06-2741 (RPL)4��
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: 7/19/06
Application Number: 06-00002741 Owner:
Property Address: 81506 ULRICH DR DIAMOND
APN: 764-270-999-102 -300234- 81506 ULRICH DRIVE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 22000
Contractor: D [n1 a
Applicant: Architect or Engineer: FAMILY POOL CONSTRUCTION
P O BOX 2832 2006
LA QUINTA, Ca 92247
(760)564-3655
Lic. No.:.658996 CITY OF LA QUINTA
�IP1A C -
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a icensed under provisions of Chapter 9 (commencing with
Section 70 0) of Diision 3 of the Bus sionats'Code, and my License is in full force and effect.
License 5 License No.: 658996
Date: ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury t t 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 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.).
(_ ) 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I haveand 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 STATE FUND Policy Number 1344032-06
I certify that, in the performance of th work f hfEh this permit is issued, 1 shall not employ any
person in any manner so as to be ubiect to the workers' compensation laws of California,
a d agree that, if I should b bject to the workers' compensation provisions of Section
rd
of the Labor Code, I sha o with comply with those provisions.
WARMING: VAILURE TO SECURE WORKERSI COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO T%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 p mit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the o e information is correct. I agree to comply with all
city and Punty%ordinances and state laws relating to buil nstruction, and hereby authorize representatives
of tfy',o-s�unty b enter upon the above-mentioned prope � pection purposes.
(Applicant or Agent):
Application Number . . . . . 06-00002741
Permit. . . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
225.00 Plan Check
Fee
146.25
Issue Date . . . .
Valuation
. . .
. 22000
Expiration Date . .
1/15/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
180.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
1/15/07
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
1/15/07
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 . . . .
27.00 Plan Check
Fee
6.75
Issue Date '. . . .
Valuation
. . .
. 0
Expiration Date
1/15/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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
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Special Notes and Comments
SPA'& FOUNTAIN. ALARMS/BARRIERS
SHALL
LQPERMIT
Application Number . . . . . 06-00002741
7 ---------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
-- - - - - - - - - - - - - - ------ - --- ---------------- - - - - ------ - - - - --
Permit Fee Total 323.00 .00 .00 323.00
Plan Check Total 170.75 .00 .00 170.75
Grand Total 493.75 .00 .00 493.75
0
LQPERAIIT ,
1
Pool Equlpre►d
5po
34'
.onstruction
Pools 5pap 1=oudain�
C7�O�G4 3G��
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 #
^,1
d�
Project Address: U /�d b G
Owner's Name: D
A. P. Number:.
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
§ +
Address: _
Project Description:j� (N -
City, ST, Zip: A �7_
Telephone:`]
State Lic. # : IO
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo.
Sq. Ft.:
# St l ies:
# Units:
Telephone # of Contact Person: —1
Estimated Value of Project: 9,,9vJ Z)
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
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 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
93.75