05-2866 (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:
O5-=QQOQ286.6
57602 SANTA ROSA TR
762-240-013-21 -30487
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
�'otJi%4c,Jo
Architect or E
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
�.FJUL z o zoos ID
CITY Or
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 and Professionals Code, and my License is in full force and effect.
License Class: License No.:
/Date:�'��'T� ce` G�C&�e0
,,-Date
/ Con ctor: Vhf"/ 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
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, 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' Statb 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.).
I—) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
{ INSPECTIONS (760) 777-7153
Date: 7/11/05
Owner:
SANTA ROSA DEV
40847 SANDPIPER CT
PALM DESERT, CA 92260
Contractor:
CASA VERDE LANDSCAPE MAINT COR
WCC: GRANITE
WC:' 9549987 09/05/05
CSLB: 624647 08/31/06
-----------------------------------------------
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 C-27 - Policy Number '--------- - - - - - -
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 become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor/CCooddie, I shall forthwith comply with thole provisions.
�Wa 7 Applicantj
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
UBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 th above information is correct. I agree to comply with all
city and county ordinances and state laws relating to b ding construction, and hereby authorize representatives
of thi co my t enter upon the above-mentioned pro rty for inspection oses.
te:� Signature (Applicant or Agent):
LQYERMIT
Application Number .
. . . • 05-000,02866
Permit
BLDG POOL PERMIT
Additional desc .
Permit .Fee
207.00 Plan Check,Fee
-134.55
Issue Date . - . .
Valuation .
. 19792
Expiration Date
1/07/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000•
162.00,
PermitMECH
POOL
Additional desc .
Permit Fee
26.00 Plan Check.Fee
6.50
Issue Date . . .
Valuation
0
Expiration Date
1/07/06
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
1/07/06
Qty Unit Charge
Per
Extension
BASE -FEE
15.00
1.00 30.0000
------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
----------
30.00
------------
Permit . . .
WALL/FENCE PERMIT
Additional desc .
Permit Fee
15.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
208
Expiration Date
1/07/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
------------ ----------------------------------------------------------------
Special Notes*and Comments
POOL & SPA ONLY. 13 L.F.
4' EQUIPMENT
BLOCK WALL, CITY STANDARD.
ALARMS/BARRIERS SHALL
BE IN PLACE PRIOR
TO PRE -PLASTER INSPECTION.
LQPERMIT
Application Number
. . . . .
05-00002866
Fee summary-•
Charged
Paid
Credited
•Due
- ------ - - - - - - - - --
Permit Fee Total
---- - - - ---
293.00
---- - - - - --
.00
---- - - - - -- -
.00
- - - -- -
293.00
_ Plan Check Total
152.30
.00
.00
152.30
Grand Total
445.30
.00
.00•
445.30
y'
LQPERMIT
4
SPECIFICATIONS
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SWIMMING POOL PLAN FOR:
SANTA ROSA TRAILS LLC
SWIMMING POOL PLAN FOR:
SANTA ROSA TRAILS
CONSTRUCTION
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SM'BIYMG POOL PLAN FOR:
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Hill #
Permit # ar—
Project Address: S? `p A i
A. P. Number:
Legal Description:
Contractor:;. CASO
X Address: — U
X City. ST. Zip:
X Telephon -�
State Lic. # : C/f-c/
Arch.. Engr.. Designer:
Address:
Cin. ST. Zip:
Telephone:
State Lit, 4:
A Name of Contact Person: A
Telephone # of Contact Person: -M,
City of La Quints
Building er Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Ski IVI LS
Owner's Name: 19 ��� ;�D /1 / n L�
dress: Ie a-j�-�i' t�
. ST. Zip: C /l/ —I'V ► CA gaOay
✓i���F�phon7ect Description: eOO d. E/'.7J 9
City Lic. ay:
Construction Type: Occupancy:
!l Project type (circle one): New Add -n Alter Repair Demo
QV
M 1 S Sq. Ft.: aLQO a) IN Stories: It Units:
stimated Value of Project: Q�� v(� o
A 1101 ld�A►1T. n.. .
#
Submittal
Req'd
Recd
-W WV I FIFO UFMC
TRACKING
PER;►trr FEES
Plan Sets
Pian Check submitted
Item
Plan Check Deposit
Plan Check Ralance
Amount
Structural C,Ics.
Reviewed. ready for corrections
Truss Caics.
Called Contact Person
Energy Calcs•
Plans picked up
Construction
Mechanical
Flood plain plan
Plans resubmitted
Grading plan
Y' Review. ready for correcilons/issue
Electrical
Plumbing
S.1 LL
Suheontaetor List
Called Contact Person
Grant Deed
Plans picked up
ILO.A.'Approval
Plans resubmitied
Grading
Developer impact Fee
IN HOUSE:-
"' Review. ready for correetions9ssue
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Tueal Permit Fees
Zoe •