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07-0293 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:: 07-00000293 Property Address: 48471 STILLWATER'DR APN: 658-140-999-124 -29436 - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 32000 Applicant: 1 I' BUILDING & SAFETY DEPARTMENT BUILDING PERMIT : Owner: DR. 'SAM PEREZ 48-471 STILLWATER DR. LA•QUINTA CA 92253- (760)343-6887 ------------------ 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 Class: C27 C53 License No.: (801813 Date: A 6 O7 Contractor: I C nm RA 0- Lam}—t/U ' 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 _) 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 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 _ 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 this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT - _ VOICE(760)777-7012 - FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Dater 1/29/07 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. - 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 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 become subject to the workers' compensation provisions of Section . 3700 of the labor I shalrthw' awp{y w_ ith t rose provisions. Date: � 07 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U 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 b Ming construction, and hereby au horize representatives of this county to enter upon the above-mentioned pro ert or in ction f¢6 S. Date: (o -i- Signature (Applicant or Agent): Contractor: Architect or Engineer: VICTORIA LANDSCAPES/WA ,53725 AVENIDA MADERO LA QUINTA, CA 92253 (760) 77.7-1417 Lic. No.: 801813 ------------------ 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 Class: C27 C53 License No.: (801813 Date: A 6 O7 Contractor: I C nm RA 0- Lam}—t/U ' 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 _) 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 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 _ 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 this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT - _ VOICE(760)777-7012 - FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Dater 1/29/07 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. - 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 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 become subject to the workers' compensation provisions of Section . 3700 of the labor I shalrthw' awp{y w_ ith t rose provisions. Date: � 07 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U 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 b Ming construction, and hereby au horize representatives of this county to enter upon the above-mentioned pro ert or in ction f¢6 S. Date: (o -i- Signature (Applicant or Agent): LQPERMIT Application Number 07-00000293 Permit . . . BLDG POOL PERMIT _ Additional desc - Permit Fee . . . . 297.50 '' Plan Check Fee 193.38 Issue Date . . . . Valuation . . 32000 Expiration Date 7/28/07 Qty Unit Charge Per Extension c BASE.FEE• 252.00 ' 7:00 6.5000 THOU BLDG 25,001-50,000 _ ------------------------------------------- 45.50 Permit . . MECH POOL w Additional desc . Permit Fee 26.00 Plan Check Fee. '6.50 Issue Date Valuation . . . . . .. .0 Expiration Date 7/28/07' 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.. 7/28/07 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 7/28/07 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 i-4 OUTLETS 3.00 Special Notes and Comments POOL, SPA, ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number 07-00000293 -' ------------------- - - - Special Notes ,and Comments. --PLACE-AT PRE-PLASTER_INSPECTION._ EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged -------- Paid Credited Due .----------------- Permit Fee Total 401:50 00' ..0-0 401.50 Plan. Check Total 219.38 00 00 21"9.38 Grand Total 620.88 .00 .00 620.88 - LQPERMIT C�- Lc I, 0 OdC1 I r i J CITY OF LA QUINTA SUB -CONTRACTOR LIST 2°�� J6 ADDRESS Y�-YZL.-_STZ��u�j4-I�� .�� PERMIT NUMBER _ OWN ER��- `1p 13UILDER��--fit V L::�'t1.I__I rJL fhis form shall be costed 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 of building permit. For ea;ch applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade / Classification , Contractor :• ::. :.:::::; :;<_ :::::..:. State Contractor s License ..._ � � �� • .� ..��, •�� � � � •:...,: <:W:oikers Com ehsation lrisurai�ce ��.' ` Cit . B' y usmess Licenser •: • EARTIiWORK (C-12) Company Name 2 �w� Classification (e.g. A, B, C 8) C License Number (xxxxxx) �/ EAP. Dat' {xz;.;x/xx) z If C7 � Carrier Name Ie.g. State Fund, CalComp) 5�fE �' fJfl Policy Number Exp. Date (Format Varies) lxx/xx/xx) z :. Oe3 7301/1 License Numbe: (xxxx) --3 1'D\1' j Y Exp. Date (xx/xx/xx) b- _ CONCRETE (P-8) uc� ��Si'�u' g C-�S (3�• %fit Or �J %ice -L2 -cp {x}22 5 1 t-7 ,, 2 - FRAMING (C-5) STRUCT::S7EEL jC 51)NA'PLD�jAt, 6utJCrE �! NO �a �2c-1-0033730 j o7 ct�o3 1 3 "r MASONRY (C-29) �S3 �6 )b7 % jlO7 LWtt2'r t;A0 % S . PLUMBING (C-36) ���JCb►�-r �7 L'�3 (�i . U(.e �G 5 3 07 LATH: PLASTER (*-35) pbcx L 3 6FS�3S Mg �1i1 T 1 i-��. RC1- 3� a gO �j0 e DRYWALL (C-9).... . HVAC IC -20p...:::..:> ELECTRICAL. (C-10) ,.. �. tZ(q- W GS 3 FSO (g'/ 3 I 31 c 7 E iCE✓ r�'1 #� I � , 3 sf 3 07 SHEET METAL (**-43). FLOORING (Cr='15): GLAZING (C-17)`. :::.::::QUINT INSULATION; (C-2).- � .... BUILDII JG & SAF ETY DEPT. SEWAGE DISP (C-42) . . E D PAINTING (C-33) CERAMIC TILE (C-54) DA BY CABINETS (0-6) # I FENCING (C-13) LANDSCAPING ICG27.) POO L(C-53) G Vf<C.-pt-( atA 3i oOLS E5.'j ii$�c$3C� a Si�t">� �k�U �']S`� g ! 0.7 '0 Aja cy. TA A RE -INSPECTION FEE OF $3c° CITY OF LA QUIN BUILDING & SAFWILL BE CHARGED IF THE APPROVED SAFETY DEPT. PLANS AND JOB CARD ARE NOT ON FOR CONSTRUCTION THE SITE FOR A SCHEDULED INSPECTION. oAMa !•off ,�'��C EPTLONS! SPA SET @ +18" ..: spa play ///Jl1//i M 1 5' 3' pool -X X X TANNING SHELF V lC�TU cA-W) I til C_ S3 72-5- -0 Eg_�D 1-0- e--A- +18" i I 3' 16'0 __a__. a CHILD SAFETY FENCE .:................... ............................ .... ............:.... .............- . EXISTING PATIO RESIDENCE DR. PEREZ Li OF—y1 l S1'LLL vJ+�,"YL P, LQ c-4- �12ZS3 Bin # Permit # Project Address:' — Lf A. P. Number: Contractor: V ie,_7?)124� Address:) —'725' City, ST, Zip: Telephone: 7&z� T77 State Lic. # : �RfD! &/ 3 Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Plan Sets Structural Cala. Truss Cala. Energy Cala. Flood plain plan Grading. plin' Subcoutactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinta 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 Stru u C7 Owner's Name: 5 �1 Address: City, ST, Zip: c� Telephone: 7&,q 3c •3 rn _RQ0 Project Description: Lic. #: W VVA Total Permit Fees Construction Type: Occupancy,: Project type (circle one): New Add'n Alter Repair Demo S11 -Al J C17.�_ Sq. Ft.: # Stories:# Units: L O l-7, 3 1 Estimated Value of Project: <Don `40� APPLICANT: DO NOT WRITE BELOW THIS UNE Reed IRACMG . PERMIT FEES Plan Check submitted item 0� Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Cheek Balance Plans picked up Construction Plans resubmitted Mechanical 2" Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.M.I. Plans resubmitted Grading Review, ready for. corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. .Date of permit issue Total Permit Fees