07-2703 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 e(Pa�rw
j/�Application Number. 07-00002703
`Property Address: 81895 RANCHO SANTANA DR
APN: 767-200-999-22 -312023-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000
Applicant: Architect or Engineer:
NIS.
n�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/04/07
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LICENSED CONTRACTOR'S DECLARATION - -
Owner:
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
ADAMS RESIDENCE
81-895 RANCHO SANTANA DR.
DLA QUINTA, CA 92253
OCT o 1001
C53 License No.: 6611
License.,Clas —
` T
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Contractor:
�I��'
MCINTYRE POOLS & SPAS, INC.
SIN N
83695 AVENUE 45
a
INDIO, CA 92201
Carrier MAJESTIC INS CO Policy Number 020060333602
(760)342-3612
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
LiC. NO.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/04/07
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LICENSED CONTRACTOR'S DECLARATION - -
WORKER'S 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
C53 License No.: 6611
License.,Clas —
` T
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date_ 9 Contractor: \ (/
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
IIiIT�7j�
i ( _ _
_
YR
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER-BUILDECLARATION
insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier MAJESTIC INS CO Policy Number 020060333602
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
. construct, alter, 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 I shQQyyId b come 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
3700 of the Labor odd, I efhforthwith th/Otalprovisions.
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).:
Date r"" Applicant:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
__ - j i
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 hisor her own employees, provided that the
DOLLARS ($100,000). 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.).
(_ 1 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.).
(_ 1 I am exempt under 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:
LQPERAIIT
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, indemnify and hold harmless the City
of La Quinta, 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 that I have read this application and state that the above information is correct. I agree to comply with all
city and cou ty ordinances and state laws relating to build' struction, and hereby authorize representatives
of this cooful/n to enter upon the.above-mentioned property o " Ton puR C /y
Date: v --Signature (Applicant or Agent):
Application Number . . . 07-00002703
Permit
. . . BLDG POOL PERMIT
Additional
desc .
Permit Fee_
. . . 207.00
Plan Check
Fee
134.55
Issue Date
. . . . .
Valuation
20000
Expiration
Date 4/01/08
Qty Unit Charge Per
Extension
BASE
FEE
45.00
18:00
9..0000 THOU BLDG
2,001-25,000
162.00
Permit
. . . MECH POOL
Additional
desc .
Permit Fee
. . . . 26.00
Plan Check
Fee
6.50
Issue Date
Valuation
0.
Expiration
Date 4/01/08,
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 Fee45.00.
Plan Check
Fee
11.25
Issue Date
. . . .
Valuation
. . .
. 0
Expiration
Date 4/Q1/08
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 4/01/08
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
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Special Notes and Comments
POOL, SPA,.ALARMS/BARRIERS
SHALL
BE IN
LQPERMTT
Application Number . . . . . 07-00002703
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 311.00 .00 .00 311.00
Plan Check Total 160.55 .00 .00 160.55
Grand Total 471.55 .00 .00 471.55
LQPERMIT
Bin #
Permit #
Je Project Address:
A. P. Number:
Legal Description:
X Contractor. �� l
x Address:
1� City, ST. Zip'
X Telephone-..
State Lica #
Arch., Engr., Designer:
Address:
It
ity, ST. Zip:
elephone:
atc Lic. #:
1C Name of Contact Person:
X Telephone x of Contact Person
U Submittal
Plan Sets
Structural Calcs.
Truss Cala.
Energy Cala.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:. .
Planning Approval
Pub. Wks. Appr
School Fees
j o
City of La Quinta
Building S Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
OHrer's Name:
je
in, ST.ZiAa I
lcphone:
oject Description:
Citv Lic. tt:
Construction Type: Occup
ani•:
�n Project type (circle one): New Add'n After . Repair '° Demo
MCC So. Ft. t► Stories:
M Units:
�-5 ._'"f Mb. r*Estimated Value of Proiec
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACKING
Plan Check submitted J
Reviewed, ready for corrections J
Called Contact Person
Plans picked up
Plans resubmitted
2'' Review, ready for corrections/issut
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for eorrectionslssue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
hitchanical
Electrical
Plumbing
SAI.l.
Grading
Developer Impact Fee
A.I.P.P.
Toul Permit Fees
Amount