05-1749 (RPL)�F�Q�rw
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pCSF BUILDING & SAFETY DEPARTMENT
t504
(760);777-7012
ALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number
05-00001749
Date 5/09/05-
/09/05Property
PropertyAddress . . . .
78900 CITRUS
APN:
772-101-006- -
-
Application description
POOL.—RESIDENTIAL
Property Zoning..
LOW DENSITY RESIDENTIAL
Application valuation-.
18000-
8000Owner
Owner
Contractor
--------------------7------------
CAPITAL PACIFIC HOLDINGS
---------------------------------
CALIFORNIA POOLS &
SPAS
4100 MACARTHUR BLV STE.200
WCC: SEABRIGHT
INS
NEWPORT BEACH, CA 92660
WC: BB1050510
01/01/06
CSLB: 65.6128
10/31/06
CCC: C8 C27 C29
C53
P.O. Box 1504�� VOICE (760) 777-7012
78-495 CALLS TAMPICO Taf 4 4 FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: a S '% 0 Date: �— P - c%
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
C'olvT2,�a- c, me
Architect or Engineer's Address:
Lic. No.:
/V^
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed u r provisions,of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
ode, and my Licens i in a and effect.
License Class tens No. [J7(9/ u
Date / Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' 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 Contractors' 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).):
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
Owner
WORKERS' 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 whjyli this permit is issued.
XAlav4ed will main n workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ wo rs' compensation insurance tarn
�(�%(✓
_ I certify that, in the performance of the work for i 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 t I. I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pr ions.
v` 65^ Applican A.
WARNING: FAILURE TO SECURE WORK S' COM SAT OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THO SAND 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.).
Lender's Name 944
4
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 grees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission can thew being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void 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 lag a to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this countyAnter upgn t e ab ve entioned property for inspection purposes.
Date J ZQ S Signature (Applicant or Agent): _4
----------------------------------------------------------------------------
Application Number . . . . . 05-00001749
----------------------------------------------------------------------------
Permit . . . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
BLDG POOL PERMIT
F� 3sl[iI�7
11/05/05
Plan Check Fee . . 122.85
Valuation . . . . 18000
Qty Unit Charge
Per
Extension
BASE FEE
45.00
16.00 9.0000
-7--------------------------------------------------------------------------
THOU BLDG 2,001-25,000
144.00
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 11.0000
----------------------------------------------------------------------------
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
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 PRIOR TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT
INCLUDED IN
PERMIT.
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
--------------------
293.00 .00
----------
.00
293.00
Plan Check Total
148.85 .00
.00
148.85 .
Grand Total
441.85 .00
.00
441.85
Permit #
L
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit. Application and Tracking S�ee
Project Address:
Owner's Name: 6-2-A-1 -5
A� P. Number:
Address:
Legal Description:
City, ST, Zip:
Telephone: VON,
Contractor: C6LL-1*E2M1q POOLS &spas
Address: 08m av,) Project Description:
City, ST, Zip :6606A e-1 [a
9.7-930 DooL d-,5 PA -
Telephone:
State Lie.#
Arch., Brign, Deskper:
City Lie. 091 =14
4
Address:
City, ST, Zip:
. .. . .......
Telephone:
State Li
Name of Contact Person:
Construction Type: occupancy*
M
X.- X
Project type (circle one):(SP Add'n Alter R*ir Demo
Sq. Ft.: Mories: # Units:
Telephone # of Contact Person%27;
S-'71jjV;L&75,-o;Lq Estimated Value of Project:. 10000
APPLICANT: DO NOT WRITE BELOW THIS LINE
# 'Submittal Req'd
Rec1d
TRACKENG PERMIT FEES
Plan'Sets
Plan Check submitted
b 05 item Amount
Structural CnIcs.
Reviewed, ready for corrections
Plan.Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L.
H.O.A. Approval
Plans resubmitted
Grading
PN HOUSE:-
Review, ready for correctionslissue'
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees'