12-0858 (RPL)- 1.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: _ 12-00000858'
Property Address: �4"8270 PASO TIEMPO LN
APN: 646 -360 -017 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation' 19400
Applicant:
Architect or Engineer:
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that m n d under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Pro s ono ode, and my License is in full force and effect.
License Class: C27-053 is nse No.: 964474
/ate • • Contractor
WNER-BUILDER DECLARATION
I hereby affirm under penalty of 'jury that I a exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, B ' ass and P fessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or r 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
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 propertyF 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. _, BAP.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: IF'
LQPERMIT
Owner:
MCMENOMY
48270 PASO TIEMPO LANE
LA QUINTA, CA 92253
Contractor:
DESERT OUTDOORS INC
79405 HIGHWAY 111, Pl�
LA QUINTA, CA 92253
(760)399-9600
Lic. No.: 964474
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/01/12
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 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 NORGUARD INS Policy Number DEWC229889
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 Nect to the workers' compensation laws of California,
and agree that, if I should b e s )e to the workers' compensation provisions of Section
_ 3700 of the Labor Code, I I tfo w' comply with those provisions.
Date:
WARNING: FAILURE TOS CURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T CRIMINAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). INA TION TO HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR C5Q4 IN EREST, 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 aV
correct.Iagree to comply with all
city and county ordinances and state laws relating to buildinherebyauthorizerepresentatives
of t1t�s county to enter up the above-mentioned property fes.
Oate • •gnature (Applicant or Age
Application Number 12-00000858
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee 207.00 P1an.Check Fee 134.55
Issue Date Valuation 19400 .
Expiration Date 1/28/13
Qty Unit Charge Per Extension
BASE FEE 45.00 .
18.00 9.0000 THOU' BLDG 2,001-25,000 iFq,nn
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 6.0000
EA PLB
FIXTURE
6.00
1.00 3.000O.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
ADD -SPA & RAISED BOND
BEAM TO EXISTING
POOL. 2010 CODES.
--------------------------------------------
Other Fees . . .
.
-----------
BLDG STDS ADMIN (SB1473)..
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total
234.00
00 .00
234.00
Plan Check Total
141.3.0
.00 .00
141.30
Other Fee Total
1.00
.00 00
1.00
Grand Total
376.30
.00 .00
376.30
LQPERMIT
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BUILDING
& SAFETY DEPT.
APPROVED
FOR CONSTRUCTIONLIJ
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TYPICAL RBB / SHEER DESCENT SITE PLAN
WATERFEATURE PLAN
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NOT TO SCALE
TIEMPO LANE SCALE: K' = t'd
Ill PASO i OF 1 -
Bill # City O Lel Quinta
Btdt&i?g 8r Safety Division
Permit # P.O Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sleet
Project Address: ya Owner s Name . rAcmvrjolym
A. P. Number Address:
1 Legal Description: City, ST, Zip: V '
i. Contractor. Desert Outdoors Tel hone:
Ate: 78-065 Main St. Ste. 205 Project Description:
city. ST zip: La Quinta, Ca. 92253
Telephone: 760-399-9600 l L,
State Lie. # : c-53 964474 City Lia#;
Arch., FW-. Designer Flying Buttress
Address: 77725•Enfield Ln. Ste. 130
city, ST, zip: Palm Desert, CA. 92211
! Tele hone:
p 760-772-4411 Construction Type:. Occupancy:
State Lia #: 33446= Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: J Sq. Ft :# Stories: # Units:
Telephone # of Contact Person: . 1M • -1 Estimated Valine of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
VI if
N Submittal Req'd 'Reed V.PERl1IIF FEES
"i
Plan Seas Pian Check submitted Item Amount
Strnctarai Cafes Reviewed, ready for UL 31 D2 Plaa Check D -posit,
Thus Calcs. Called Contact Person Plan Check Rdance _
1
Tine 24 Calcs Plans picked up BY: Construction
Flood plata plan Plans resubmitted, . Mechanical . N s
Grading plan 2•' Review, ready for correcilawriusue Electrical
Subcontaetor19st Called Contact Person Plumbing
Grant Deed Plans picked up SILL
H.O.A. Approval Plaits resubmitted Grading
IN HOUSE:- ''a Review; ready for correctionsfissne Developer Impact Fee
` Planning Approval Called Contact Person A.LP.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees