06-3952 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06=Q0:003`952-
Property Address: 81595 RANCHO SANTANA DR
APN: 767-200-999-58 '-312022-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 31800
Tuvl 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s a P fessionals Code, and my license is in full force and effect.
License CI ss: B C29 C53 License No.: 455121
ate: I r ntr ar: -
OWNER -BUILDER DECLARATION _
I hereby affirm under penalty, perjury tha I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, iness a d Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, o it any structure, prior to its issuance, also requires the applicant for the
permit to 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 penalty of not more than five hundred dollars ($500).:
1 _ 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 ISec. 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 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 _ ) 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 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:
PIK
LQPERAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/09/06
Owner:
STEVE BUTLER
81595 RANCHO SANTANA DRIVE
LA QUINTA", CA 92253D
(760)777-9920 C
Contractor: NOV 21 2006
TOPMAN BUILDERS
P.O. BOx 10202 CITY OF LA QUINTA
PALM DESERT, CA 92215 FINANCE DEPT.
(760)772-7296
Lic. No.: 455121
------------------
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 this permit is
issued.
1�I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier CLARENDON Policy Number 01KR-0030-842
I certify that, in the performance 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, if I should acro e s bject to the workers' compensation provisions of Section
3700 of the Labor Code, she !'f h ith comply with those provisions.
t2� . o4A •
WARNING: FAIL R CURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER' CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD ION TO TH COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR C EST, 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, 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 th ove in rmatibn is correct. I agree to comply with all
city and county ordinances and state laws relating to bu ding cons c o and hereby authorize representatives
of this county to enter upon the above-mentione o e y for i ecti purposes.
Application Number .
. . . . 06-00003952
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
297.50 Plan Check Fee
193.38
Issue Date . . . .
Valuation
31800
Expiration Date
5/08/07
Qty Unit Charge
Per
Extension
BASE FEE
252.00
7.00 •6.5000
-----=----------------------------------------------------------------------
THOU BLDG 25,001-50,000
45.50
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
5/08/07
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
5/08/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
---------------- ------------------------------------------------------------
EA EDEC PRIVATE SWIMMING POOL
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check Fee''.
8.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date ..
5/08/07
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
LQPERMIT
Application Number . . . . . 06-00003952
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 401.50 .00 00 401.50
Plan Check Total 219.38 .00 .00 219.38
Grand Total 620.88 .00 .00 620.88
LQPERAI[T
Bin If
City of La Quinta .
Building 81: Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Q'uinta, CA 92253'- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit €I d_
'J
Project Address: 15` 5 ` t) Q
A. P. Number.
Legal Description:
Owner's Name: S� J e LP IZ
Address:
'
City, ST, Zip: Vl_ ' O Y C4,lZZ Jto
—
Contractor O --Aq ,.
Telephone:
#
Address: 'I I - U
.City, ST, Z• e- k 22 r
Project Description:
Telephone:
State Lic. # : Cj�j •t Z City Lic. #:
Arch , Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction T Occupancy':
�� DO pr
State Lic. #: Project type {circle one): New Add'n Alter Repair Demo
Name of Contact Person:3J Sq: Ft: #Stories: #Units:
Telephone # of Contact Person z��j– �js Estimated Value of Project: 'n.,1�
APPLICANT: DO NOT WRITE BELOW THIS LINE
-
#
2
Submittal
Plan Sets
Req'il .
Rec'd
TRA CIQNG .
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for correctionsPlan
Check Deposit
Check Balance
Truss Calcs
Called Contact PersonPian
Energy .Cates.
Plans picked up
Constriction
Flood plain plan
Pians resubmitted
Mechanical
Grading.plan'
2'' Review, ready for correct ioas/issue
Electrical
Sabcontactor List
Called Contact Person
Pipmbing
$.M.I.
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted .
Grading
Developer Impact Fei.. ;
IN HOUSE:
'''Review, ready for corrections/issue
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
:..:.:....:........:: ..:..
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.....
Total Permit Fees . ..
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