05-1745 (RPL)BUILDING & SAFETY DEPARTMENT
-4 (760),777-7012
3 TAMPICO FAX (760) 777-701-1
;ALIFORNIA 92253. INSPECTION REQUESTS (760) 777-7153
e,
BUILDING PERMIT
9
kropeCd
05-00001745
Date 5/09/05
ress . . . ..
78890 CITRUS
A
772-101-007- -
-
Application description
POOL - RESIDENTIAL
Property Zoning..
LOW DENSITY RESIDENTIAL
Application -valuation--:
17000
Owner
Contractor
------------- ------- - ------------
CAPITAL PACIFIC HOLDINGS
---------------------------------
CALIFORNIA POOLS &
SPAS
4100 MACARTHUR BLV STE.200
P.O. BOX 1280
.NEWPORT BEACH, CA 92660
COACHELLA, CA 92236
(760) 398.-9222
WCC: SEABRIGHT
INS
WC: BB1050810
01/01/06
CS.LB: 656128
10/31/06
CCC: C8 C27 C29
C53
9
P.O. Box 1504 �� VOICE (760) 777-7012
78-495 CALLE TAMPICO T4hf 4 4 FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: o5- 174 . Date: .5-- /0 -os -
Applicant: `4s -
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
aLA
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 ����t !!Fe and effect.
/License Class ✓/ Lic rise No. ✓(O [ �D
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for thelollowing 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 Contractors' State License Law (Chapter 9 (commencing with Section 70.00) 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirn under penalty of perjury one of the following declarations:
_ 1 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.
1 have and will maintai workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ s work compensation ins nce camera
_ I certify that, in the performance of -the work for whi permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
' compensation laws of California, �ndagree that,I sh uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
` forthwith comply with those provisions.
ate n1
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.
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.).
Lenders Name
Lenders Address
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 I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize rep entatives of this county to rifer upon t e e mentioned property for inspection purposes.
�te S .b�65' Signature (Applicant or Agent):
,----------------------------------------------------------------------------
'Application Number . . . . . 05-00001745
----------------------------------------------------------------------------
Permit . . . . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date
BLDG POOL PERMIT
11/05/05
Plan Check Fee . . 117.00
Valuation . . . . 17000
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
----------------------------------------------------------------------------
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
11/05/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.00.00
-----------------------------------------------------------------------------
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
11/05/05
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
11/05/05
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. ALARMS/BARRIERS
SHALL BE IN
PLACE AT PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
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
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
1.a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # .` G►
l�
Project Address: ` �'
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: -
C L FO l pool—s.
City, ST, Zip:
Telephone: ...........
Address: C) Box 2,4go
Project Description: r S
City, ST, Zip: 6CA d [
ooL 5 A
Telephone:
State Lie. # : City Lic. #;
Arch., Engr., Designer:
QG /
Address:
City, ST, Zip:
Telephone: ;: x::::;;:;:<i:•i.::::?::::<::::::<.: .::::
<:::r:::: s
State Lic. #:
Construction Type: Occupan
YP cy:
Project type (circle one): Ne Add'n Alter Repair Demo
Name of Contact Person: b.4AJ
Sq. FL:
# Stories:
# Units:.
Telephone # bf Contact Person:.2-7 4 y -7r-oL
Estimated Value of Project:- QQ
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
S �,
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
AN HOUSE:-
'`" Review, ready for corrections issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees