06-2717 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002717
Property Address:
4.5530 SUNBROOKILN
APN:
604-421-008-8 .-23995 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
.Application valuation:
25000
Applicant:
veil',
Architect or Engineer:
PIP
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSE CONTRACTOR'S ECLARATION
I hereby affirm under penalty of peri ur I am tensed �UcNo.:.
ons of Chapter 9 (commencing with
Section 70001 of Division 3 of the smess n roles 'd my License is in full force and effect.
License Class: C$3 618892
j OWNE UILDER DECLARATION
I hereby affirm under penalty of perjur that I am exe pt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Busin ss 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).:
(_) 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 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 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
Owner:
PAMELA PITKIN
45530 SUNBROOK LANE
LA QUINTA, CA 92253
Contractor: L_
BLUE HAVEN POOLS
2318 S.'VINEYARD AVENUE (A)
OT,TTAR 10, CA 917 61
(909)947-6474
Lic. No.: 618892
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 '
Date: 7/17/06
w U
JUL 212006
CITY QF LA QUINTA
------------------
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 AMERICAN HOME Policy Number WC3422016
I certify that, in the performance of the work for which this per it is issued, I shall not employ any
person in any manner soas t ecome subje the work s' compensation laws of California,
an agree that, if I s ul b ome subje to the w ker compensation provisions of Section
0 Of th abor oodre, .s all forth th comply wi ose provisions.
Iate: Applicant: /
WA NING: FAILURE TO SECURE WORKERS COMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001 IN ADDITION TO THE COST OF CO PENSATION, 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 cess ion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that Xfor
ove i or tion is correct�apresentatives ty with all
city and cou%�y ord}'Pan�es and state laws relating to bcon tr tion, and h
of this-couliRv to sfSter upon,Nfe above-mentioned prop its ction our es.
(Applicant or Agent
I
LQPERMIT
Application Number .
. . . . 06-00002717
Permit . . .
BLDG_ POOL PERMIT
Additional desc .'.
Permit.Fee . . . .
252.00 Plan Check Fee
163.80
Issue Date -.
Valuation . . .
25000
Expiration Date
1/13/07
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
1/13/:7
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
1/13/07
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
1/13/07
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
k
Application Number 06-00002717
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
-------- - ----- ---------- ---------- ----------
Permit Fee Total 356.00 .00 .00 356.00
Plan Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 .00 545.80
Bin#
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - •(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
t
Project Address: Su
Owner's Name:
�z k q
A. P. Number: �01/ IZ�
Address:! S �v
Legal Description:
Contractor: 6�'�,1N fOD
City, ST, Zip: �A Oq (�-41 ca ZZ�
Telephone:
Address:
Project Description:
Q of avid
City, ST, Zip: d+i (G
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
FconstructionTelephone:
#
_
Type: Occupancy:
State Lic. #: -
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: ��
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person: qoq gi1-1 1 18
Estimated Value of Project: S
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING ;
PERMIT FEES
Plan Sets
Plan Check submitted
1 1
Item
Amount
lStructural
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"d 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
�� J