06-2188 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
• LA QUINTA, CALIFORNIA 92253
Applicant: Architect or Engineer:
f
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am lic der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pro ssion Code, and my License is in full force and effect.
LicenseCCllaass: C8 C27 C29 icense No.: 656128
ate: V. t� ontractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business 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 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).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and /01
the structure is not intended 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 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 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.).
(_) 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:
LQPERDIIT
Owner:
NUNEZ
57890 RESIDENZA CT
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS &'SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
------------------------------
WORKER'S COMPENSATION DEI
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.
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 SEABRIGHT Policy Number BB1060510
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any m90RKERS'COMPENSATION
subject to the workers' compensation laws of California, -
and agree that, ia subj ct to the workers' compensation provisions of Section
3700 of the Labshe ith comply with those provisions.
/Date:, plicant:
WARNING: FAILURE TO SECURCOVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/26/06
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.
certify that I have read this application and state that the above inf atio is correct. I agree to comply with all
city and court ordinances and state laws relating to buil ' g constru 'on, a d hereby authorize representatives
of this ty t w�enner
upon the above-mentioned prop y or inspec o poses.
ate: I�fOS' ature (Applicant or Agent):
Application Number:
06-00002188
Property Address:
57890 RESIDENZA CT
APN:
764-010-011-89 -30092
Application description:.
POOL - RESIDENTIAL
.Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
23000
Applicant: Architect or Engineer:
f
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am lic der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pro ssion Code, and my License is in full force and effect.
LicenseCCllaass: C8 C27 C29 icense No.: 656128
ate: V. t� ontractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business 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 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).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and /01
the structure is not intended 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 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 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.).
(_) 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:
LQPERDIIT
Owner:
NUNEZ
57890 RESIDENZA CT
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS &'SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
------------------------------
WORKER'S COMPENSATION DEI
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.
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 SEABRIGHT Policy Number BB1060510
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any m90RKERS'COMPENSATION
subject to the workers' compensation laws of California, -
and agree that, ia subj ct to the workers' compensation provisions of Section
3700 of the Labshe ith comply with those provisions.
/Date:, plicant:
WARNING: FAILURE TO SECURCOVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/26/06
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.
certify that I have read this application and state that the above inf atio is correct. I agree to comply with all
city and court ordinances and state laws relating to buil ' g constru 'on, a d hereby authorize representatives
of this ty t w�enner
upon the above-mentioned prop y or inspec o poses.
ate: I�fOS' ature (Applicant or Agent):
Application Number
. . 06:-00002188
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
234.00 Plan Check
Fee
152.10
Issue Date
Valuation
23.000
Expiration Date
11/22/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
21.00 9.0000
THOU" BLDG, 2,001-25,000
189.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
.
. 0
Expiration-Date
11/22/06
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
•11/22/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 .30.0000
y
EA ELEC PRIVATE SWIMMING
POOL
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee
33.'Q0. Plan Check
Fee
8.25
Issue.Date
Valuation
. . .
. 0
Expiration Date
11/22/06
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 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
SpecialNotes and Comments
POOL/SPA ALARMS/BARRIERS SHALL BE IN
...LQmRMIT
Application Number . . . . . 06-00002188
----------------------------------------------------------------------------
Special Notes and'Comments
PLACE AT"PRE-PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
Permit Fee Total 338.00 .00 •.00 338.00
Plan Check Total 178.10 .00 .00 178.10
Grand Total 516.10 .00 .00 516.10
LQPERMTT
:
,
:r
, •
7.
qumina-
.._
........;fir 1,
8t'SaFOt al-Bldh
`Permit #
Gale :! i ipico
1�
La.:Quirita, CA';<Q225,3:=:`(760:) y777=70.12
{r
�n er mit App1!lation sand frac cng Sheet '
J ct Address.
r1 O ��5�
,
Q.wners:Naiie A��
77 ...: . .............. c\ •:
A P Number: •
:;;Address: - �l �.. �.
....::.......... . �r
� er�C-�
Le a1:r=�
u
ST; Zip
Contractors .
r 1� -
:`Tele' b!'
h ne•
.
Jeet'Descrt frog'
,r ..
........:...:.
Z
-State Lie: # �) ,g
Arch., Engr., Designer:
t 'ST Zi e°
�. .� P•
:'Tele hone:' . �:;` ;.;'.:'_; • .�.`
' �
�Cottstrucftoti ::: e> O.ccu-.an':
.State:Ltc '
P
. s ro•eix• ; ' Demo -:: :i.Ircle;ogeJ •:�Altec� ';Repair..
r ,,.. ,. ,:.,... , .. .. ............. ,..-
�
.
,. .,..,J......
of n :,.., <r
tact P F
tones:,
,
, . ... . „.,.._:,:r:J.:::::.::...:::.i_:.r::.::.•.: r.:• -c:- 9': -
................._. ... .-..._ ,.......!....._,::,.,.. .. ,.:•:>.... .:: Units:;.::'
r:
h ne : of. on
C tactEE� -
i, r
t t�^ ,
4 ` ; . • .
/� O NOS' WRITE -
_ ,A
-BEL 01NrT IS LIFE';:; :.
.,.,. "may:'°y, .Y• 'n^..,.
I �.1
1
',`u',r , -?:yy
Fr ?P.ER�IVIirT:
`mfr,<Iw
..
..
...
..... ,.vJ
- ..A,.-. :_..., ..:. .:+..
,lu: `S
2i,
k.sa
>♦):n
-
i ,;.:_
tem
Ain�oiiutJ
Structural.Calcs.
..:..:.::,.-.,:,:,:.....::..
d^;read. riot-corrections
$ : X-.�
, . x.�. ,tem. mr�,
PIanCtieckD
.:........
:,:,'_.:>-.::•::,..:,::<;;..
C
.. 4=17
... ... ...
ailed . o t
;i _ .� .n ct=Person... •
-�..,.,,..,.._..Y,.>.�,r.,....,,-:rr,,..., ,
-
nee
-
.......r....._....._.-,._r.
..:............
..
.
�nec .,Gales.
�
11, . • .:
... � zs
.
[an
: ;_.�::•.....:.
sig;',•:
77777777
:Gradin' lan`
S:P.:2:'
s5 :13evie' for:coi�rectionsAssue.
Electncat�
'
Subcontactor List
+ wz,:4,5CatledrContac;Person
R '
s`Plnmbmg'�.
Grant Deed
;'Plans .picked:•up:
} SM7�
]F :U:A. Approval
p ;a resubmitted
y '
INR QUSE:-�".Review,:redy'for:corrections/�ssue
1`Devel `'
oiler Impact Fee
Planning Approval
Called Contact Person
'
AX.:I P:P.
1R.ub. Wks.�Appr
-
�1)ateof�per•'mifissue•
School Fees .
Total`Pe�iiiit Fees