09-1090 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
09-00001090
52285 SILVER STAR TR
APN:
767-630-015- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
18800
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner: .
ANDY HALL
52285 SILVER STA
LA QUINTA, CA 92
(760)777-9920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
\� �\ Date: 10/13/09
7
y — p I P
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10
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.). _
(_) 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.).
(_ 1 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: VIC
LQPERMIT
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 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 county to enter upon a above-mentioned property for inspectigAA irposes.
gnature (Applicant or Agent):
Contractor:
Applicant: Architect or Engineer:
MCRAE POOL & SPAS
79105 DESERT STREAM DR
LA QUINTA, CA 92253
(760)772-2440
PC
Lic. Noo..:: 82 823017
-----------------------------------------------------------------
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: C53 -C27 .License No.: 823017
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
r i
ate: 0` 1.110 1ontractor: aft
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
OWNER-BUILDE 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 F&CEMPT . Policy Number EXEMPT
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 subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code,'I shall forthwith com I with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
V d 9
an a licant for a ermit sub'ects the a plicant to a civil penalty of not more than five hundred dollars ($500) •
of*a ( ! I ( cr'n
y — p I P
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10
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.). _
(_) 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.).
(_ 1 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: VIC
LQPERMIT
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 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 county to enter upon a above-mentioned property for inspectigAA irposes.
gnature (Applicant or Agent):
Application Number
09-00001090
Permit . . .
BLDG POOL PERMIT
-Additional desc .
Permit Fee . . . .
198.00 Plan Check Fee
128.70
Issue Date . . . .
Valuation . . .
. 18800
Expiration Date
4/11/10
Qty Unit Charge.
Per
Extension
BASE FEE
45.00
17.00 9.0000
--------------------------
THOU BLDG 2,001-25,000
------------------------------------
153.00
--------------
Permit . . . MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date
Valuation
0
Expiration Date..
4/11/10
Qty Unit.Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
EAMECH FURNACE >100K-----------------------------------------------------------------------------
11.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
4.5.00 Plan Check Fee
Issue Date . . . .
Valuation
0
Expiration Date
4/11/10
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,.
4/11/10
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.
i.00 3.0000
----------------------------------------------------------------------------
EA PLB-dAS PIPE 1-4 OUTLETS
3.00.
Permit . . . . . .
WALL/FENCE PERMIT.
LQPERMIT
Application Number 09-00001090
Permit ' WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00
Plan Check Fee
.00
Issue Date . . . .
-Valuation'
160
Expiration Date 4/11/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
POOL/SPA, 10 L.F. 4' EQUIPMENT
ENCLOSURE, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. 2007 CODES.
----------------------------------.-------------------------------------
Other Fees . . . . . ... BLDG STDS ADMIN (S81473)
-----
1.00
Fee summary Charged Paid
Credited
Due
Permit Fee Total 317.00
.00 00-
317.00
Plan Check Total 154.70
.00 .00
154..70
Other Fee Total. 1.00
.00 .00
1.00
Grand Total 472.70
.00 .00
472.70
s
Bin # '
City of -La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1�
0
Project Address:
Owner's Name: H l
J -
A. P. Number.
Address: S z - 8-s- S ,
Legal Description:
Contractor: C ,i2.9 IS SQ ATelephone:
City, ST, Zip: LA ttAC4 �-
Address:
City, ST, Zip: (- 2_�_
Project Description: S Dad/ I
/
Telephone: l� 0
State Lic. # :
CityLic. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
rawl
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New -Add'n Alter Repair Demo
Name of Contact Person: C C
Sq. FL:
# Stories:
#Units:
Telephone # of Contact Perso �GQ 3
Estimated Value of Project: a ^
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG .
PERMIT FEES
Plan Sets
Plan Cheek submitted
ftem
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for correctionslissuc
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted.
Grading
IN HOUSE:-
3" Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CITY- OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESST2 Sj 52L -D PERMIT NUMBER OWNER�fA BUILDER C24 rte DI'
this form shall be posted on the job with the Building Inspection -Card at all times in a conspicuous place. Only persons appearing on this list or their employees are66thorized to worl
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, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade ification >;;:: '':..... i .Bits a License:`:;
Tra Class Contractor S a ontract ::;.:.>:;
t t4 C or's. Licel�se.:.:.Wprkets.Corq ty, n .5s
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date
(e.g. A, 8, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx)
EARTHWORK (C-12) g _3 _ S
CONCRETE (C-8)->
FRAMING '{C-5) '
STRUCT::STEEL-t ..1)
l= i1� �i�
-
3 1-01,9
-0
33
=2LID
MASONRY (C-29)
PLUMBING 1C-361
/ I l
(/
/ /
/ /
/ %
LATH; FLA sTF.R JP= )
S
_10-31-10
YAL=
DRYWALL IC -9)...'.. :
HVAC. (C-20) .: `°.,•.`:.:.
ELECTRICAL (C 0Y :.:.:
%1I I
- -
C
3
/,,
D-�/'(J
R060ING-.I6.39)"':'.:>
SHEET -METAL
IC -17)`. `
INSULATION:1C72) : : .
IGLAZING
SEWAGE DISP• I6-42)
PAINTING (C=33)
CERAMIC TILE (C-54)
CASINETS (C-6)
FENCING (C-13)
LANDSCAPING
1760nml�420ql
POOL (C-53)
n
UAC 01\/ I)m L
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p.
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