06-1185 (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:
�0-6 "000011857
5'1075--CAL-LE—PALOMA
770-142-011-100 -OOOOOC
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
15000
Architect or
Tdy . 4 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
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: C53 LAense No.: 614611
r ate: _0�ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I amexempt 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).:
(_) 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 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.).
1 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:
LQPERMIT
Owner:
BARAJAS ALBERTO
51-075 CALLE PALOMA.
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & SPAS, INC.
83695 AVENUE 45
INDIO, CA 92201. _
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3 /23 % 0.6
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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
�n Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier HRH INS Policy Number C20060333601
I certify that, in the performance of the work for which this permit is issued, 1 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 Code, I shall forthwith comply with those provisions.
pate: Applicant:
WARNING: FAILURE TO SECURE 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 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 to enter upon the above-mentioned pr pe y for inspection purposes.
Dafesc: Signature (Applicant or Agent):
Application Number . . . . . 06-00001185
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
162.00
Plan Check
Fee
105.30
Issue Date . . . .
Valuation
. .
. 15000
' Expiration Date
9/19/06
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
13.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
117.00
Permit
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00
Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0
-Expiration Date
9/19/06
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
9/19/06
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
9/19/06
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 ONLY. ALARMS/BARRIERS
SHALL
LQPERMIT
Application Number . . . . . 06-00001185
----------------------------------------------------------------------------
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 266.00 .00
.00
266.00
Plan Check Total 131.30 .00
.00
131.30
Grand Total 397.30 .00
.00
397.30
LQPERMIT
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LA QOINTA: CA.-��2
Bin #
City 'of •La .Qunta
Building 8L "Safety Division
Permit #
P.O.:Box:.1504, 78.495 Calle Tampico
'ated
La.Quinta,: CA. 92253,- (760),777-7012
Building Permit
A licat'"
pp,. io n and Tracking Sheet
APPL`ICANTi
DO NOT WRITE BELOW THIS LINE
#
Project Address: -(:
S'
Req'd
pw•ner's:Name• `
A. P. Number:
a- ce -.S
Plan Sets
Address:.
J tl
Legal Description:
ST
• Ip.
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Contractor::(;irl u re t...
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3/24 .d Item Amount
:Reviewed, ready for corrections
Address•. )K`� _ ///
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�ProJect Descnption:c-
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City. ST. Zip:-
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R.PP).
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Telephone., :K 7 r.
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State Lic. #: _61"'1151 Ci' Lic.
Arch.. Engr.. Designer: '
Address:
Plan Check Balance
City. ST. Zip:
`
Telephone: one:
Plans picked up
: Ct
"Consru . �'`'
c '
ti on Type: O cc an ••
uPc
Sta to Lic #•
P roJ ec •
t �Pe rel
(c one :..N
e -New Add'
n Alter Repair DemoName
of Contact Person,
:
Flood plain plan
T
Telephone # of Contact Person
Plaris resubmitted
Sq Ft
# Stories:
#Units:
Total Permit Fees
'ated
b. Yalue
Estimof Proiect: �S
APPL`ICANTi
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
. TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted
Structural.Calcs.
3/24 .d Item Amount
:Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contac(Person
w
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plaris resubmitted
r Mechanical
Grading plan
god Review; readv`•for corrections/issue Electrical
Subcontactor'List"'
Called Contact Person`
;Plumbing
Grant Deed.
; Plaint picked: up "
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
`IN HOUSE:-
'"' Review, ready ror corrections/issue Developer Impact Fee
Planning Approval
Called Contact.Person •
A.LP.P.
Pub. Wks. Appr
Date of perinit issue
School Fees
;
Total Permit Fees