05-3119 (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:
0"5-0:0-0-0-3-2'f 9
57513 SANTA ROSA TR
762-240-013-17 -30487 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
17000
Architect or Engi
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
JUL 2 5 2005
CITY OF
Owner:
SANTA ROSA DEV
40847 SANDPIPER CT
PALM DESERT, CA 92260
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/33/06
Date: 7/22/05
LICENSE ON CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ,
I hereby affirm under penalty.of perjury that I am li - ed un er provisions of Chapter 9. (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of is'pD of the Busin and Pro s Ona Code, and my Ijc e/�s in f7,II a and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Clas it
No.: n[ ®� L for by.Section 3700 of the Labor Code, for the performance of the work for which this permit is
" j issued.
94tete: Q�ittractor /\. I have and will.maintain workers' compensation insurance, �as required by Section 3700 of the Labor
✓ _ �'T Code for the performance of the work for h: 's permit is issued. My workers' compensation
0 LDER DECLARATION.
1 hereby affirm under penalty of perjury at I am exem om 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
permii to file a signed statement that he or she is licensed pursuant to theprovisions 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 provided. thatthe
improvements areNnot intended "or'offeredfor 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(sl 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:
' +4
LQPERMIT
insurance carrier and policy number -are:*.
Carrier CS C2.7 'C29. C53 PogcY Nu be - - - - - --
_ I certify that, in the performance of the work or whir t s permit is issued,.) shall -not employ any
person in any ".manner so become sub ct to the orkers', compensation laws of California,
and agree that; if I should -me subject t the rk s' "compensation provisions.of Section
320 of
the LaborCope', Co , 1 s all fort with co pl with__t ose provisions. -
D �A�licarlT -
WARNING: FAILURE TO SECUhEW6RJiRS'COMPENs—A7iCawwE 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. Each person upon whose b'ehalfthis application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit ia result ofthis application,
- the owner, and the applicant, each agrees to, and shall defend, indend old harmless the City
of La Quinta, its officers, agents and employees for any actor omisate the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of -this application becomes null.and voidor
is t commenced
within 180 days from date of issuance of such permit, or cessatiok.for., 0 days will subject
permit to cancellation.
certify that I have read this application and state that the ab informat6andkintatives . I re 'to comply with all
.city and county ordinances and state laws relating to buildi c structiothori a representatives
of this count to Bent tupopAhe above-mentioned prope 'for i spections
D e• v Sture (Applicant or Agent). '
Application Number .
. . 05-00003119
Permit . . . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
180.00 Plan Check Fee..
117.00
Issue Date . . . .
Valuation . . .
. 17000
Expiration Date
1/18/06
Qty Unit Charge
Per
Extension
BASE FEE
45-.00
15..00 9.00.00
7 -------------------------------------------------------------------------
THOU BLDG 2,001-25,000
135.00
Permit . . .
MECH POOL .
Additional desc.
Permit -Fee . . . .
26.00 Plan Check Fee•.
6.50
Issue Date . . . .
Valuation
0
Expiration Date
1/18/06
Qty '-Unit Charge
'Per
Extension
BASE FEE
15.00
1.00 11.0000
EA MECH•FURNA E >100K
11.00
Permit . . .
ELEC POOL PERMIT -RES
Addt`ona•1 desc
Permit Fee
45.00 P1ari Check Fee
11.25
Issue'Date -.
Valuation
"0
:. Expirati.ori Date
1/18/06'=
Qty-". Unit Charge
-Per
Extension
BASE; -FEE
X115 : 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
}1/18/06
Qty Unit Charge
Per
Extension
BASE-. FEE
15_00-
2.00 6.00.00
EA PLB FIXTURE
12.00
11.00 3.0000
EA PLB WATER='INST/ALT/REP
3:00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
1.00
---------------------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number . . . . . 05-00003119
-----------------------------------------------
Special Notes and Comments
--------------
---------------
BE IN PLACE
PRIOR TO PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT
INCLUDED IN
PERMIT.
Fee summary
-----------------
Charged Paid
--------------------
Credited
--------------------
Due
Permit Fee
Total 284.00 .00
.00
284.00
Plan Check
Total 143.00. .00
.00
143.00
Grand Total
427.00 .00
.00
427.00
LQPERMIT
Bin #
, 1 Cl ay ,of lu UFII ta
Building. 8r Safety Division
PA Box 1504, 78495 Calle Tampico,
La QLiinta. cA192253 - (760)'777-7012 ;
Build►n Permit APP'1►cation,and,Tracking Sheet
g.
Permit #
Project Address:_ s l S ' Owner's Name:
A. P. Number: Address: -
Legal Description: „'City, ST, Zip:
C 0
ontract r: C `d "-TeleP h one: i
Lo
I,
Address: C) sox : Project Description:
City, ST, Zip: G h .):;;( 3 �® oo L `'
Telephone:
hone: �9 � Z
Z
r ..
State Lic. #: _ City Lic #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
- R.
TelP
e hone: Co structi on T � . Occupancy:
CYP Y:
'State Lic. #: (circle one • N
. 5 'Add'n Alter Repairair Demo
Name of Contact Person: DAA y r Sq: Ft.: #Stories: } #Units:
Telephone # of Contact Person: ,2 �, 4?5_—O Y. Estimated.Value of Project:
APPLICANT MNOT WRITE;BELOW,THIS LINE
#
Submittal
Req'd
Recd
~ % TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted.
2 r`Ii7S
:Item
Y
Amount
Structural Cates.
Reviewed, ready for corrections
Plant Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked Upf
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2""'Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
iPlumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
'Plans resubmitted
Grading
.IN HOUSE:-
-
7rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Cal led'Contact,Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit fees