12-0233 (RPL)P.O. OX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:12-"00:0:0,0233
Property Address:
78"0-7.6--RED—HAWK IN
APN:
C62 -3---52-0---021f -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Tity/ 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/19/12
Owner:
ADAM REKIPI
78076 RED HAWK LALNE
LA QUINTA, CA 92253
-
to I
r � � r
Contractor:
r� 2LI12
STONECREEK POOLS & SPAS(
O !
104 CALLE LOS HIBISCOS
RANCHO MIRAGE, CA 92270
Gulf 4.-,�rJ,L°•iP1TA
(760)601-6003
, i?<)`` ~
Lic. No.: 365900
--------------------------------------------------
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.
L' ense Class: C27 C53 ens LicNo.: 365900
Date: Contractor:
OW DER DECLARATION
I hereby affirm under penalty of r' ry that I am ex from the Contractor's State License Law for the
.following reason (Sec. 7031 .5 siness and Profe ns Code: Any city or county that requires a permit to
construct, alter, improve, dem ish, 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.).
(_ 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.).
I—) 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
-----------------------------------------------
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.
_ 1 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 STATE FUND Policy Number 0002499-2010
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 tha I shoul ome subject to the?' r ers' compensation provisions of Section
700 oft La Or Co , I s all forthwith co pfy th those provisions.
/ �/ pplicant:
WARNING! FAILURE TO SECURE7W9 KERS' CO�JP ENS ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD�ITION TO THE COST F COMPENSATION,DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABI�.CODE, INTEREST, ND 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 app' anon and state that the above information is correct. ree to comply with all
city a county ordinances a state laws relating to buildiZtction, and hereb u rize representatives
Zofs court to er up the above-mentioned grope ftion purpose .
: ( Signature (Applicant or Agent):
C
Application Number . . . 12-00000233
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.00 Plan Check Fee
134.55
Issue Date
Valuation . . .
. 20000
Expiration Date
9/15/12
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
9/15/12
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
9/15/12
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-.
9/15/12
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. ALARMS/BARRIERS SHALL BE IN
LQPERA1IT
LQPERMIT
Application Number . . . . 12-00000233
----------------------------------------------------=-----------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED. 2010
CODES. SEE PERMIT #06-2166 FOR
PREVIOUSLY ISSUED GAS & ELECTRIC
INSTALL.
----------------------------------------------------------------------------
Other Fees ... . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
-----------------
Credited
Due
--------------------
Permit Fee Total 311.00 .00
--------------------
.00
311.00.
Plan Check Total 160.55 .00
.00
160.55
Other Fee Total 1.00 .00
.00
1.00
Grand Total 472.55 .00
.00
472.55
LQPERMIT
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CITY OF LA QUINT
BUILDING &.SAFETY DEF
APPROVED
FOR CONSTRUCTION
)AT 41- �By j— L_
0
Bin. #. " ., , , .:..
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�Ii}/ ®f''. .QIP
Buffdtng'8s Safety,Ditdsfon: :.
P.O.Box:1SO78-49S.Caffe?amplco''
La.Quinta, CA 92253 -' (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#' �y,
n i
��-
Project A'dd=:21
Owner's Name:.
A. P. Number. _
Address: 076
Legal Description:
Contractor.
City, ST. Zip: -�
Telephone: �
Address: O
ProjectDescription:
City, ST, Zip:
Telephone:
State Lir-'# : City Lia #:.
Designer:
Address:
City., ST. Zip:
Telephone:ConstructionTy
Construction pe:. Occupancy:
State Lic #: 3.—M Project type (circle one): <1 "J Add'n Alter Repair Demo
Name of Contact Person:Sq. #Stories: # Units:
Telephone # of Contact Person: lj -_,7 Estimated Value of Project Zo
APPLICANT: DO NOT WRITE BELOW THIS. UNE
!E
Submittal
Plan Sets
Req'd
`Rev'd
TRACICINIG PERM[r.FM-
Plan Cheek submitted(Z Item Amount
Str4ctuhd Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Cales.
Called Contact Parson Pian Cheek Balance
Title 24 Calci6
Pians picked up Coastracdon
Flood plain plan
Plans resubmitted.' . Mechanical
Girding plan
2'' Review, ready for corrections/issue. Eleetrkal
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S bLL
H.O.A. ApprovalPlans
resubmitted Grading
IIV 130US1i:-.
''' Review; ready for eorrectionslissae Developer Impact Fee
Planning Approval.Called
Contact Person A.LP-P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
Total Permit Fees