07-0190 (RPL)P.O. BOX 1504
'78-495 CALLE TAMPICO
1
'LA QUINTA, CALIFORNIA 92253
Application Number. 07.-00000190
Property Address: 52238 -SHINING STAR LN
APN: 767-200-999-51 -312022-
Application description: POOL RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application. valuation: 30000
Architect or Engineer:
bl�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT '
LIC SED CO ACTOR'S DECLARATION
I hereby affirmN oder penM[tp,(( that I 460U�menEeNo.�:8
hapter 9 (commencing with
Sectin7 OOYOfDivisioMess d cense is in full force and effect.
Licen ass C53`� 383
OWNER -BUILDER DECLARATION
I here y a rm under penaltyFfp..sr�,wy h t am exempt from the Contractor's State license Law for the
following reason (Sec. 7031.nesofessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or r u 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).:
(_)
A, 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CO TRUCTIO LENDING AGENCY
I hereby affirm and enalty peri r t a e is onstr tion lending agency for the performance of the
work for which t per it is is d . 3 `
Lender's Name:
Lender's Address:
LQPERA1IT
Owner:
MORGAN GOUGH
52238 SHINING STAR LANE
LA QUINTA, CA 92253
(760)777-9920
Contractor:
STEWART POOLS & SPAS
P.O. BOX 961
PALM DESERT, CA 92261
(760)217-7777
Lic. No.: 856383
VOICE (760) 777-7012
FAX (760) 777-70.11
INSPECTIONS (760) 777-7153
Date: 1/18/07
�p \
1AIN 1 � 2007
cl
WORKER'S COMPENSATION DECLARATION ---"'X` 5 uGY7;
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 EXEMPT Policy Number EXEMPT
I c=at, in the performance of the work for which this permit is issued, I shall not employ any
person in any mann as to become subject to the workers' compensation laws of California,
and agree that, i s uId co subje o the workers' compensation provisions of Section'
700 of th or ode, I f r c ply with those provisions.
ate:_ 0� ppli n
WARN G: AILURE TO SE E WO RS' OMP S ERAGE IS UNLAWFUL, AND SHALL
SUBJ T A EMPLOYER TO INA ALTIES ND 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 perm' or cessation of work for 180 days will subject
permit to cancellation.. .
I certify that) hav��'�'ead this ap c tion and stag
t ab v or n ' correct. I agree to comply with all
city and coyhty olbinances d s t aws r atdi uc on, hereby authorize representatives
of this qpu 1fAo ,apo th ovg e i oses.
Application Number
07-00000190
Permit . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
284.50 Plan Check Fee
184.93
Issue Date
Valuation
30000
Expiration Date
7/17./07
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
32.50
Permit . .
MECH POOL
Additional desc .
Permit Fee . . . .
•26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
.7/17/07
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
7/17/07
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
7/17/07
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
LQPERAIIT
Application Number 07-00000190
Special Notes and Comments '
PLACE AT PRE-PLASTER.INSPECTION.,
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
------------------ ---------- ---------- ---------- ---------
Permit Fee Total 388.50 .00 .00 388.50
Plan Check Total 210.93 .00 .00 210.93
Grand Total 599.43 .00 .00 599.43
LQPERMIT
Bin #
City a Q� L Qulnta � .
Building u 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:_5Z Z3 �74- Zla
A. P. Number:
Legal Description:
Contractor: �—��/T �._
Address: �7� ��� 6�
Owner's Name:
5 --
Address:.r20,z46 .5 36
City,'ST, Zip:
Telephone:
Project Description:
City, ST, Zip: yf1 7
Telephone: 792
State Lic. #
City Lic. #:
Arch., Engr., Designer:
Address: -(l-
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
P cY:
Project type (circle one): New, Add'n Alter Repair Demo
Name of Contact Person: j
Sq. FL:
#Stories:
#Units:
Telephone # of Contact Person: 7,0 21,7 —;7;7
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd : _
Recd
TRACMG I
Pian Check submitted
r7
PERMIT FEES
Item Amount
Structural Coles.
Reviewed, ready for Y�l,'Erections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans ticked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plin,
Z" 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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
ARCHITECTURAL COMMITTEE CERTIFICATE
(Exhibit "A" to the Architectural
Improvement Application and Agreement)
The Architectural Improvement Application and Agreement was reviewed by the
Architectural Co ittee on and has been:
Approved Conditionally Approved Rejected
Subject to the following
Conditions set forth below.
r
Returned for Further Information
Required Modifications
Comments
Yes No
Recording to be sent by owner to County Recorder's office for roof and/or
exterior wall modifications..
Deposit Required Deposit Amount Required $
/ ' 7
Date ` Architectural Committee
Architectural mmittee Architectural Committee
Architectural Co �mittee Architectural Committee
NOTE: THIS APPROVAL IS VALID FOR 90 DAYS FROM APPROVAL DATE
9
11
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CITY OF LA QUINTA SUB -CONTRACTOR LIST
�,v p .�f2 / OWNER vv�-i BUILDER.�!����� y`�'�•�
JOB ADDRESS Sot a'Z 3 S .S�-/ i �.S'T 4 PERMIT NUMBER f
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 are authorized to work
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
.�L�_��.:.....,.,4 4, ,.1,,.., m..at ha rmmnlatcirl by onnlirant "On File" is riot an acceptable reSDonse.
of building permit.. For
Trade I Classification
each appncaoie uaue, an helot ration
Contractor;Censen;Irisurance
!eyues«u VV %J.. 959.. - .,., ,,.....r.....,.. -7-
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.,rr...,...... _.....- - -- -
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Carrier Name Policy Number' Exp. DateLicense
(e.g.-State Fund, CalComp) (Format Varies)Ixx/xx/xxl
Biisiriess IE
Number
(xxxx)
Company Name
Classification
le.g. A, B, C(xxxxxx)
License Number
Exp. Date
Ucx/xx/xx)
EARTHWORK (C-12) :.;
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SHEET METAL (C=43) -:: `
FLOORING
GLAZING (0-77);
INSULATION
C-42)
SEWAGE DISP (P-42)-
PAINTING (C=33) ::
PAINTING
CERAMIC TILE (C-54)
r
CABINETS (C-6)
FENCING (0-13).
LANDSCAPING M. 27.1..'
POOL IC -53)