06-2251 (RPL)e, 4
P.O. BOX .1504
78-495 CALLE TAMPICO
LA QUPNTA,' CALIFORNIA 92253
Application Number: 06-00002251
Property'Addiess: 44830 CALLE SANTA BARBARA
APN: 604-391-006-6 -25953 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY. RESIDENTIAL
Application valuation: 18.000
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
vP
---------------------------------------------
- LICENSED CONTRACTOR'S'DECLARATION -
I hereby affirm under penalty of perjurythatI am licensed under: provisions. of. Chapter 9 (commencing with
-Section 7000)'of Division ,3'of the Business and Professionals Code, and my66ense is -in full force and effect. -
�Liiccense Cllass: C12-053 - icense No 74'66
Dar te.. fes;' �Con�'
OWNER -BUILDER DECLARATION`
I hereby affirm,under:penaltyof perjury'that I am exempt from`th6 Contractor's;Siate License Law*for the
.following reason (Sec. 7031.5, Business and�Professions.Code: Any`city.orcounty.that requires`'a permit to -
construct, atter, 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 islicensed puisuantto the provisions of the'Contractor s State"'` '
License Law (Chapter -9 (commencing with Section 7000) of,Division 3 of.the-66siness:and Professions Code) or
that he or she is exempt therefrom ano�the basis for the allegeiJ exemption.• Any violation of Sec'i_ nA 7031.56 .
any applicant for a.permrt subiects,the applicant to a civil penalty of not more than five hundred'dollars.($500).:
I—) I, ;as owner property, or my, employees with wages as their sole.& npensation, will do the.work, and
the structure is not intended or offered forsale (Sec. 7044, Business and Professions Code':. The
,Contractors' State License:Caw does not apply to an owner of'property who builds orimproves thereon, -
and who, does the work himself or herselfthrough his or her own employees,'providedthat'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,bueden of proving that he or she did not build or
improvefor the purpose of sale.). - - - -
(_ 1 I, as owner of:the.property, prn exclusively contracting with licensed contractors'to.constructthe.project (Sec.
7044, Business an -Professions Code: The Contractors'. State License Law does not apply to an ovine; of
property who builds.'orimprovesthereon, and-wha contracts or the projects"with;a contractor(s) licensed
pursuant to the Contractors' State•Licens_e Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
CONSTRUCTION LENDING AGENCY
.I hereby affirm under penalty of perjury that there is a construction lending agency for r the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: ,��
_ RFV
LQPERMIT
Owner:
KELLY BRENDON
44830 CALLE SANTA BARBARA
LA QUINTA, CA 92253.
(
VOICE'(760) 777-7012
FAX (760) 777-701 T
INSPECTIONS (760) 777-7153
Date: . 6/02/06
.Contractor: V (/
NEUBURGER EQUIPMENT REN A /CO JUAA''
P.O BOX 623
JUN`.
LA QUINTA, .CA '92.253 Cjn �6
(760) 771-9822- N
LiC. No.: 746662 ACF, QV/kyr
FpT • A
_ WORKER'S. COMPENSATION DECLARATIOW. ,
,I hereby affirm under penahy,.ofperjury.one of. the followingdeclarations:_
have and will maintain a certificate,of consent to self -insure -for workers'.compensation,.asrprovided
for by Section'3700 of the Labor'Code,'for the performance of the work for which this permifis
issued.
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" comm pensab,6& -
insurance carrier and policy number are: - - -+
Carrier STATE FUND:'.,"- Policy Number 15.76693-200Ei
I"certify that, ih the performance of'•the'work for which this permit is issued, I shall not employ,any
person in any manner -s0 as to,become`subject to -the workers' compensationIlaws of California,
and agree that if. f. becornesubjectto the workers' compensation provisions of Section
' [[
3700 of the Labor Code I shall for h. comply with thos r visions.
Date.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE-IsLNLAWFUL;--AND SHALL.
,. SUBJECT'AN EMPLOYER TO -CRIMINAL PENALTIES AND CIVIL FINES UP TO�ONE'HUNDREO THOUSAND
DOLCXRS.($1bo,000I.._IN 46DITION TO THE COST'OF COMPENSATION, DAMAGES AS -PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT rACKNO W LED&MENT
IMPORTANT 'Application is he 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 andhold"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 thisepermW
2. Any permit, issued as 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 construction, and hereby authorize representatives
of this county tq enter upon the above-mentioned property for inspecsinu.purposes.)_
fl 1
Application Number .
. . . . 06-00002251.
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . .
189.00 Plan Check Fee
122.85
Issue Date . . . .
Valuation . . . .
18000
Expiration Date
11/29/06
Qty Unit Charge
Pere
Extension
BASE FEE
45.0.0
16.00 9.0000
THOU BLDG 2,001-25,000
144.00,
Permit:
MECH POOL
Additional desc .
Permit Fee
26,:00 Plan Check Fee
6.50`
Issue Date . . .
- Valuation
0
Expiration Date
ll%29/9C
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
Expirati'ori.•Date
.11/29/06
Qty. Unit Charge.
Per
Extension,
BASE FEB
15_..00
1. 6o- 30.0000
EA ELEC PRIVATE SWIMMING 'POOL
30.00 -
Permit_
PLUMBING
Additional desc:.
Permit:, Fee. . . .
33.00.. Plan Check Fee ..
'8. 2.5
Issue •Dat'e
>_. Valuation_
0 -
Expiration.Date
11/29/06
Qty Unit Charge
Per
Extension
BASE FEE' - •,`
.15 .00
00
2 .00 6.0000
EA PLB, FIXTURE
12- 00 .
1•.00 3:000'0.
_
EA PLB_WATER INST/ALT/REP
3.00
1.00 3.00007EA
PLB GAS`PIPE 1-4 OUTLETS.
.3.00
--------------------------------------
Special Notes and Comments
Pool/Spa Alarms/Barriers Shall.Be In
LQPERMIT
Application Number . . 06-0000.2251
Special Notes and Comments
-----------------'---------------------
Place .At Pre -Plaster Inspection
Equipment Enclosure not included
Fee.summary. Charged.
Paid 'Credited
Due
- ----------
Permit Fee Total 2.93.00
I
.00
--------------------
00
---
-293.00
Plan Check Total 148.85
.00
.00.
148.851*
Grand Total 441.85
.,00
.00
441.85
LQPERMFF - .
Bin #
City of La Qurnta
Building a Safety Division
-P.O. Box 1504, 78495 Calle Tampico
La Quinta, CA;922�53 - (76.0). 777-7012'
B.uiidingPermit A 1lcaion and 6t
ion , :' .Tracking Sheet
Permit #
Project Address:*. V' 03OL4a
Owner's Name:
A. P. Number:
Legal'Description:
/
Contractor: veli. b..' ., " �-lul y ^ 1
Address: RU 1 ' %02,3
Address:
Cit); ST, •Zip:. u 2_ �3.
Tele hone:
_ , •. , . ::{ �.
PrglecVDescription:
City,-ST, Zip:,L,:.Ct)u;:, Gam. p
D :y
/ loi7
Telephone: P®C'^_ !/
j,5
State Lic. # : 7 (o
City. Lic. #:
`Arch:, Engn, Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type. Occupancy:
Proj."ect type (circle'one)" New:' Add'n Alter Repair Demo
Narrie of Contact Person: f P ,vCv vin nntl
Sq:•Ft : • '
#Stories
#Units:
..Telephone # of Contact Personk7t o) a 6o -4 g /.(
Estimated; Value of Project. C� pct
APPLICANT
: O NOT,WRITE, BELOW .THIS TINE k
D
#
Submittal
Req'd
Recd
TBACIQNG .
PERMTf FEES
Plan Sets
P6- .Check submitted
Item
Amount
Structural Calcs.
-
Reviewed, ready for.:correctwns .
Plan Check Deposit
Truss Calcs.Called..
ontactPerson
Plan Check Balance
Energy Calcs.Plans.p�cked
up
Construction
Flood plain plan
Plans resubmitted
Mechanical .
Grading. plan
2nd Renew, ready for coftection�rissue' .
Electrical '
Suhcontactor:List
Called Contact Person
Plumbing '
Grant Deed
-Plans picked-up
S.M.1L
H.O.A. Approval:
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctionsfissue:Developer-impact
Fee '
Planning Approval
Called Contact Person
A.I:P.P.
-Pub. Wks. ApprDate
of permi(issue
School Fees
-Totat "mit Fees
'
r�
�l(A'P