06-3520 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00003520
58061 CARMONA
764-200-006-5 -316811-
POOL - RESIDENTIAL'
LOW DENSITY RESIDENTIAL
30000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICE ED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th ' ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi ss an Pro,
ro sionaIs Code, and my License is in full force and effect.
License Clals: C8 C27 C2 License No.: 656128
gWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am Vxxempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and ProfeBions 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).:
1 _ 1 1, 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 1, 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 1 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: PW
LQPERMIT
Owner:
CORAL OPTION I
79295 RANCHO LA QUINTA DR
LA QUINTA, CA 92253 1
Contractor:
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/02/06
e
D
OCT p 5 2006
CITY Of. �
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.
XI 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 SEABRIGHT Policy Number BB1060510
I certify that, in the performance he work for which this permit is issued, I shall not employ any
person in any manner so as t become subject to the workers' compensation laws of California,
and agree that, if I should b subject to the workers' compensation provisions of Section
�� of the bor Code sal fo with comply with those Provisions.
ate: te: G pplicant:
WARNING: FAILURE TO SECURE WORKER
SUBJECT AN EMPLOYER TO CRIMINAL PE
DOLLARS 15100,000). IN ADDITION TO TH
SECTION 3706 OF THE LABOR CODE, INTO
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
,LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
�ST, 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 p mit.
2. Any permit issued as a result of this application ecomes null and void if work is not commenced
within 180 days from date of issuance of suc permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this applic tion and state that t information is correct. 1 agree to comply with all
city and county ordinances and to laws relating to uildi con ruction, and hereby authorize representatives
of this�eo�unty)o entEr uBon eabove-mentioned p pe i�ispe ion purposes.
(Applicant or Agent)
Application Number . . . . . 06-00003520
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee. 284.50 Plan Check Fee 184.93
Issue Date . . . . Valuation . . . . 30000
Expiration Date .3/31/07
Qty Unit Charge Per Extension
BASE FEE 252.00
5.00 6.5000 THOU BLDG 25,001-50,000 32.50
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Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
7xpiration Date 3/31/07
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
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Permit . . . ELEC POOL PERMIT -RES
Additional desc . .
Permit Fee 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation 0
Expiration Date . . 3/31/07
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
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Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date .. 3/31/07
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, WATER FEATURE.
LQPERMIT
Application Number . . . . . 06-00003520
----------------------------------------------------------------------------
Special Notes and Comments
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 388.50 .00 .00 388.50
Plan Check Total 210.93 .00 .00 210.93
Grand Total 599.43 .00 .00 599.43
LQPERNIIT
sin# City Of. La QUiilta
Building U Safety Division
Permit #P.O. Box 1504, 78-495 Calle Tampico
G, uv La QuiniA, CA 92253 - (760) 777-7012
JJ Building Permit Application and Tracking Sheet
Project Address Owner's Name: e�
A P. Number: Address: N
Legal Description: City, ST, Zip:
Contractor;`` Y\ t Telephone:
...........
Address'?,(,-'),. 12-36P Project Description:
City, ST, Zip C.&.. 2—Z3
Telephone: 7603cW-ZZ Z
State Lia. # : Z City Lie. #:
Arch., Engr., Designer:
Address: .
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Telephone # of Contact Person:.
Construetion Type: Occupancy:
Project type (circle one): Add'n Alter Repair' Demo
Sq. Ft.: #Stories: # Units:
Estimated Value of Project: C) O
r: ;APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal'
Req'd - RWd TRACIONG . PERMIT FEES
Plan Sets
Pian.Clieck submitted Item Amount
Structural Cates.
Reviewed,• ready for corrections Plan Check Deposit
Trans Calcs.
Galled Contact Person. . Plan Check Balance
Energy Calcs.
Plans Picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan'
r' Review, ready for correctionstissue Electrical
Sabcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SILL
H.O:A. Approval
Plans resubmitted Grading
IN HOUSE:-.
''' Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. App'r .
Date of permit issue
School Fees
• Total Permit Fees