appedring 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. Failure to comply will result in a stoppage of work and/or the 'voidance of huildinn nPrmit_ For each-aDelicahle trarfe_ all infnrmatien renuesterl hpinw mutt he rmmnlatarl by annlicant_ •(fin File' is not an acceptable resDonsa." L1 rx� Trade Classifi n Tr I atio `'Contract or• " '. ... . ': • ; :...., . > t`r-s::;'<:°`% s a ......... t te..Contractol' . Uceltiss.: •`�:1N,4tkers:C�m ensatfort:Irisurance: �. ry= '�" ..._ < • • . city_. B370 sitlees License Company Name. • Classification (e.g. A, 0, C-8) Ucense Number (xxxxxx) Exp. Date (jWxx/xx) -Carrier Name le.g: State Fund, Calcompl Policy -Number' (Format Varies) wap•. [fate` (xxlxxlxx) Ucense Number (xxxx) Exp. Date (xxl.xxlxx) f:ARTHWORK (C -12j coNcR!I:T Ic.=$1 : n .FRAMING "lC-b) • :'; r , •. h! ., r� Pff . . . . . . . . . . -r Of . . . . . . . . . . . . .... N 1 I. S ClIp 0 'till pw Co, tow 49" V L ............... ......... . .