06-0359 (RPL)P.O. BOX 1504
78-495 CALLE.TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06_-00000359_,
Property Address: 58457 QUARRY RANCH RD
APN: 766 -060 -041 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 35000
Applicant: _
all
4M
Ta�/.4
Architect or Enginee
w/d
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
0 Q' -
FEB 0 3 2006
CITY OF LA QUIW A
----------------------------------r----------------
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 n rofess' nal Code, and my License is in full force and effect.
License Clas C53`` cense No.: 853887
D 0^Cont ctor: '
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 (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
Licen"%e 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 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 withacontractor(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
- `0
Owner:
PORTEOUS
58-457 QUARRY RANCH ROAD
LA QUINTA, CA 92253
Contractor:
OUTDOOR SOLUTIONS INC
78034 CALLE BARCELONA STE C
LA QUINTA, CA 92253
(760)777-1199
Lic. No.: 853887
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 2/02/06
------------------------------------------------
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 '
`%sued.
_ 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, I shall not employ any
person in any manner so as 10 become subject to t wor rs' compensation laws of California,
and agree that, if I should becom subject to a orker compensation provisions of Section
of the LaboorrCCo I s II rthwit omp wit ose provisions.
Da415710
OG Applican
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..- Eachpersonupon whose behalf this application is made, each person at whose request and4or - - - - --
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 Ouinta, 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 in rmation is ct. agree to omply with all
city and coun y o dinances and state laws relating tobuilding uilding on ructi eby thorize resentatives
of this n t enter upon the above-mentio�needdy,,'rbppe purp s.
D d�Signature (Applicant or gels" .
Application Number . . . . . 06-00000359
-
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 317.00 Plan Check Fee
206.05
Issue Date Valuation . . . .
35000.
. Expiration. Date &/01/06
Qty Unit'Charge Per
Extension
BASE FEE
"252.00
10.00 6.5000 THOU BLDG 25,001-50,000
65.00
Permit MECH"POOL
Additional desc .
Permit Fee . . . 26.00 Plan Check Fee ..
6.50
Issue Date Valuation
0
Expiration Date ". 8/01/06
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 8/01/06
QtyUnit Charge Per
Extension
BASE FEE
15.00
1.00 30.0000 EA' ELEC PRIVATE•SWIMMING POOL
310.00
Permit . . PLUMBING
Additional desc
Permit Fee . . . . 33.00 Plan CheckFee8.25
Issue Date . . . . Valuation . .
0
Expiration Date 8/01/06
Qty Unit Charge Per
Extension '
BASE FEE
15.00
2.00 6.0600 EA FL5 FIXTURE
12.00
1.00 3.0000 BA 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. 40 L.F. 24" BLOCK/PLANTER
' LQPERMIT j -• �'
_ .. ..
Application Number . . 06-00000359
--
7 --------------------------------------------------------
Special,Notes and Comments
WALL, CITY STANDARD(COURTSEY.-
INSPECTION). ALARMS/BARRIERS SHALL BE
IN PLACE PRIOR TO PRE -PLASTER
INSPECTION:. EQUIPMENT.ENCLOSURE NOT
INCLUDED.IN PERMIT.
Fee summary Charged Paid Credited. Due
Permit Fee Total 421.00 .00 .00 421.00
Plan Check Total 232.05 .0.0 .00 232.05
Grand Total 653.05 .00 .00 653..05
/f CIT OF LA QOINTA•� SUB-C0.NTRACTOR. LISW
JOB ADDRESS �J �' Lf 7 ��� A� 9� PERMIT NUMBER D�-- 03�,� OWNER PA%I— Po �� s - BUILDER . 0 09 0''`— �Luno+JS
This form shall be posed on the job with the Building Inspection Card at all times in a. conspicuous place._ Only persons appearing on this list or their employees are authorized to wor
-'ter► this job: Any -changes to this list must be approved by the Buildirig Division prior to commencement of wort:. Failure to comply will result. in a stoppage of work and/or the voidanc
of building permit. For each applicable trade; all information requested below must be completed by applicant. "On File* isnot an acceptable response.
vWeb
Trade / C1a¢vf,cat.nn
.. - Contractor' : '�:�-•..,:;:<
.......... .:.. State;Contractors
Lrcense::••�::::••.••:::>>.
::. '��..::` .or ers;.'ornpensa t,oR::.nsurance:°'•::':� •. �'::..;.�'::.
•rty. usrness
Cense'.�<:•::
Company Name
Classification
(e:g.. A-, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx).
Carrier Name
(e.g. State Fund,. CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xxl
License Number
(xxxx)
: Exp. Date
(xx/xx/xx)
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Project Address:
A. P. Number:
City Of La Quin to
Building Jai Safety Division .
-- --- ----------P.O.-Box -1504,-78=495 Glle Tampico --- -- ------ -T- —
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
A4L4_YQ.p Owner's Name: �
K Nv P�°zyo s
Contractor. X 0llTpo0'1-
Address: 1 - 03 q CA - L <
City, ST, Zip: Y LA- U1v-J- - Ct 92 25 3
Telephone:
7
i
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x �O
9
g
State Lic. # : k C 5 3 $ $'3 g $ 7 City Lie. #: L&. #q
Arch., Engr., Designer:
Address:
Address: K '5 e- q 57 &_iA_a N /1.,► _ d .,
City, ST, Zip:
Telephone:
C
StateL '
tc. #•
i
Name of Contact Person:SC-M ✓Lo x:5D52
So
Telephone # of Contact Person: %Co 0 77 t f . G q 15 --
5 --APPLICANT:
APPLICANT: DO I
# Submittal Req'd Ree'd
Plan Sets Plan Check subn
lStructural Cafes. Reviewed, ready
Truss Cafes. Called Contact P
—
Title 24 Cafes. Plans picked up
:��JEstimated Value of Project: X 3 S, 00 O
Flood plain plan Plans resubmitte
TRACKING PERMIT FEES
Grading plantad Review, reads
for corrections
Subcontactor List Called Contact P
Plan Check Deposit
Grant Deed Plans picked up
erson
H.O.A. Approval Plans resubmitte
Plan Check Balance
IN HOUSE:- '^' Review, ready
Planning Approval Called Contact P.
Construction
Pub. Wks. Appr Date.of permit iss
1
School Fees
Address: K '5 e- q 57 &_iA_a N /1.,► _ d .,
City. ST, zip: >< LAt csCv,.JTQ CA-
Telephone:
7F77777—
C
Project Description: K
i
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So
� � 0 � �� � Loth INA Lt. �ca•�a��iL
gcswl^ra 4/tiA-,rtCw q -
`c. JT: -
cons ructt' 0n Type:e: • Occ u Pan N•..
Project type (circle one): ew Add'n Alter Repair Demo
—
Sq. Ft. : . # Stories: # Units:
:��JEstimated Value of Project: X 3 S, 00 O
JOT WRITE BELOW THIS LINE
TRACKING PERMIT FEES
iitted Item Amount
for corrections
Plan Check Deposit
erson
Plan Check Balance
Construction
1
Mechanical
for corrections/issue.
Electr¢al
!rson
Plumbing
S.�t.l.
i
Grading
for corrections/issue
Developer Impact Fee
rson
AIP.P'.
ue
°
Total Permit Fees
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