08-1686 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-itit 4 4Cl"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Appllc8tion Number-: 7727,0q1"6 86 i; Owner:
"Propert Aiidr s': 57431`PASEODE LA PAZ LA QUINTA .57 ESTATE
APN: 764-010-008-15 -31910 - 78401 HWY 111 STE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 9 53
Property Zoning: LOW DENSITY RESIDENTIAL `\
Application valuation: 26000 C/
Contractor: �?
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS,
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612 .
/► Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
^\ o%e
Date: 10/08/08
-----------------------------------------------------------
.4
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of°perjury that I a license .nder 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 an -Proles i als 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:4'C53' ."License No.: 614611. '
for by Section 3700 of the Labor Code, for the performance of the.work for* which this permit is
issued.
-Date: .. �;.ii• „-Fico ntractor::_" t
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: -
hereby affirm under penalty of per ry at°I am exempt from the Contractor's State License Law for the
Carrier DELOS . INS CO Policy Number .. 01DKRM12001870
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.f which this permit is issued, [-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 beco a su a 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 ubje . �t the workers' compensation provisionsof. Section
License Law (Chapter 9. (commencing with Section 7600) of Division.3 of the Business and Professions Code) or
3700 of the,Labor,Code, I shall rth h comply with those provisions.
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 hundreii dollars ($500).:
_ '
Oate� i .' t Applicant:,
1 _ 1 I, as owner of:the property; or my, employees with wages as their sole compensation, will do the work, and
'—
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE "W S' COMPENSATION COVERAGE IS UNLAWFUL, AND -SHALL
- Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN DRED.THOUSAND
and woo does the work himself or'fierself.through his or:her own employees, p ov ded that the
DOLLARS ($,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 orimprovement 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.).:
Application Number . . . . . 08-00001686
Permit
. . .
BLDG POOL PERMIT
Additional
desc . .
Permit Fee
. . . .
258.50 Plan Check Fee
168.03
Issue Date
. . . .
Valuation . . .
. 25760
Expiration
Date . .
4/06/09
Qty
Unit Charge
Per
Extension
BASE FEE
252.00
1.00
----------------------------------------------------------------------------
6.5000
THOU BLDG 25,001-50,000
6.50
Permit
. . .
MECH POOL
Additional
desc .
Permit Fee
. . . .
26.00 Plan Check Fee
6.50
Issue Date
. . . .
Valuation . . .
0
Expiration
Date
4/06/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00
-----------------------------------------------------------=----------------
11.0000
kA 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 . .
4/06/09
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
4/06/09
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
LQPERMIT
Application Number . . . . . 08-00001686
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 15.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 240
Expiration Date . . 4/06/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS SHALL
BE IN
PLACE AT PRE -PLASTER INSPECTION.
15
L.F.X 4' HIGH CITY STANDARD WALL.
Fee summary Charged
-------------------------------------
Paid
Credited
----------
Due
Permit Fee Total 377.50
.00
----------
.00
377.50
Plan Check Total 194.03
.00
.00
194.03
Grand Total 571.53
.00
.00
571.53
LQPERMIT
Bin #
City Of' La Quints
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
U Quirita, CA 92253 - (740) 771 -7012-
77-7012•Perm!t Application and -Tracking Sheet
-Perm! t
Permit # I
Q� (�
Project Addres
_ Is
"�
o .C.�G
Owner's Name: Q /SAr0.11
A. P. Number:
Address: -.7-667 Qsro
Legal Description:.City,
Contractor:
S .
ST, Zip:L S
Telephone: I
Address: 6
U 4 � . '
Project Description:... ') CA ��
ST, Zip:. YXrJ`O
WadCity,
251471
Telephone: V14z
��6rF2
State Lic. # : C S3
Arch., Engr., Designer:
f Q
City• Lic. #:.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: f'�
Constrgction Type: Occupancy:
Project type (cirele one): New Add'n 'Alter Repair Demo
Sq. Ft.:#Stories:
# Units:
Telephone # of ContactPerson:_
Z
G"G
Estimated. Value. of Project: 201006
APPLICANT:
DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd •
Rec'd
TRACKING'. .
PERbM FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Floodplain plan,
Plans resubmitted
Mechanical
Grading.plan'
rd Review, ready for corrections/issue
Electrical
Subcontactor List
Called"Contact Person
Plumbing
GranfDeed
Plans.picked up.
S -KI.
H A.A. Approval
Platis resubmitted
Grading.
IN ROUSE:-
7rd 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