06-1629 (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:
06-00001629
57855 RESIDENZA CT
764-010-011-81 -30092
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
Architect or
.-WA.""
TdAf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with.
Section 7000 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.. .
License,�as-. C_9License No.: 614611 ['
'Date: ontraofor: V �f00
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).:
(_ 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 (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.).
(_) 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:
LQPERMIT
Owner:
BATSHON.
57-855 RESIDENZA COURT
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & SPAS, INC.
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/06
WORKER'S COMPENSATION DECLARATION
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.
X I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier HRH INS Policy Number 020060333601
_ 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 become subject to the workers' compensation provisions of Section
r3 00 of the Labor Co forthwith comply wiithy those
provisions.
D -W-5/ 5/ A' plicant", 1, J
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.($ 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.
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 whosb 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. 1 agree to comply with all
city and cou ty ordinances and state laws relating to building construction, and hereby authorize representatives
of thi o ter
upon the above-mentioned pro2ynection purposes.
Dat gnature (Applicant or Agent): % J • - \ ��
Application Number 06-00001629
Permit BLDG POOL PERMIT
Additional desc.
Permit Fee . . . . 207.00 Plan Check.Fee
134.55 i
Issue Date . . . . Valuation
20000
Expiration Date 10/21/06
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 10/21/06 -
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 10/21/06
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 10/21/06
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 3.0.000 EA • PLB GAS PIPE 1-4 OUTLETS
3.00
------------------------- .---------------------------------------------------
Special Notes and Comments
.
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
e
LQPERMTT - - .. .. ..
Application Number . . . . . 06-00001629
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----------------
V�
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 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
Y••• or
Permit #
06-164
1f Project Address:
A. P. Number:
r
Contractor �'
Address:
X City, ST, Zip:N�
Telephone:. -] q? ' C
State Lic. if
Arch., Engr., Designer:
Address:
rTelephone:'
ST. Zp.
Lic.i'i:
1C Name of Contact Person:
[Telep�hone of Contact Petsoo
It. Submittal
Rewd
Plan Sets
Structural Cala.
Truss Calcs.
Energy Cales.
now plain plan
Grading plan
Subcoatactor List
Grant Deed
H.O.A. Approval
IN HOUSE:.
Planning Approval
Pub.'A'ks. Appr
School Fees
City of La
B QuInta
wilding at Safety Dlvt ton
P.O. Box I SO4, 78.495 Calle Tampico
2 Qulnta, CA 92253 • (760) 777.7012
Building Permit Application and Tracking Sheet
JOwner's Name:
Address: �—c
City. ST. Zip:ICIP
'` J )[Telephone: e
VPro'ea
1 Description:
Citv Lic. sl:
�3
Total Permit Fees
Conswction Type:
Occupancy:
J�pL-.�-i
Project type (circle one): New Add., Alter Repair Demo
Sq. Ft.; �Q�
- ;
`` =--.
Stories:
M Units:
_...
stimated Value of Project:
ArLt�gNT: DO NOT WRITE BELOW THIS LINE
Reed
TRACKING
Plan Cheek submitted
PERMIT FEES
%m
Reviewed. ready for corrections
Amount
Called Contact person
Plan Check Deposit
Plans picked up
Plan Check Balance
Plans resubmitted
Construction
2" Review, ready for eorrectionsAssue
Mechanical
Called Contact person
Electrical
Plans picked up
pt"'n°t"s
Plans resubmitted
S.hl.l.
Review, ready for eorreetions/issue
Grading
Called Contact Person
Developer Impact Fet
Date of permit issue
A.I.P.P.
Total Permit Fees
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