05-0716 (RPL)4
BUILDING & SAFETY DEPARTMENT
O. Box 1504 (760).777-7012
495 CALLE TAMPICO FAX (760) 777-7011
\ QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number ... .
. . 05=00000716
Date 3/02/05
Property Address . . . .
. . 55525 TURNBERRY WY
APN:
767-550-009- -
-
Application description .
. . POOL - RESIDE14TIAL
Property Zoning . . . . .
. . LOW DENSITY RESIDENTIAL
Application valuation
. j�o?Osoc� •
Owner
Contractor
,
------------------------
------------------------�.
CALIFORNIA COVE AT LA QUINTA MCINTYRE POOLS &
SPAS, INC.
8105 IRVINE CENTER DRIVE
83695 AVENUE 45
#800
INDIO
CA 92201
IRVINE CA 92618
(760) 342-3612
WCC: STATE FUND
WC: 1769111
01/01/06
CSLB: 614611
09/30/05
CCC: C53
----------------------------------------------------------------------------
Permit . . . . . . BLDG
POOL PERMIT
Additional desc . .,
Permit Fee 207.00
Plan Check Fee
134.55
Issue Date . . . .
Valuation . .
. . 20000
Qty Unit Charge Per
Extension'
BASE, FEE
�. 45.00
18.00 9.0000 THOU.
-----------------------------------------------------------------------------
BLDG'2,001-25,000
162.00
Permit . . . . . . MECH
POOL
Additional desc
Permit Fee . . . . '24.00_
Plan Check Fee
6.00
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA
----------•---------------------------------------------------------_---------
MECH FURNACE <=100K
9.00
Permit . . . . . . ELEC
POOL PERMIT -RES
Additional desc
Permit Fee . . . .
45.00, Plan Check Fee
11.25
Issue Date . . . .
Valuation
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 30.0000 EA
ELEC PRIVATE SWIMMING POOL
J"
30.00
Permit . .PLUMBING
-------------------------------------
1.
Additional desc
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 1
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: L05— 0 9/�o Date: .9j ? •U5
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
o14M4GTO
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 Lic is rce and effect. - ' .
cense Class ♦ License Nis/
Date Contractor✓1 �N(rZp
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U I, 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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
1of the work for which this permit is issued.
1 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
suue�d.�, wyyrke� ' compensation insurance cameya ?glicVh ej ar :
arrier
Tie Policy Numbert/ (tel 1 ri
I certify that, in the perlormance of the work for which this permit is issulecr 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 Code, I shall
forthwith comply with those provisions.
orate F.pplicantvl�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OVERA` GE IS UNLAWFUL,, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
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.
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 4/4
Lenders Address
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 tenter upon the above-mentioned property for inspection purposes.
Date` Signature (Applicant or Agent): tl V
Page 2
Application
Number 05-00000716
Date 3/02/05
Permit Fee
. . . . 33.00 Plan Check Fee
8.25
Issue Date
Valuation . .
. . 0
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
PLACE PRIOR
TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary
Charged Paid Credited
Due
------------------
Permit Fee
---------- ---- ----- ----------
Total 309.00 .00 .00
----------
309.00
Plan Check
Total 160.05 .00 .00
160.05
Grand Total
469..05 .00 ..00
469.05
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