06-1628 (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:
06-00001628
57735 RESIDENZA CT
764-010-011-84 -30092 -
POOL.- RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
T'ht 4 IWQ"
Architect or Engineer:
A.,/A-)
---------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 q C53 / License No.: 614611
oo
�ontractoy��y�!
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 _ 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.).
1 _ 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.l.
(_ 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:
LQPERA11T
Owner:.
WOOLVERTON
57-7.35 RESIDENZA CT
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
r.
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: -
1 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 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
3 00 of the Labor Code, I shall forthwith com ly with those provisions.
e:. Applicant: I
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 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 co my tidinances and state laws relating to building construction, and hereby authorize representatives
of th' t nt r upon the above-mentioned prope r i pection purposes��'.�\
at 6ignature (Applicant or Agent): c Y
Application Number . . . 06-00001628
Permit . . .
BLDG POOL PERMIT
Additional desc
`
Permit Fee
207.00 Plan Check
Fee
134.55
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
c
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . .
Valuation
0
Expiration Date
10/2=/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 3.0000
EA PLB GAS PIPE 174 OUTLETS
3•.00
------------- ---------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number. 06-00001628
-------------------------------------------- - - - - -- - -- - - - - - - - - - - - - - - - - - - -
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 Total 311.00 .00 .00 311.00
Plan Check Total 160.55 .00 .00 160.55
Grand Total 471.55 .00 .00 471.55
----------
----- --- --------
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City of La
Qulnta
Permit N Building at Safety DIftlon
P-0- BOX 1 SO4, 78-49S Calle Tampico
/� — / / La Quinta, CA 922S3 - (760) 777.7012
Building Permit Application and Tracking Sheet
X Project Address: � � "
:�S (C:.-2 Z..%�i OH�ler's Name:
A. P. Number
moo. ++cscnptlon:
x Contractor:
x Address:`
X City, ST. Zip: -T7N JJb r
Telephone:•
State Lic. #:
Arch., Engr., Designer.-
Address:
esigner:Address:
City, ST. Zip:
Telephone:
State Lic.
1C Name of Contact Person:
X Telephone of Contact Person:
tl Submittal
Req'd
—Plan Sets
Structural Cala.
Truss CaICL
Energy Cales.
now plain plan
Grading plan
Subcoatactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. "U Appr
School Fees
1
<----lY. Sr. Zip: � t -�J
J FTelephone:
Project Description:
Y Lic. a:
r-� -�
�r:i't� •:``,
Construction Type:
«, ,�'•. Occupancy;
Project type (circle one): New
-� Add'n Alter Repair Demo
Sq.Stories: N Units:
stimated Value of Proiect•.
-ANT: DO NOT W
Ar-rLtRITE BELOW THIS LINE C
Reed
Plan Check submitted
Reviewed. ready for corrections
Called Contact Person
Plans Ricked up
Plans resubmitted
_" Review, ready for corrections/Issue
Called Contact person
Plans picked up
Pians resubmitted
3" Review, ready top eorreetionsAissue
Called Contact Person
Date of permit issue
PERIITT FEES
Item MMM—MMM
Amount
Plan Check Deposit
Plan Check Balance
Construction
hIeehanicel
Electrical
Plumbior
SAM.
Grading
Developer impact Fee
A.I.P.P.
Total Permit Fees