07-0141 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00000141
Property -Address: -52290 SILVER STAR TR
APN: 767-200-999-60 -312021-
Application description: • POOL - RESIDENTIAL
Property Zoning:— LOW DENSITY RESIDENTIAL
Application valuation: 20000
Applicant:
�n
0l/u
Architect or Engineer:
WA
4 VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/17/07
Owner:
ELLISON RESIDENCE
52-290 SILVER STAR
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS &
83695 AVENUE 45
INDIO, CA 92201
(760) 342.-3612
Lic. No.:'614611
SP
-------------------------------------------------------------------------------------------------
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 7,000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Licen lass: 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 Contractor: 1 _ 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
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 1, 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:
LQPER. IIT
insurance carrier and policy number are:
,Carrier MAJESTIC INS CO Policy Number 020060333602
_ I 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,
�1and agree that, if I should become subject to the workers' compensation provisions of Section
Dat
l L OAppi caLib r , I shall forthwith comply with the pros.'
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 bu ding construction, and hereby authorize representatives
of this u ty to enter upon the above-mentioned pe inspecuo puR rposeZ2.
Date: Signature (Applicant or Agent)' ' "- /�//�j//��1�
Application Number 07-000.00141
Permit BLDG POOL PERMIT
Additional desc
.
Permit Fee 207.00 Plan Check
Fee
134.55
-Issue Date . . . . Valuation
. . .
. 20000
Expiration Date 7/16/07
Qty Unit Charge Per
Extension.
BASE FEE'
45.00
•18.00 9.0000 THOU BLDG 2,001-25,000
162.00
Permit . . . MECH'POOL
Additional desc
Permit Fee 26.•00 -Plan Check
Fee
6.50.
Issue.Date . . . . Valuation
.0
" Expiraton'Date 7/16/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.00
Permit ... . . . ELEC POOL PERMIT -R29
Additional desc
"
Permit Fee . . . . 45.00 Plan Check
Fee
11.25
Issue Date Valuation
0
Expiration Date 7/16/07
�..
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.•00 Plan Check
Fee
8:25
Issue Date . ." . . Valuation
0
Expiration Date 7/16/07-
/16/07Qty-
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 3.0.000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
Special Notes and Comments -
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
LQPERMIT - - - -
\ Application Number . . . . 07-00000141
----------------------------------------------------------
Special Notes and Comments.
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged
Paid
Credited
Due
--------------------
Permit Fee Total 311.00
.00
--------------------
00
311.00
Plan Check Total .160.55
.00
00
-160:55;
Grand Total 471:55
.00_
.00
471.55
�• LQPERMIT _:.
-
• , , .
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: _
wner's Name: G
A. P. Number:S i lV
Address:
Legal Description:
Contractor: a 9 `
City, ST, Zip: L�
Telephone:
Address: �,— (�
Project Description:
City, ST, Zip:I 2
c
Telephone:
TeleP
State Lic. #:
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
.;• ........ : ,:::•:::;;;:•;.::sN.:..�
`a'°<»:< : `:z>: ::<>,<:<:<<'
Construction Type: Occupancy:
State Lic. #• .
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:QIA
Sq. Ft.:
#Stories: —7—#
Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT 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
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2od Review, ready for corrections/issue
Electrical
Subcontactor 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 corrcctionsrissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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