06-2280 (RPL)P.O. BOX 1504
F-� 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant: -
�
l
06-00002280
47700 STILLWATER DR
658-140-999-63 -29436 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
c&t�v - 4 4a Q "4p M.
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING .& SAFETY DEPARTMENT
BUILDING PERMIT
hereby affirm under penalty of perjury that 1 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 Class: C8 C27 C29 License No.: 839002
7 �^��
,Date: ! O -Contractor: Q 1part4h &Vlrvt1Vr4- t
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, as owner of the property, or. my employees with wages as their sole compensation, will do the work, and t
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 improvesthereon,
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.).
(_) I am exempt under Sec. B.&P.C. for this reason
t.
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:
LQPERMIT
Owner:
DAN & BARBARA ANDERSON
47-700 STILLWATER DR.
LA QUINTA, CA 92253
Contractor:
RIPARIAN ENVIRONMEN'
P.O. BOX 13990
PALM DESERT CA 922!
(760)398-9997
Lic. No.: 839002
VOICE (760) 777 -7012 -
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/06/06
------------------
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 workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued:
1 have and willmaintain 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 STATE FUND Policy Number 1769754-2006
I certify that, in the performance of the work for which this permit is issued, 1 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 become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forth
with co qly with those provisions.
Date: Applicant: !.Pe 19 /
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 (5100,000). 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 the above-mentioned pro(ey/for i1sApeciion purp/o//A/es.
Date: GL Signature (Applicant or Agent): (/.Y 1
r
0
LQPERMIT
Application Number .
. ... . 06-00002280
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
252.00 Plan Check
Fee
163.80
Issue Date
Valuation
25000
Expiration Date
12/03/06
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
-12/03/06
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
12/03/06
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
6.75
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
12/03/06
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 ALARMS/BARRIERS SHALL BE IN
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.#
U1
Project Address:* �d�
Owner's Name:
I. r
A. P. Number:
Address: --I(Y) 511 lJ��a�eX
Legal Description'
Contractor: R.k; Ck v•
City, ST, Zip:Le-53
Telephone:
Address: - �. !� q�0
Project Description:
City, ST, Zip: rpcLt
r
Telephone: -OkoWNU
State Lic. # City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:Armcl
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: .'jSrJ
Estimated Value of Project-,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING .
PERMTT FEES
Plan Sets
Plan Check submitted .
Z
Item
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
2"' Review, ready for'correctionsrissue
Electrical
Subcontactor.List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O."pproval '
Plans resubmitted
Grading
IN,HOUSE:-
7n° Review, ready for correcdons/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
0
0
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Dan & Barbara Anderson POOL & SPA C27. _ _ ! PO BOX 13990
Palm Desert, CA 92255
47-700 Still waterOffice (760) 398 - 9997
La Q u inta, CA 92253 DATE: " 05-131-06 ��Q ° ' Q ' FAX (760) 398 - 3290
SCALE: 1/8" = 1 g;i fiO.113 p;ort s � CA LICENSE 839002
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