07-1517 (RPL)44 P.O. BOX 1504 VOICE (760) 777-7012 ,
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date:. 5/23/07
Application Number: _07-00001517 7 Owner: "
Property Address: 53220. AVENIDA NAVARRO KHAIR JOSEPH
APN: 774-065-010-14 -000000- P O BOX 529
Application description: POOL - RESIDENTIAL NORTH HOLLYWOOD, CA 03 d
Property Zoning: COVE RESIDENTIAL '------------------- - --'--- -
Application valuation: 18000
Contractor: MAY 2 51007
Applicant: Architect or Engineer:. Owner City OF
LA
F!!19 QUINt_ A
n pr
---------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
,. Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor: _ 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
' OWNER -BUILDER DECLARATION. insurance carrier and policy number are: ,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier Policy Number
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for -which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit.to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subjec rkers' compensation provisions of Section '
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 37,00 of the Labor Code, I shall f 0#r0QJh comply ith th se.provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byy _
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - ate: � Z / Q pplicant:
(_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
' 1V 1 1, 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
nrnnerttr mlhn hnildr nr imprn„nq thv!ovn, and .'rhe eantrasta for trd y—jcutu v,lih,u WiwautuiN IILeuseu
pursuant to -the Contractors' State License Law.).
1 _ 1 I am exempt under Sec. B.&P.C. for this
Date:• caner: .
• NSTRUCTION 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
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.
I. LOCH p050n 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. /,...�
certify that I have read this application and state that the above infor is correct yl•agree to comply with all
city and co my o dinances and state laws relating. to building ruction eby authorize representatives
of thi o my to nter upon the above-mentioned propert ins rpo
iY o
Date: S' ture (Applicant or Age
"Application Number 07-00001517
Permit . . BLDG POOL PERMIT
- Additional desc .
Permit Fee 189.00 Plan Check
Fee
122.85.-
Issue.Date Valuation
. . .
. 18000
Expiration Date 11/19/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
16.00 9.0000 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 11/19/07•
Qty', Unit Charge Per
Extension
BASE FEE
15.00 .
1.0,0 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 11/19/02
Qty Unit,Charge Per
Extension
BASE FEE.
15.00
1.00 •36.0000 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 11/19/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 6.000Q FA PTR FTXTTT_R,E
12.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00 j
1.00 ,' 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
--------------------
Special Notes and.Comments
--------
------------- _
POOL/SPA•.'ALARMS/BARRIERS SHALL BE IN
C
' LQPERMIT
Application,Number . . . 07-00001517
Special'Notes and Comments-
PLACE
ommentsPLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------- ---------- ---------- ----------
Permit
------ -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
Na I
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40
Pn m
SITE PLAN
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
I
SELF
CLOSING
GATE
R1' 6 WATER
RETURI
TMP' PJ
m
m
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Z
SCALE: 1/8"=`I' -O"
i
LIGHT
SWITCH I
18" RAISED J,
BOND BEAM
SEAT ` ;� •a a • • ` F HEATER
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DRIVEWAY ' 'a o FlL R
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X-0" SELF e i a .. < of a
SKJIM ER CLOSING 4 •a 'i •. O
$ METAL;; -_j a
GAT a PLANTINGS TO SCREEN
rt)�-- ,• = ." - =�• - PROPANE TANK
16"x16" 16"x16" - _ •• .: - a i
—5'-0" BROWN COLUMN COLUMN,
BLOCK WALL 4 '
<a .
Bin_
...City-of La Quinta
. Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012 `
Buildin Permit '
g t Appllcatlon and Tracking Sheet -
Permit #
\La
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Project Address:',5732-2-0 401—�4"fv-if..0
Owner's Name:. K wZ
A. P. Number:
Address:�p
Legal Description:.
Contractor: 0W,,L,Q_4—
City, ST, Zi3
Telephone: g% $ -.3 8 3S_9
Address: f o _ 2j 2_
Project Description: Qpp C �'.
/.
City, ST, Zip: NO t/� aO 6_& 14603
Telephone: / Q 3 / J1
City Lic. #:..
1
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: qq�
IfY
State Lic: #:- « , ,, ��;
' "
'Name of Contact Person:
ConstructionType: Occupancy:
Project type (circle one): New Add'z, Alter Repair Demo
Sq. Ft :. #Stories: #Units:
Telephone # of Contact Person: _ 7 .
Estimated Value of Project:.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING -
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan CheckDeposit
Truss Calcs.
Called Contact Person
Plan CheckBalance
Energy Calcs.
Plags picked up
Con structian
Flood plain plan,
Plans resubmitted
Mechanical
Grading; plan ,
2"' Review, ready for correctionsrissue
Electrical
Subcontactor"List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for eorrectionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person .
A.LP.P:
Pub. Wks. Appr
Date of permit issue .
School Fees
Total Perm a Fees
M
UP
Pr
E
14V
V
.� CITY.OFLAQ.UINTA .SUB-CONTEQCTOR I ICT
_
-y--
ERMIT �^ rJOB ADDRESS :-
This posted __ OWNER��JILDERo,eo o h the Buil rispectiondim.1 Card -at o ' s a_
on
appearing on this list or their employees are authorized to work
of thi sor
ob: nAnny'* changeQs to this ^ fist must-
-be approved by, the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
inn
Trad / as Jca ion
:EARTHWORK 1Cr12j
CONCRETE (t;-81'` '
FRAMING'(C-5)
$TRUGT:_STEEL (G-5])
MASONRY -IC -29)
PLUMBINQ (C-36)
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nt actor. ::
Company Name
_I --.W UPIUVV 111UQ1L y appilicant. -Un File' is not an -acceptableresponse.
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$tate. CenVaete S LI
►' cense ' Workeis Cemeensatlendne,. 9
Classification License Number=Date Carrier Name Policy NumberExp. Date
(e.g. A,.B, C-8) (xxxxxx) ' le.g. State Fund, CalComp) ' (Format Varies) (xx/xx/xx)
y/ /D .! 0
LY3 g� '• .09/
CILV Business License
License Number Exp. Date
Ixxxxl (xk/xx/xx)
tATH;;PLATER (C,351IC
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DRYWALL (C-9) . >..:
ELECT:RICAL,(C of :...
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R990ING'.IG=39)`„
SHEET METAL
FLOORINGI,C:15);
GLAZING.LP-07K
(C-2) .
SEWAGE DISK; (G-421` . <
.IN
PAINTING (C=33) '
CERAMIC TILE (C-54)
CABINETS (C-6)
'
FENCING (C-13).77
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LANDSCAPING (C=27) 'K'P
POOL (C-53) 4 ayllri000a116-o
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