05-3448 (RPL)P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00003448
81816 COUPLES CT
764-060-048= -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
Architect or
k/! `
Td4t 4 4 Qa&z
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-------------------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thatl am licensed under provisions of Chapter 9 (commencing with
Section 7000) of vial f the Business -and: Professionals Code, and m cense' in fu r effect.
License Class: License.No.:�(_
Contr torp
JW
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1. am exempt from the Contractor's State License Law for the
following reason. (Sec. 7031.5,.Businew 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.applicent'for the
permit to file a signed statement that, he or she is licensed pursuant to theprovisions of the Contractor's State
License Lew (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefromand 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 ofnot more than five hundred dollars (8500).:
(_) 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
Contractore''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. Ili however, the.building or improvement is sold within
one year of completion, the owner -builder will have the burdenof proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 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. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDINWAGENCy
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:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/04/05
Owner:
MARGULEAS YOUNG HOMES
C/O ,AVAIL PROPERTY MGT
P O BOX 1032
PALM DESERT, CA 92261
Contractor:
CALIFORNIA POOLS & SPAS
WCC°: SEABRIGHT INS
WC: BB1050510 01/0.1/06
CSLB: 656128 10/31/06
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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.tnis,permit is
Issued:
1 have and will maintain workers' compensation insurence,.as required by Section 3700 of the Labor
Code, for the performanoe•of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier C8 C27 C29 C53 Policy Number =-_-_-'---- ----
_ I certify that, in the performance ofthe work for which this permit is issued, I shall not employ any
person in any manner so as to become subject mthe workers' compensation laws of California,
and agree that; if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shalbforthwlth comply with those provisions.
a` �Or- Applirya � —
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 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,sgrees to, and shall defend,indemnify,and hold harmless the'C)ty
of La Quints, its officers, agents and employees for any act or omission related to the work being
performed under or following'issuan_ce of this permit.
2. Any'permitissued as•a result of this application becomesmull 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 have read this application and state that the above information:is,correcte I agree to comply with all
city and county ordinances and state laws relatin to building construction, and hereby authorize representatives
of this. Unty to enter. upon the above-ment property for inion purposes.
Date:9 -e7"0 Signature (Applicant or Agen
Application Number . . . 05-00003448
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee 189.00 Plan Check'Fee 122.85
Issue Date Valuation . . . . 18000
Expiration Date 1/31/06
Qty Unit Charge Per Extension
BASE FEE 45.00
16.00 9.0000 THOU, BLDG 2,,001-25,000 144.00
Permit . . . MECH POOL
Addi-tional desc . .
Permit Fee 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 1/31/06
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >10.OK 11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc . .
Permit Fee . . . . 45_.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/31/06
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 . . 1/31/06
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 3.000'0 EA PLB GAS PIPE 1-4 OUTLETS 3.00
Special Notes and Comments
POOL & SPA ONLY. 'ALARMS/BARRIERS SHALL
LQPERUff
Application Number . . . . . 05-00003448
---- --------------------------------------------------
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 293.00 .00 .00 293.00
Plan Check Total 148.85 .00 .00 148.85
Grand Total 441.85 .00 .00 441.85
LQPEUAff
Bin #City
'
Of La Quinta
Building &r Safety Division
P.O. Box 1504,78-495 Calle Tampico
-La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
OSS
Project Address: 1 Owner's Name: j15
A. P. Number. ; Address:
Legal Description: City, ST, Zip: -
Contractor: C L S Telephone: A:
Address: p Bo D Project Description:
City, ST, Zip: CA Cl tA cMg 3 60 DooL
Telephone: 9Z 2 Z, a
State. Lie. # ; 65 (./,a City Lic. #a
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lica#: „ Project type (circle one): a Add'n Alter Repair Demo
Name of Contact.Person:AAM jjM4 Sq. Ft.: # Stories: # Units: -
Telephone# Of Contact Pers 2 �; —� Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
y
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check.Deposit
Truss Calcs.
Called Contact Person
Plan, Check Balance
Tide 24 Cales..
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact. Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H:U.A. Approval
Plans resubmitted
Grading
N HOUSE:= .
7rd Review, ready for corrections/issue
Developer ImpactTee'
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue '
School Fees
Not, Permit€Fees