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08-0546 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: PIA LICENSED CONT CTOR'S DECLARATION hereby affirm under penalty of perjury that I am Ii nsed er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P ofessi Is Code, and my License is in full force and effect. License Class: C53 License No.: 614611 Dater tractor. 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' 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.). , ( ) I ani 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/02/08 Owner: SHERLOCK 81910 SEABISCUIT WAY LA QUINTA, CA 92253 ,(760)777-9920 Contractor: MCINTYRE POOMC11X�t.ktR0CUW1tT 83695 AVENUE INDIO, CA 92 (760)342-361 Lic. No.: 61 �. 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 DELOS INS CO Policy Number 01DKRM12001870 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 becom bject to the workers' compensation laws of California, and agree that, if I should come s t to the workers' compensation provisions of Section /377000 'offtthe Labor Code shall f ith comply with those provisions. ate: ' V !_ Applicant: WARNING: FAILURE TO SECU 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 . 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 the ab in s correct. I agree to comply with all city and county ordinances and state laws relating to buildin nor hereby authorize representatives ofthi"iK, upon eabove-mentioned property inspe irposes. Uate: ature (Applicant or Agent)' 0 Application Number: -00000546 Property Address: 81910 SEABISCUIT WY APN: 767-200-999-34 -312023- Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation:. 27000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: PIA LICENSED CONT CTOR'S DECLARATION hereby affirm under penalty of perjury that I am Ii nsed er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P ofessi Is Code, and my License is in full force and effect. License Class: C53 License No.: 614611 Dater tractor. 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' 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.). , ( ) I ani 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/02/08 Owner: SHERLOCK 81910 SEABISCUIT WAY LA QUINTA, CA 92253 ,(760)777-9920 Contractor: MCINTYRE POOMC11X�t.ktR0CUW1tT 83695 AVENUE INDIO, CA 92 (760)342-361 Lic. No.: 61 �. 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 DELOS INS CO Policy Number 01DKRM12001870 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 becom bject to the workers' compensation laws of California, and agree that, if I should come s t to the workers' compensation provisions of Section /377000 'offtthe Labor Code shall f ith comply with those provisions. ate: ' V !_ Applicant: WARNING: FAILURE TO SECU 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 . 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 the ab in s correct. I agree to comply with all city and county ordinances and state laws relating to buildin nor hereby authorize representatives ofthi"iK, upon eabove-mentioned property inspe irposes. Uate: ature (Applicant or Agent)' LQPERMIT Application Number . . . . . 08-00000546 ' Permit . . . . BLDG POOL PERMIT Additional desc . Permit.Fee . . . . 265.00 Plan Check Fee 172.25 Issue Date . . . . Valuation 26760 Expiration Date 9/29/08 Qty Unit Charge Per Extension BASE FEE 252.00 2.00 6.5000 ----------------------------------------------------------------------------- THOU BLDG 25,001-50,000 13.00 Permit . . MECH POOL Additional desc .. Permit Fee 26.00 Plan Check Fee 6.50_ . Issue Date . . . Valuation 0 Expiration Date 9/29/08 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 9/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 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 9/29/08 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 Permit . . . . . . WALL/FENCE PERMIT LQPERA1JT Application Number . . . 08-00000546 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 240 Expiration Date 9/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, 15 L.F. 4' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE - IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee Total 384.00 ..00 .00 384.00 Plan Check Total 198.25 .00 .00 198.25 Grand Total 582.25 .00 .00 582.25 Zul OOS �- 5 'U u. ,,,4, co `y y:LLW 6 •t r Bin # City of La. Quints :Building u Safety Division ' Permit # 5 P.O. Box 1504, 78-495 Calle Tampico La Quilita, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:'8 _ /O s it Owner's Name: A. P. Number: Address:.81. O S 1 T Legal Description: City, ST, Zip: Jct a. uo 5 Contractor - A! TA i4fe. L.k Telephone: _ Address: 3 -6 KA :ProjectDescription:. S b City, ST,Zip:. ° .60. Zt? 0 12 Telephone: 3 ¢ Z Td 'T State Lie. # : City Lie. #:. y1'I Arch., Eng., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: P cy: State Lit. #: C'S 3 — 614611'_,Project type (circle one): New Add'n ' Alter Repair Demo Name of Contact Person: e f Sq. FL: #_ Stories:.. [# Units: Telephone # of Contact -Person: ' Estimated Value.of Project: 7 APPLICANT: DO NOT WRITE BELOW THIS LINE . # Submittal Req'd Recd TRACMG . PERMTr FEES Plan Sets Plan Check submittedItem Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit . Truss Cities. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan , Plans resubmitted Mechanical Grading, plan tad Review, ready for correctiorisrissue Electrical Subcontactor.List Called Contact Person Plumbing GranfDeed Plans. picked up S.M.I. H.O.A. Approval Plans resubmitted Grading. IN HOUSE:- ''" Review, ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P: ' Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees �a7OOO r a�-7