06-2073 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002073
Property Address:
53760 VIA BELLAGIO
APN:
772-510-059- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
25000
Applicant: Architect or Engineer:
nom,,AIA/
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
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 Clash; C53 Li Anse N 614611
D� � 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).:
(_ 1 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.).
(_) 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 contractorls) 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 thispermit is issued (Sec. 3097, Civ. C.). -
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
GIOIA
53-760 VIA BELLAGIO
LA QUINTA,'CA 92253
Contractor:
MCINTYRE POOLS & SPAS, INC
83695 AVENUE 45
NDIO, CA 92201
(760)342-3612
Lic. No.: 614611
VOICE (760).777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/18/06
P !n
.111N im 1006 -
My
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 workerscompensation, 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 HRH INS Policy Number 020060333601
_ 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,
and agree that, if I should became subject to the work 'compensation provisions of Section
9%/ 337700 of the Labor Code, I shall forth ith c y �i hose provisions.
Dat�� Applicant: Z�
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 1$100,0001. 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-permitsubject 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, aj�d hereby authorize representatives
of this count t enter upon the above-mentioned property for inspection C
Da>�� Signature (Applicant or Agent):
Application Number . . . 06-00002073
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
252.00 Plan Check
Fee
163__80
Issue Date' . . . .
Valuation
25000
Expiration Date
11/14/06
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
11/141-'-06
_
s 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
11/14/06
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
11/14/06
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 & WATERFEATURE.
LQPERNIIT
Application Number . . . . . 06-00002073
Special Notes and Comments
ALARMS/BARRIERS SHALL BE tN PLACE PRIOR
TO PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED.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
LQPERMIT
woof n
Permit #
4
X Project Address:
A. P. Number..
x
Contractor:
%( Address: n v
X City, ST, Zip: —.F7fV �
Telephone;
A State Lic. #
Arch.. Engr.. Designer:
Address:
City. ST. Zip:
Telephone:
State Lie. #:
X Name of Contact Person:
X Telephone # of Contact Person:
p Submittal
Plan Sets
Structural Calcs.
Truss Cales.
Energy Calc,
Flood plain plan
Grading plan
Subeontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:.
Planning Approval
Pub. Wks. Appr
School Fees
City of La.uin
Q to
Building K Safety Division
P-0. Box 1 SO4, 78.495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
LLPsvz; 1'6 Owner's Name: i C5 \ P. VO �
S
City Lie. #:
Cit}. ST. Zip:
Telephone:
Project Description:
1 _ r
Total Permit Fees
ConMction Type:
Occupancy:
Project" (circle one): New Add'n Alter Repair Demo
-�.-�
L
#Stories:
# Units:
_.
stimated Value of Proiect:
AreLi%-ANT: DO NOT WRITE BELOW
THIS LINE
Reed
TRACKING
mom
Plan Check submitted
PERMIT FEES
Reviewed. ready for corrections
Item
Amount
Called Contact Person
Plan Check Depos(t
Plans Picked up
Plan Check Balance
Plans resubmitted
Construction
Review, ready for eorrectionsAssue
Mechanical2"
Called Contact Person
Electrical
Plans picked up
Plumbing
Plans resubmitted
SAM.
Review. ready for eorreetionsAssue
Grading
5CAlltd
Contact Person
Developer impact Fee
te of
A.I.P.P.
permit issue
Total Permit Fees