06-1278 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: �06-00001278
Property Address: 54185 EAST -RESIDENCE CLUB DR
APN: 775-380-999-23 -31627 -
Application description: POOL : RESIDENTIAL
Property Zoning: MEDIUM DENSITY RES No Application valuation: 10000
Applicant:
Architect or Engineer: ID I MAR 312005
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 a d Professionals Code, and my License is in full force and effect.
License Cl as : C8 C27 C29 License No.: 656128
Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury �that I a exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Businesnd Pr fessions 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):
(_) I, as owner of the property, or my employees with wades 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.). -
(_) 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:
NADADOR, LLC
78120 CALLE ESTADO, SUITE 203
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
r�OACHELLA, CA 92236
(760)398-9222-
Lic. No.: 656128
VOICE (760) 777-7012-a
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/30/06
-----------------------------------------------
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 HRH INS Policy Number BB1060510
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 be ome subject to the workers' compensation laws of California,
and agree that, if I should becom subject to the workers' compensation provisions of Section
3700 of the Labor Code, I s all hwith comply with those provisions.
[Tate:�V� Applicant:
WARNING: FAILURE TO SECURE WORKERS' CC�PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALAND 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 county ordinances and state laws relating to building c tion, and hereby authorize representatives
of cco/Ynty too enter upon the above-mentioned property f spe ti purposes.
DateSignature (Applicant or Agent): /
Application Number .
. . . . 06-00001278
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
117.00 Plan Check
Fee
76.05
Issue Date . . . .
Valuation
. . .
. 9760
Expiration Date
9/26/06
Qty Unit Charge
Per
r
Extension
-
BASE FEE
45.00
8.00 9.0000
------------------------------------------------------------
THOU BLDG'2,001-25,000.
-----------------
72.00-
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
" Issue Date.
Valuation
. . .
. 0
Expiration.Date
9/25%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
9/26/06
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 . . . .
27.00 Plan Check
Fee
6.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
9/26/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
.
Application Number . . . . 06-00001278
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date. . . Valuation
240
Expiration Date 9/26/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
--- ----------------------------------------------------
Special Notes and Comments
SPA. 15 LF 4' EQUIPMENT BLOCK WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE PRIOR TO PRE -PLASTER
INSPECTION.
Fee summary Charged Paid Credited
Due
----------------- ---------- --- ------ ----------
Permit Fee Total 230.00 .00
_--------
.00
230.00
_ Plan Check Total 100.55 .00
.00
100.55 -
Grand Total 330.55 .00
.00
330.55
LQPERMTT
I
Eginfit
City of. La Quinta
Building 8U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
7D La Quints, CA 92253 - (760) 777-7012
/(Cq�
Building Permit Application and Tracking Sheet
ProjectAddress:5ggq 6 e$.' cS..A�, Owner's Name: _
v• A A. P. Number:
Address: .
Legal Description: City, ST, Zip:
Contractor `\ �• l ` S Telephoner 8
Address: 0 2
Project Description:
City, ST, Zip C Z23
Telephone:
State Lie. # : Z City Lic. #: t $ r X i
�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lie. #: Project type (circle one): 6, Add'. Alter Repair Demo
Name of Contact Person:
o Sq. FL: # Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project:.
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG .
PERMIT FEES
Plan Sets
Plan.Check submitted Z
Amount
Item
Structural Calcs.
Reviewed; ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2°" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing 6�a
Grant Deed
Plans picked up
5
!—tel odT c s
S.M.I.
ILO.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apprate
of permit is ue
1II�IT
School Fees
_4
11 kop CONSTRUCTION I
�! yo Total Permit Fees
DATE BY
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