06-1094 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: .,06-00001094
Property Address: 80844 SPANISH BAY
APN: 775-310-011- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 is in full force and effect.
License Class: /C5�3 License No.: 786324
ate: (JlJ Contractor
OWNER -BUILDER DECLARATION
I hereby' affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).:
(_) 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 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.).
1 _) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.).
1 _) I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
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 ISec. 3097, Civ. C.). -
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
BROWN ROBERT J
80-844 SPANISH BAY
LA QUINTA, CA 92253
Contractor:
ALPINE POOL'S & SPA'
41995 BOARDWALK ST,
PAT•M DESERT, CA 9221
(760)346-2350
Lic. No.: 786324
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS ("760) 7.77-7153
Date: 3/16/06
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WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury one of the following declarations:
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.
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 are:
Carrier STATE FUND Policy Number 000232362006
1 certify that, in 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 California,
. and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith c mply with those provisions.
Applica;
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. ,
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 aresult 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 correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and.Jimeby authorize representatives
of this co/uggty p enter upon the above-mentioned ;rope y for i e on
tD3 e: �190X Signature (Applicant or Agent
LQPERMIT
Application Number .
. . . . 06-00001094
Permit . . .
BLDG POOL PERMIT
Additionaldesc.
Permit Fee
1612.00 Plan Check Fee
105.30
Issue Date
Valuation
15000
Expiration Date
9/12/06
Qty Unit, Charge
Per,
Extension
BASE FEE
45.00
13.00 9.0000
----------------------------------------------------------------------------
THOU BLDG'2,001-25,000
117.00
Permit
MECH POOL
Additional desc .
Permit Fee-
26.00.-. Plan Check Fee
6.50
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
9/12/0
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
9/12/06 .
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
9/12/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00-
5.002.00
2.006.0000
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
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Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
• civ _l • -
Application Number . . . 06-00001094
------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
----------------- -------- 7- ---------- ---------- ----------
Permit Fee Total 266.00" .00 .00 266.00
Plari Check Total 131.30 .00 .00 .131.30
Grand Total 397.30 .00 00 397.30
LQPERMIT-
Bin #
ity of. La Quinta
Building U Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico -
q
La Quinta, CA 92253 -'(760) 777-7012/0
Buildihg Perm'it'Appflcatdon' an&Trzicklfig Sheet
Project Address:- (W 1tq SI)
Owner's Name:'
A. P. Number:
Address: ULt 4 -
Legal Description:
City, ST, Zip:
Contractor:
C_
Telephone:
Address:
WHkK-' sl
Project Description: Abo
City, ST, Zip:
Telephone:
F.
State Lic. #.: CityLic.
Arch., Engr.,'Designer:
Address:
City, ST, Zip:
Telephone: x
Constru . ction Type: Occupancy:
State Lic.
Project type .(circle .one):, New Add'n Alter Repair. Demo
Sq. Ft.:
# stones:
#Pnits:'
Name of Contact Person:
Telephone # of Contact Person:
Estimated Valud of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
-Req'd
Itec.'d
TRACKING
PERMIT FEES
Plan set,
Plan Check submitted
Item
iAmount
Structural Ca'Ics.
Reviewed, ready for'c6rrcctions
Plan Check Deposit
Truss. Calcs.
Called Contact Person
I.Plan Check Balance
Enirgy Calcs..
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan,
2"' Review, ready forcorrectionsfissue,
Electrical
Subcon'tactor List
Called Contact Person
Plumbing
Grant Deed
A
Plans picked tip
>
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE: -;I
3H 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
all NOTE:
1
TWD EXISTING LANDSCAPE TO BE
RELOCATED AND REPLANTEd
-12" IN VARIOUS LOCATIONS
I 5'�P. ILL,WAV � N��t i-L NfCP- WALL DY
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