06-4144 (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:
06-00004144
49035 SERENATA CT
646-300-019- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
29000
Tilit 4 4 Q"
Architect or Engineer:
a/A
------------------
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.
Liyense Class: C53 I
Lic o.: 856835
/Date: ontracwr: �--
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)..-
1,
$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 (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.). .
(_) I am exempt under Sec. , B.&P.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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
ROBYN ANDREWS
49035 SERENATA COURT
LA QUINTA, CA 92253
Contractor:
VACATION POOLS INC
83900 AVE 45 STE C
INDIO, CA 92201
(760)775-0468
Lic. No.: 856835
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/06
----------7------------------------------------
WORKER'S 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 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 PolicyNumb'er' 1795938-2006
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
37 0 of the Labor Code, I shall f rthwithmr*y with those provisions.
Date:pplicant:
WARNIN : 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 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.
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 hereby authorize representatives
of this count to ter upon the above-mentioned y for inspectio ur ses:
te:gnature (Applicant or Agentwo
Application Number . . . 06-0.0004144
Permit BLDG POOL PERMIT
Additional desc .
- Permit'Fee 278.00 °, PTan Check
Fee..
180.70
Issue Date Valuation
29000
Expiration Date 5/29/07 -
Qty, Unit Charge Per
Extension
BASE FEE
252.00
4.00 6.5000.THOU BLDG 25,001-50,000
26.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . 26.00 Plan Check.Fee
6.50
Issue Date- Val-uation
0
Expiration Date 5/29/07
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 5/29/07
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 33.00Plan Check
Fee..
8:25
Issue.Date Valuation
0
Expiration Date 5/29/07
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
LQPERMIT
-
Bin # City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit# La Quinta, CA 92253 - (760) 777-7012
l XQX Building Permit. Application and Tracking
Project Address:
Submittal
Owner's Name: (,tis
Reed
A. P. Number: 6 q (b --
— -
Address: 3 S
Plea Sets
Legal Description:
Contractor:Toqc
Address: g� j -7(,9jlp
City, ST, Zip:
(�*
s�
City, ST, Zip:
Telephone: -
Project Description:
S
-22A
Telephone 76D) 7 7S - 046
8
City Lic. #:
Structural Calcs.
Reviewed, ready for corrections
State Lic. # : 856 53.E
Arch., Engr., Designer:
Truss Calce.
Address:
Called Contact Person
City, ST, Zip:
Energy Cates.
Telephone:
Plans Nicked up
Construction Type: ".I;k S
pancy:
State Lic. #:
Name of Contact Person: IM `
Flood plain plan
Project type (circle one) a Add'n Alter epair Demo
Sq. Ft.: 3
# Stories:
# its:
Telephone # of Contact Person:
- i9 io
Estimated Value of Project:
090
�- eppt MANT: DO NOT WRITE BELOW THIS LINE _
#
Submittal
Req'd
Reed
TRACKIIVG
PERMIT EES
Plea Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calce.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans Nicked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subeontactor 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 corrections/issne
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
2'd 2TTLLLL6:0l 69t?0SLL09LT ONI S -100d N0IiU3U0:W0dJ
1
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