06-1068 (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:
06-00001066
79567 CORTEZ LN
649-051-011-11 -2667
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAI
25000
Architect or
'Oh,/#,/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
Thereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3•of the Businessand Professionals Code; and my License is in full force and effect.
License C ass: License No .
date: Contractor
/ O I DECLARATION
I hereby affirm under penalty of perjury that,l em exempt from the Contractor's State License Law for
following reason (Sec. 7031.5, Business end Professions Code: Any city or county that requires:a permit to
construct, atter,.improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permitto'file a signedstatement that he or she is lioensed'pursuam to the.. provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Susiness and Professions Code) or
that he orshe 'is exempt therefrom and the basis for the:alleged exemption. Any violation of Section 7031.5 by*
any.applicant-fora permit subjects theapplicant to a civil penahy of not more than five hundred dollars ($500).:
(_) 1, 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 ttwl purpose of sale.).
(_) 1, as owner of the property,am exclusively contracting with licensed contractorsto'constructtheproject (Sec.
7044, Business and Professions Code: The Contractors' State License Lew doss,notepply 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 Lew.).
(_ 1 I am exempt under Sec. , B.BPZ. for this reason _
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a constriction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ: C.).
Lender's Name: _
Lender's Address:
LQPERIIIIT
Owner:
EPIC ENTERPRISES
P.O. BOX 12052
PALM DESERT, CA 92255
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS' (760) 777-7153
Date: 3/15/06'
WORKER'S COMPENSATION DECLARATION
1 hereby. affirm under penalty of'perjury one of the.foilowing.declarations:
_ 1 have and will maintain a certificate of consent to self-insure;for workers' compensation, as provided
for by Section 3.700 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
Code, for the performance, of the work for which.this permit is issued. My workers' compensation
insurance carrier and policy number -ars:
Carrier. Policy. Number
1 certify that, i'n.the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation. laws of Callforniai
and agree that, if I should ome.subjectto the orkers' compensation provisions of Section
0 of•the Labor Code s fo ith omp v $h those provisions.
DC AppliEam:.
WARNING: FAILURE TO SECURE WORKERS' COMPENVION ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE;HUNDRED THOUSAND
DOLLARS (11100,000). 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 fora 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 Quints; 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 permitissued as -a result of this application becomes null and void if work is not commenced
within IS0'deys 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 applicatiomand state that the above information is:correct. I agree to comply with all
city and county ordinances and state laws relating to buil 'ng construction, and hereby authorize representatives
ofth/is county to nter upon the above-mentioned o or inspection p poses:
,BSte: ignature (Applicant an
Application Number . . . . . 06-00001068
Permit . . . BLDG POOL_ PERMIT
Additional desc .
Permit Fee . . . . 252.00 Plan Check Fee 163.80
Issue Date . . . . Valuation . . . . 25000
Expiration Date . . 9/11/06
Qty Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG�2,001-25,000 207.00
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation 0
Expiration Date . . 9/11„06
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >106K 11.00
---------------------------------------------------------------------------------
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit. Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date . . Valuation . . . . 0
Expiration Date 9/11/06
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 . . 9/11/06
Qty Unit Charge PerExtension
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
- -----------------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
Application Number. . . . . . 06-00001068
------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE-PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLULDED IN PERMIT.
Fee summary Charged Paid. Credited Due
----------- ----------------------------
Permit Fee Total 356.00 .00. .00 356.00
Plan Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 .00 545.80
LQPERMrr
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible parry of record on such a
permit. Building permits, are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit. and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State -and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carryout these obligations, and these risks are especially serious -with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific.information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through, their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Budder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF'BUILDING AND SAFETY
78-495 Calle. Tampico
La Quinta, CA.92253
(760) 777-7012
FAX: CAOV177-7011
I/
2 o`l 0lN21- r�,--z- Lhi
P k OPERTY ADDRESS
ff. , no)o I
PERMIT -NUMBERS)
CITY OF LA QUINTA 'SUB -CONTRACTOR .LIST
JOB ADDRESS riiN 'PERMIT NUMBER 406 -106 OWNER SIG �'l1S-? ��UILDER all)UbW-16D`L)`�
This form shall be posted on the. job with the Building Inspection Card at all times in o 'coonsnicuous place. .Only persons appearing on this list or their employees are 'authorized to work
on this job. Any changes to this list '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
of building permit. For each applicable trade, ail information- requested below_ must be completed by applicant. 'On File" is not an acceptable response.
Trade /.a±lassifica;ion.`
Contractor ; =:
'.� :>.;..
, :,.$tatW(
ontractor . Lic�e0ses:Com
tle�x
License.:
Company Name '
Classification
License Number
Ezp. Date
Carrier Name
Policy Number:
Exp. pate .
License Number'
Exp. Date
(e.g. A. B, C-8)
(xxxxxx)
(xx/xx/xx)
(e.g. State Fund, CalComp)
(Format varies)
(xx/xx/xx)
lxxzx)
(xx/xx/xx)
EARTHWORK (C -12j :. ;.
Du
J/V C ,
CONCRETE, (C78)
FRAMING :(C
`
-S4Rt1CT: STEEL IC-lia1
MASONRY IC•29)
PLUMBING "(C-36)
I'v V
�-
1: ::. PLASTER JG -35)
(,t
/V C
DRYWALL (C-9).. -:
EL4CTRICAL. (C-10)' .,',.' .
/JC-
::,-:<:-
RQQFING IC:=391;::::,;:::;
SHEET METAL.(4=4$1. `
FLOORING 19:15i:
GLAZING (6474 .:::...:::: .:...:
•
'INSULATION '.IC -2j
9EWAGE.DISP-(C-42), '<
PAINTING (C=33)
:
CERAMIC TILES (C-54)
CABINETS (C-6).
FENCING (C713) `
(0-27)
�JLANDSCAPING
POOL (C-53)
)/VC'_
,
Bi" #City
of La Quinta
Building a ,Safety Division
P.O. Box 1504, 78-495 Calle-Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
06- Ao SOB
Project: Address: —7 q5�"7 0
Owner's Name:
A. P. Number:
Address: Q goA;;Lo 9 O�
Legal Description:
Contractor: 601
City, ST, Zip: P9 GlAf- e �a
Telephoner/
Address:
Project. Description:
City, ST, Zip:
Pj
Telephone:
State Lic. # : City Lic. #.
Arch.; Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic: #:
Name of Contact. Person: tin-
Construction Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:..
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Rec'd
TRACIONG .
PERMIT FEES
A#
!/
Plan Sets
Plan Check submitted
y
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
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correcdon&4ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
ILU:A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, readyYor correcdonslissue.
Developer Impact Fee
Planning Approval,
Called Contact Person.
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees