11-1103 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:.
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
11-0000.1103
77153 CASA DEL SOL
773-3'60-014– –
POOL - RESIDENTIAL
MEDIUM DENSITY RES
30000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ROGER ADAMS
77153 CASA
LA QUINTA,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
;U OCT 10 2011 `U
Contractor: I
PREMIER OUTDQOR INOITY OF LA QUINTA
Date: 10/10/11
following reason (Sec. 7031.5, Business .Professions Cade: Any city or county that requires a permit to
construct, cher, Improve, demolish, or re zany structure, prior to Its issuance, also requires the applicem for the
permit to filer 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 Divisiom3 of the'Business and Professions Code) or
that he or she Is exempttherefrom and the.basis for the alleged exemption. Any violation otSectlon 7031.5 try
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($560).:
(_ 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 amended 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 improyes.thereon,
and who.does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered forsale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that heofshe 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 Ucertsa Lew.).
1 _ 1 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 performance of the
work for which this permit Is issued (Sect 3097, Civ. C:).
Lender's Name:
Lender's Address: �� 1
LQPERMIT
person inany man
and agre&that, if 1
3700 of the Labor
,01%;OU (I ant:
WARNING: FAILURE TO'SECUI
SUBJECT AN EMPLOYER TO C
DOLLARS (8100,000). IN ADD
SECTION 3708 OF THE LABOR
to
provisions of
any
TANSATION COVERAGE IS UNLAWFUL, AND SHALL
ND CIVIL FINES UP TO ONE HUNDRED THOUSAND
IST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
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 agrees to, and shall defend, indemnlfy.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 and void If work is not commenced
within 180 days from date of Issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify thati have read this application and,state that he a e I mationis correct. I agree to comply with all
city and county ordinances and state laws relating to aiding Ion, and hereby a orize representatives,
of t�nity ter upon theabove mentioned pro rtYfov Ion puatS re;(Appllcamor.Agent):
77588 EL DI Ar6TTbT F!NJ'lxC6171M.
I
PALM DESERT, CA 92211
(760)34'5-9791
Lic. NO.: 963116
---------------------------------------------------------------------------------------------------
NSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION'DECLARATION
I hereby affirm under pen
I
licensed:- nder provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Divisioa
Profe ars Code, and y License is in full force, and effect.
— I have and will maintain a certificate of consent to self-insurefor workers' compensation, as provided
License Class: C53Licen
963116
for by Section 3700 of the Labor Cade, forthe performance of the work "forwhich this permit Is
JBIness
Ste: Irl II
issued.
�! have and will maintain workers' compensation Insurance, as requiredby Section 3700 of:the Labor
Code, for the performance of'the work for which_this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penam exempt from the Contractor's State License Law for the
Carrier CALIF INS- Policy Number 460030110307
following reason (Sec. 7031.5, Business .Professions Cade: Any city or county that requires a permit to
construct, cher, Improve, demolish, or re zany structure, prior to Its issuance, also requires the applicem for the
permit to filer 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 Divisiom3 of the'Business and Professions Code) or
that he or she Is exempttherefrom and the.basis for the alleged exemption. Any violation otSectlon 7031.5 try
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($560).:
(_ 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 amended 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 improyes.thereon,
and who.does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered forsale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that heofshe 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 Ucertsa Lew.).
1 _ 1 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 performance of the
work for which this permit Is issued (Sect 3097, Civ. C:).
Lender's Name:
Lender's Address: �� 1
LQPERMIT
person inany man
and agre&that, if 1
3700 of the Labor
,01%;OU (I ant:
WARNING: FAILURE TO'SECUI
SUBJECT AN EMPLOYER TO C
DOLLARS (8100,000). IN ADD
SECTION 3708 OF THE LABOR
to
provisions of
any
TANSATION COVERAGE IS UNLAWFUL, AND SHALL
ND CIVIL FINES UP TO ONE HUNDRED THOUSAND
IST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
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 agrees to, and shall defend, indemnlfy.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 and void If work is not commenced
within 180 days from date of Issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify thati have read this application and,state that he a e I mationis correct. I agree to comply with all
city and county ordinances and state laws relating to aiding Ion, and hereby a orize representatives,
of t�nity ter upon theabove mentioned pro rtYfov Ion puatS re;(Appllcamor.Agent):
Application Number . . . . . 11-00001103
Permit. . . .
BLDG POOL PERMIT INV FEE
Additional desc .
Permit Fee . . . .
569.00
Plan Check Fee
184.93
Issue Date
Valuation . . .
. 30000
Expiration Date
4/03/12
Qty Unit Charge
Per
Extension
BASE
FEE
504.00
5.00 13.0000
THOU BLDG
25,001-50,000
-----------------------------------
65.00
Permit... . . . MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check Fee
6.50
Issue Date
Valuation . . . .
0
Expiration Date
4/03/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 11.0000
EA MECH
FURNACE >10.0K
11.00
Permit.ELEC POOL PERMIT -RES
Additionaldesc .
Permit Fee 45.00 Plan Check Fee .
I$sue Date . . . Valuation
Expi-ration Date 4/03/12
11-.25
0'
Qty Unit Charge Per Extension
BASE.FEE 15.00
1..00 30..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 . . 4/03/12
Qty Unit Charge Per Extension
BASE FEE 15.00'
2.00 6.0000 EA PLS 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
-.-;a7. J7,1k�
Application Number . . . . . 11-00001103 .
-----------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
•EQUIPMENT ENCLOSURE NOT INCLUDED.2010
CODES.INVESTIGATION FEE ASSESSED PER
1997 UNIFORM ADMINISTRATIVE CODE §304.5
FOR WORK BEGUN WITHOUT BUILDING PERMIT.
Fee summary Charged Paid Credited Due
Permit Fee Total 673.00 .0'0 .00- 673.00
Plan Check Total 210.93 .00 .00 210.93
Grand Total 883.93 .00 .00 883.93
LQPERMIT
4JA
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DAWAL29:1f6Y klZ_
Bin- #:.
pph #
Projeex:Addtt ss: 11 - SPIL
.
Citi Of La Quints
Bull gng 8[ Safety DMWm
P.O. Box 1504,78-495 Cage Tampico
La.Qu1nt4. CA 92253•• (760) 777.7012.
Building Permit, Appifcation and Tracking Sheet
o'a Name . 46 (l O rn
A P. Number.
Address:.
I'°ga1 D
coatractor.
Ad&= -7)SX( , L
OU T O O k
O G I S r t r
City. ST. Zip:
Telephone:
rro}ea Damiption: Sw S A
City. sT. Zip:
Telephone~ L4 —
State UQ # : 3 It C Lie #:
&J. ,5v,4 -GAILY/� , alAy5
Arcb.. Engr.,:D esigttest
7..
Address:
City. ST. Zip.
Telephone:
Stdc Lie #:
Name of Contsa Person:
6y (
Cm*ucftn Type:. Oocapanw:
Ptojoot type (dude one): New Add'a Apex Rope"v Demo
Sq. Ft.:
# Storks:
# Unto;
Telephone # of Coined parson:
EstimaW Vtdiue of Pmjact:
APPLICANT: DO NOT WRITE BELOW THIS -UNE
d
Submittal
Req -d
-'Rei -. T8AC MG P1;8A4i'P IM.
Pisa Sea
Pfau Cheeef<oabmitled !� b Yhm Amew4t
Iitractaeal Cales.
fRevk%14 ready for correcoom 'Plan Check Deposit • .
Trass Calex.
Called coatael Pawn, Plan chectewance.
lids U Cala.
Pfaus Visken 1% P4 conairaetloa
Plow plain plan
l�laarrnnbatltted / fldacharikal
Grading plan
Y! Review, ready ft cur �� �Q Electrical
Sobeontaetor List
Called Coutad Person Plumbing
Grant Dead
Pians plelted up
HOA. Approval
Plans resubmitted Gnedlog
WHO
fReview, rea ft for eorrectiomAssae Developer lmpaet Fee
Planning Approval
Calleet.Contaet Penn A.LP.P.
Pub. VU. Apps' -
Date of permit lune
Sehool Fea
Total Permit Fees