10-0135 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number: 4��,_1-0,-,00000135
Property Address: 79135- SHADOW TR
APN: 649-030-069-10 =31310
Application description: POOL - RESIDENTIAL'
Property Zoning: HIGH DENSITY RESIDENTIAL
Application valuation: 34000
Applicant: �Architect'or Engineer:
Bio
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
YVETTE TANNER
79135 SHADOW TRAIL
LA QUINTA, CA 92253
(760)771-3345
Contractor)
HAWAIIAN
417 W. F
GLENDO P_"
(800)730
Lic. No.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
g4ILL. BLVD 7 o
49e�r4
95 1
7 ��� nF 4.Az�eli.;y�'k
i�''PT
Date: 2/23/10
----------- ---------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of periuFKoat I am.licensed uaoer 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 Businesls�rofe!;' Is 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' License No.: 752433
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate 32 -�o ractor:
issued.
_ I have and will maintain workers'.compensation insurance, as required by Section 3700 of the Labor
r
Code, for the performance of the work for which this permit is issued. My, workers' compensation
WNER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State License Law for the
Carrier EXEMPT 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 per nce of the work for hich 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 come su ' t 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 s c 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 Co , I shall comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _/Q
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.:
ate• scant:
( ) 1, 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
WARNING:, FAILURE TO SECURE ORKERS'OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENH TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND '
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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:
LQPERA11T
�1
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 issuKeuch permit, or cessation of work for 180 days will subject
permit to cancellatio .I certify that I have read thisapplication ste above information is correct. I agree to comply with all
city and county ordinances and sta laws r lding construction, and hereby authorize representatives
of this my to enter upon t a ve- party for inspection purposes.
ate: _ /&- S" ica or Agent):
Application Number .
. . . . 10-00000135
.Permit . . .
BLDG POOL PERMIT
Additional desc ..
Permit Fee
310.50., Plan Check Fee
201.83
Issue Date
Valuation . . .
. 34000
Expiration Date
8/22/10
Qty Unit Charge
'Per.
Extension
BASE FEE
252.00
9.00 6.5000
----------------------------------------------
THOU BLDG 25,001-50,000
------------------------------
58.50
Permit . . .
MECH POOL
Additional desc
Permit Fee . . .
26.00 Plan Check Fee
6.50
Issue Date
Valuation
0
Expiration Date
8/22/10
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
8/22/10
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
8/22/10
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
1.00 3.0000
--------------------------
EA PLB GAS PIPE 1-4 OUTLETS
--------------------------------------------------
3.00
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
LQPERMIT
Application Number . . . . 10-00000135
-Permit WALL/FENCE PERMIT,
Additional desc .
"
= PermitrFee _ 15::00 _.. Plan Check
Fee
.00
Issue Date. _ Valuation
260
Expiration Date- 8/22/10
Qty Unit Charge Per
Extension
BASE. FEE
15.00
.- Special Notes and Comments
POOL/SPA; 12 L.F. 5EQUIPMENT. ENCLOSURE
& VARIOUS 1811 PLANTERS, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
-- --- --- --- -- -- ----- ---- - .. ._ . -PRE-PLASTER INSPECTION: 2007'CODES.."-*
-------------------_-------.-------------------- ---
"Other.Fees BLDG STDS ADMIN (SB1473)
2.00
Fee summary.-. Charged Paid Credited
Due
Permit Fee Total. 429.50 00
.00
429.50
Plan Check Total 22.7.83 .00
.00
227.83
Other Fee "Total 2-.00 .00
0.0
2.00
Grand Total 659.33 .00
.00
659.33
LQPERMIT
CITY OF LA QUINTA SUB-CONTRACTOR LIST .,
JOB ADDRESS 79Z .5,4) 29ADIPERMIT NUMBER OWNER ���i�� BUILDER,&WZ,2.4nr Svc D�
This form shall be 1osted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to tPis 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. / Class�ficat�on .::....:::.:.....
:. ...C.ontractor:.:.:::::...:.
ontractor:s:L,
State: C .................... cense:....::.:....:.>:: ,.:....
ers.Corri ensation;In mance; ......::.
5... .
C, .:Bus,ness
I,cense
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK fC 1:21
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MASONRY (C-2911
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PLUMBING :(:C 36) ..
_
Csfi�7
LATH, PLASTER: (:Cc35)
DRYWALL.(C=9)
;HVAC IG-20)
ELECTRICAL (C 10
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:ROOFING (C=: 9), %
SHEET'METAL>(CA31::.
FLU:ORING (:C
GLAzIN.G IC`-:1::7),
INSULATION (C 2)
SEWAGE DISP. (C42)
PAINTING I633)
CABINETS :(:C=6)
FENCING:'IC=T31
A.N. D.SCAPING:.(.0=27);:,:;
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r (POOL �,
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9fawa.jgm Spa
417-B W Foothiff Blvd, #107
Gfendara, CA 91741
(800) 730-0935
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CITY OF LA GiIJ I I TA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DAT BY 5.�
su S.
Acro 1 J. cots C -E SM78
P. n edn I
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79 13 5 Su b -t> o� o —1 azo.
3-
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Bin #
City of LaQ uin to
Bwlding 8z Safety WvWm
P.O. Box 1504, 78-495 Calle Tampko
to Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
O 13�
Project Addr= 79i 5—
Owner's Name iI% L
A. P. Number:
Address: % pl Jf�4 tbcJ T2AZG
Legal Description:
City, ST, Zip: - G�GGv: 1�
Contractor//AW/4�� Dog)(-
Telephone. 76 ec
Address:
Project Description:
City. ST, Zip: -7440 L'VAA GA q/ 7 �/� ,t/ zr2S
Telephone:gUU - 7 -3a '01a AM
State Lie. # :75-2-1-133 City Lia #:
Arcb., Engr., Designer �j�L �l .
Address: '9 /V (%/L
City, ST, Zip: 7-0 S iZ
lq
Telepbone: D
State Lie. #:
Name of Contact Person:
Contraction Type: Occupancy:
Projed type (circle one): G)Add'n Alter Repair Demo
Sq. Ft.:#Stories:
#Units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
# submittal Req'd Reed RHOCEIVEID PERMIT FEES
Plan Set
Pian Check submitted [tem Amount
Structural Cala.
Reviewed, ready for eerre,&M 2 3 20 10 Plan Cheek Deposit
Tans Cala.
Called Contact Person Plan Check Rahn".
Title 24 Calcs.
Plans picked up BY: Construction
Flood plain plan
Plass resubmitted Mechanical
Grading plau
2`! Review, ready for corrections/issue Electrical
Subeontaetor List
Called Contact Person Plumbing
Grant Deed
Plana picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
m Review, ready for correctionsfinue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees