06-1951 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92,253
Application Number:
Property Address:
APN:
Application description:
Property Zoning;
Application valuation:
Applicant:
'06=0000195I-�.
57270 PENINSULA LN
762-150-019- -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTTAT
30000
Architect or Engine
------------------
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 cla s: C53 License No.: 614611
/Date:) �G Contractors X//�
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 ISec. 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 sheds 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. 7644, 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.). -
( 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:
BELLA OCEANA LTD PARTNERSHIP
1354 BELLA OCEANA VISTA
PACIFIC,PALISADES, CA 90272
Contractor: r.
MCINTYRE POOLS & SPAS, INC.
83695 AVENUE 45
INDIO, CA 92201
(7.60)342-3612
Lic. No.: 614611
VOICE (760) 777-7012.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/10/06
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.
I have and will maintain workers' compensation insurance, as required by Section 3700 ofrthe 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, inthe 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
3700 of the Labor Code, I shall forthwith comply with those provisions.
D APplicar*' .
a
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 applicationand state that the above information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, d hereby authorize representatives
of thel coun yy to nter upon the above-mentioned propert for ' e
Date: S f / S Signature (Applicant or Agent)
Application Number . . . 66-00001951
Permit . . . BLDG POOL PERMIT
Additional desc'.
Permit Fee 284.50 Plan Check
Fee
184.93
Issue Date Valuation
. .
. 30000
Expiration Date 11/06/06
Qty Unit Charge Per
Extension
BASE FEE
252.00
9.00 (, . 5nnn TT40TT RT.nG .?4; nni -sn; nnn,
----------------------------------- -------------------------------------
32 : 51) _.
Permit MECH POOL
Additional desc .
Permit Fee . . . . 26.00' Plan Check
Fee
6.50
Issue Date' Valuation
0
. Expiraticn Date 11/06/06
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 11/06/06
\
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
J
0 .
Expiration Date 11/06/06
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
Special Notes and�Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQkRMTT
. .
'Application Number 0.6-00001951
--------------------------------------------
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' 388.50
.00
.00
388.50
Plan Check Total 210.91
.00
nn
21 n q'i
Grand Total 599.4.1
.00
.00
599.43
Bin #
Permit #
n�- / q, /
Project Address: �-70
A. P. Number:
Legal Description:
Contractor:
Address: AG X15
-
CitV. ST, Zip:
Telephone:
-State Lic. #6i vie
-) il
Arch.. Engr., Designer:
Address:
City, ST. Zip:
Telephone:
State Lic. #:
Name of Contact Person: -)(- rn
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Caics.
Truss Caics.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
—School Fees
I�
City Of La Quinta
Building 8r Safety Division
P.O. BOX 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Trai:king Sheet
Owner's Name:
I �r)s c1 ef V7
Address.
City, ST. Zip:
- * -77 —7, V q 7--F77
Telephone:
Project Description:
ao I —I
Lic. #:
Total Permit Fees
I
ax
Construction Type:
Occupancy-
Projec t 1),pe (circle one):
New Add'n Alter Repair Demo
Sq. Ft.:.X
L
#
Stories
Units:
Estimated Value of Project: v_
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd
TRACKING
PERMIT FEES
Plan Check submitted
�fQItem
----------
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
EF—t
Mechanical
2.d Review, ready for corrections/issue
Electrical
Called Contact Person
Plumb ng
Plans picked up
S.M.I.
Plans resubmitted
Grading
Review, ready for corrections/issue
Develo,)er impact Fee
1
Called Contact Person
A.I.P.P.
IDate
of permit issue
Total Permit Fees
I