08-1136 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
>LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001136
P-roperty-Address:----"57205 PENINSULA LN
APN: 762-150-024- - -
Application description: POOL RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 35000
Applicant:
Tit�v
Q".
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
lk
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that) 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 Cl ss:—0
53r License No.: 916827
Date: % O Contractor: }
PR-BUIDER 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 Codel 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 hot 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.).
(_ ) 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.I.
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX.'(760) 777-7011 "
INSPECTIONS (760) 777-7153
Date: 7/03/08
Owner:
ANDERSON RESIDENCE
57205 PENINSULA LN
LA QUINTA, CA 92253 D A
Contractor: JUL Q i 200-3
COMPETITIVE WEST POOL 0 TR
PO BOX -5865 CITY OF LA QUINTA
LA QUINTA, CA 92248 FINANCE DEPT.
(760)625-2512
Lic. No.: 916827
-----------------------------------------------
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 forworkers' 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 EXEMPT Policy Number EXEMPT
I certify that, in the performance of the work for which this permit is issued, 1 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
00 of the Labor Code, I sha Rlwvi comply with those provisions.
Date: 7 0, Applicant:
WARNING: FAILURE TO SECURE WORKERS' C044ATION 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 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 couinances and state laws relating to building construction, and hereby authorize representatives
of this OA;�,g:na,7-(Applicant
enter upon the above-mentioned property for ins etirposes.
Data: or Agent):. i
Application Number .
. 08-00001136
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
284.50 , Plan Check Fee
184.93
Issue Date . .
Valuation
30000 .
Expiration Date
12/29/08
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
-----------------------------
THOU BLDG 25,001-50,000
----------------------------------------------
32.50
Permit . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
r 6.50
Issue Date . . . .
Valuation
0
Expiration Date..
12/29/08
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 Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/29/08
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
45.00 Plan Check Fee
9.75
Issue Date
Valuation
0
Expiration Date
12/29/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 6.0000
EA PLB FIXTURE
24.00
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 . . . 08-00001136
-- -- - - - - --
Special Notes and Comments
----- - - - ---
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
"
(2)WATERFEAUTRE (1)COURTYARD PER
APPROVED PLAN.
Fee summary Charged Paid
Credited
Due
-------------------------------------
Permit Fee Total 400.50 .00
--------------------
.00
400.50
Plan Check Totai 212.43 .00
.00
212.43
Grand Total 612.93 .00
.00
612.93 4
IPA
CITY OF LA QUINTA'SUB-CONTRACTOR LIST
JOB ADDRESS , 7 -zOLS AMAfSVIA MAX PERMIT NUMBER 08 - I 1 ' OWNER_RAS AAJngC,egJ BUILDER GOAT"id ; + C Q940-4 Irdoiji
This form shall be posted on the lob with the Building Inspection Card at all times in a consolcuous p ac . Only persons appearing on this list or their employees are authorized to wort
on this job. Any -changes to this list must be approved by the- Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidanet
of building Dermit. For each aoalicable trade. all information reauested below must be cmmnleted by annlirant- "nn File" is not an accentable resnonse_
Trade Classification
:, Contractgr ::•
::;;:<�<::.;;;.:;�s::SlatgzContractors.Licepse..
......... :
::.:•;•;.:.
::. -.•.. " W.grke'rsCompensatloiiarisurance:"::':"'*`» <'^:.�
CityBiisineysLleense�:o.`::
Company Name
Classification
(e.g. A. B, C-81
License Number
Ixxxxxxl
Exp. Date
Ixx/xxlxxl
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xxlxx)
License Number
Ixxxxl
Exp. Date
Ixx/xx/xxl
EARTHWORK (C71
tu�lvle E
A
80210
11-31
f cov,
oo5oo5 -o-r
1 t e
q83
Il O
CONCRETE (C-8)
�V D
- -
u' 0 -O
rJD
oo..b li9'100
1 0
O Z O
2 -AS -01
FRAMING ,(C-5)
STRUCT.:STEEL (C-5:1) '
VAS V IJ or.J
A - e) - �
t1
TUES. /
ii -So -O
AWD
00 - 9 7'200-7
qL11,J
10 2 '10-7
A
MASONRY(C..
V
-8 -CS
-753 11 fS
1I-30.09
'evV-J
oo2o 179—Zoo7
4/1 /01
102.9o-7
�•2�•�
PLUMBING (C-36► •'.
r " CAA► >L&aoJ
- -C
1)
1-30 -0
LATH; PLASTER LC=351 '
DRYWALL (C-9)
HVAC. (C•20)•::.5:``.?: :,
ELECTRICAL IC=1g1'':',.'',
AIAJ &ARZYMN/Al-
- G
3 i
II'So "
):./1J
oa 200
r o
/Q 2 i07
�,p
ROQFING'IC=391��.' r`:�"
SHEET.METAL (C-43)
FLPRRING (Cs151:.`';:
GLAZING
INSULATION::M721.'
SEWAGE DIS P IC -42P' <;
QF
DEPT•
PAINTING (C-33)'-:
gU"J.)
VE
CERAMIC TILE (C-54) ' •
TRU
CABINETS (C-6)
Y
FENCING (C-13)
DAT
LANDSCAPING (C-27):;(:
POOL (C-53)'
oe
-30.1•
/0�i8o3
6 j0 a
CoA!ji,!°vld�b./
Bin #
City of La Quetta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701 Building Permit Application and Tracking Sheet
Permit #
(
Project Address: 57 0?2F --Al C6 LAAI_
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: 4 VL—' �520 0
Telephone:
Address: .Q 6 Ox �g
Project Description: o, S
City, ST, Zip: QtA (
ur—
Telephone: G ZS — d.,5' z—
I
rn a L4 -v fifi:1D
State Lic. # : l 1 a
-BE
City Lic. #: �Q yrO� 3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Abd'n Alter Repair Demo
Name of Contact Person: Cl" g2g�-
Sq. Ft.:
It Stories:
# Units:
Telephone # of Contact Person: ZS / Z J 3 — 7Z10�
Estimated Value of Project: 34700
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Constru•:tion
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready [or corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbir•g
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading,
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person .
�,I,p•p-
Pub. Wks. Appr
Date of permit issue
School Fees
LA
Total Permit Fees