11-0741 (RPL)P.O. BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX .(760) 777-7011.
LA QUINTA,. CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/07/11
Application Number: X11-00000741—% Owner: y
Property Address: 61100' TALEA`_DR WICK
APN: 764-280-004-2 35996 - 61100 TALEA DRIVE
.Application description: POOL - RESIDENTIAL; LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL �-
Application valuation: 30000 Contractors
Architect or Engineer: FAMILYPPOOLS CONSTnU
�ONR Applicant:,
P O'BOX 283".
LA QUINTA, CA 92247 -� cA ;: iiaJi�
T - . (760) 564-3655
r
Lic. No.: 658996
-x - LICEN CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION -
I her a ism under penalty of perjury that 1 a Ii under provisions of Chapter 9 -(commencing with I hereby affirm under penalty of, perjury one of the following declarations: - -
_ .Section 7 00) f Division 3 of the Busine r fessionals 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
Lice I 3•- ' License No.:. 658996 _ _ for by Section 3700 of the Labor Code,' for the performance of the work for which this permit is - 3.1
License issued.
ate: l ~ tractor: _ V -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
NER-BUILDER DECLARATION insurance carrier and.policy number are:
I hereby affirm under penalty of perjury that I a exempt from the Contractor's State License Law for the Carrier STATE FUND rb
Number 1344032-2011
following reason (Sec.,7031.5, Business and Pr fessions Code: Any city or county that. requires a permit to _ 1 certify that, in the performrk is 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 a subject 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 nd agree that, if I slioulect to the workers' compensation provisions of Section.
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the Labor e,Iith comply with those provisions.that'he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: pplicant: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 WARNIN (LURE TO SECURE W KENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds -or improves thereon, - SUBJECT -AN MPLOYER TO CRIMINAL PND 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 (5100,000). IN ADDITION TOF 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.).- - . APPLICANT ACKNOWLEDGEMENT '
(_ 1 I, as owner of the.property, am exclusively contracting with licensed contractors to construct the project (Sec. . IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set fortti on this application. , -
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed 1. Each person upon whose behalf this applicationis made, each person at whose request and for
pursuant to the Contractors' State License Law.). a - - - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ P, I am exempt under Sec. , BAP.C. for this reason - - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmle s the City
of LaQuinta, its officers, agents and employees for any act or omission related to the wor .being
• • , - " performed under or following issuance of this permit.
Date: - Owner: 2: ' Any permit issued as a result of this application.becomes null and void if w not commenced
within 180 days from date of issuance of such permit, or cessatio ` - ork for 180 days will subject
CONSTRUCTION LENDING AGENCY - - _ permit to cancellation.
. I hereby affirm under -penalty of perjury that there is a construction lending agency for the performance of the ,r ' ` I certify at f ave read this application and state that the ab e i - ation is correct. I agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ. C.). - • - city and unt ordinances and state laws relating to build struction, and hereby authorizerepresentatives
• - - of th' enter upo eabove-mentioned pr tion purposes. ,
Lender's Name: � � � � �
• - -
X. - nature (Applicant or Agent): `
Lender's Address:
LQPERMIT ` t.. , • ,
Application Number .
. . . . 11-00000741
Permit . .
MECHANICAL
Additional desc .
Permit Fee
24.00
Plan Check
Fee
6,00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
1/03/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00. 9.0000
-----------------------------------------------------
EA MECH
APPL REP/ALT/ADD
9.00
Permit
MECH POOL
Additional desc .
Permit Fee
26.00
Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0
Expiration Date
1/03/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1..00 11.0000.EA
MECH
FURNACE >100K
11.00
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
284.50
Plan Check.Fee
184•.93
Issue Date-'.
Valuation
•30000
Expiration -Date
1/03/12,
Qty Unit Charge:
Per
Extension
BASE
FEE
252.00 .
5.00 6.50'00
THOU BLDG
25,001-50,000
32.50
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee
45.'00.
Plan Check.'Fee
11.25
Issue Date . . . .
Valuation
. .
. 0
Expiration Date ".
1/03/12
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
' .LQPEPMIT
Application Number 11-00000741
Permit . . . . PLUMBING
Issue Date Valuation
0
Expiration Date 1/03/12 .
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
Additional desc .
Permit Fee 15.00 Plan.Check Fee
.00
Issue Date Valuation
325
Expiration Date 1/03/12.
Qty. Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
POOL/SPA, 15. L.F. 416" EQUIPMENT WALL,,.
CITY STANDARD, GAS & ELECTRIC FOR FUTURE
.
BBQ & FIREPIT. A/C UNIT TO BE
RE -LOCATED. SEPARATE MECHANICAL PERMIT
INCLUDED FOR RELOCATION. ALARMS/BARRIERS
SHALL BE. -IN PLACE AT,PRE-PLASTER
" INSPECTION. 2010 CODES.
-------------------_-------------------------------------------.
Other Fees BLDG STDS ADMIN (SB1473)
-------------
2.00
Fee summary Charged- Paid Credited
Due
-- ---------- ------- ---------- ---------- ..----------
Permit
Permit Fee Total 427:50 .00 .00
- -- --
427.50
Plan Check Total 216.93 00 .00
216.93
Other Fee Total 2.00 .00 .00•
2.00
Grand Total 646.43 .00 .00
646.43
LQPERMIT
Bin #
wty of . did • Quin'ta.
Building Br Safety DivLsion
P.O. Box 1504,78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Traddng Sheet
Permit # /\lil, .
Project Address:
Owner's Name: f
A. P. Number.
Address: )Lr'
p � tion:
Legal Description:
Contractor: A9911)V-14
z ZA
City, ST, Zip. _ C, ��7
Telephone: x;e-j
Address: ), ��
Project Description:��`� � /, /�/!0-
City, ST, Zip:.
City,
Telephone:
j_ /
State Lic. # : City Lie.—
Arch., Engr., Designer-
esignerAddress:
Address.
n'&
/V
City., ST, Zip:
Vie -
iTelephone:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person:
t :
#Uns:#Stories:
Telephone #. of Contact Perso .
q
•
sled Value of Project: 4,7 OcrJ O
APPUCA . DO NOT BELOW THIS LINE
#
SubmittalReq'
TRACIOING
PERMIT FEES
Plan Sets
Plan Check submitted
//
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up
Construction
Va. L
Flood plain pian
Plans resubmitted
Mechanical
�p
Grading plan
god Review, ready for correctionvissae
'Electricalfit.
M-Atae
Subconiactor List
Called Contact Person
Plumbing -y (,A4
yk,14fis
Grant Deed.
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
y ,. _
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