13-0033 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: '
Property Address:
APN:
Application description
Property Zoning: .
Application valuation:
1 -0000003.3
54805 AVENIDA—�VALLEJO
774-201-014- -
POOL - RESIDENTIAL
COVE RESIDENTIAL
20000
i44a
BUILDING & SAFETY DEPARTMENT
• BUILDING PERMIT
Owner:
TERILYN MCCLARY
- 54805 AVENIDA VALLEJO
LA QUINTA, CA 92253
Applicant: Architect or Engineer:
---------------------------------------------------
LICENS CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus' ass d Professionals Code, and my License is in full force and effect. ,
License Class: C53 12
License No.: 979450
Contractor: -
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, Busines and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, o//repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement th he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commeny�g with Section 7000) of Division 3 of the Business'and Professions Code) or
that he or she is exempt therefro(( 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 ($5001.:
1 _ 1 I, as owner of the property, or my employees with wages as their sdle compensation, will do the work, and
thestructureis 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 exclusivelycontracting 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'.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 issuedISl?c. 3097, Civ. C.). -
Lender's Name: -/ '
Lender's Address: /"� _
LQPERMIT
Contractor:-
CALIFORNIA
ontractorsCALIFORNIA POOL MASTER D
71974 VISTA DEL RIO
RANCHO MIRAGE, CA 9227
(760)275-9779
LiC. No.: 979450
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 .
Date: 1/08/13
�j :; 2013
LA
' FIPIANCE Der 1- -
-------------------------=---------------------
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 EX PT Policy Number EXEMPT,,
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 bec a bject to the workers' compensation provisions of Section '
3100 of the Labor C , s rthwith comply with those provisions.
D?11GI/11,t�UtE
Appli t:WA TO SECURE WORKE COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECTN EPLOYER TO CRIMINAL P-tiALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000)- IN ADDITION T //THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR COD , NTEREST, AND ATTORNEY'S FEES.
' APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is here 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. r`
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 info ion is correct. I agree to comply with all -
city and county ordinances and state laws relating to in g c s uction, and hereby authorize representatives
of,this co ty toe er upon the above-mentioned p/pert for n tion purposes.
or
e Sig use (Applicant or Age 1
a �
Application Number .
. . . . 13-00000033
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee ..
6.50
Issue Date
Valuation . . .
. 0
Expiration Date
7/07/13
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
207.00 Plan Check Fee
134.55
Issue Date
Valuation
20000
Expiration Date. •
7/07/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
THOU. BLDG 2,001-25,000
162.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc °.
Permit Fee
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation
0
Expiration Date
7/07%13
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
7/07/13
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'
1.0.0 3.0000
-----------------------------------------
EA PLB GAS PIPE i-4 OUTLETS
-"----------------------------------
3.00
'Permit
WALL/FENCE PERMIT
LQPERMIT - ,
Application Number . . . 13-00000033
.•
• Permit . . . WALL/FENCE PERMIT
-
_ Additional desc
Permit Fee 37.00 Plan Check Fee
-.00
,Issue Date Valuation
•1584
_ Expiration Date 7/07/13,
Qty Unit Charge Per
Extension
BASE FEE
_ 15.00
11.00 2.0000 HND BLDG 501-2,000
22.00
t. ----------------------------------------------------------------------------
Special Notes , and Comments
SPA WITH FOUNTAIN. 25 L.F. PROPANE GAS
LINE, 68 L.F. 5' GARDEN WALL,& 7 L.F. 4-
GARDEN WALL, CITY STANDARD.
SHALL BE IN PLACE AT ..
_ALARMS/BARRIERS
PRE -PLASTER INSPECTION. 2010 CODES.
_-------------------------------- - --
----------------_
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00' ,
Fee summary Charged Paid Credited
- -.- - - - - ------ - - - - ------ - - - - ---
Due Y
--- - - - - --
-- - - - - - - - - - - - - - ---
Permit Fee Total 342.00 .00 .00
342.00
Plan Check Total 159.05 .00 00
159.05
Other Fee Total 1.00 .00 .00•
1.00
Grand Total 502.05 .00 , .00
502.05 ,
• 1
LQPERMIT
' -
Bin. #
C(�/ of U. Quin- to
Bufkiittg a Safety Ditdslon
P.O. Box 1504,78-49S Caffe Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Pmject.Address: 5190-5- J uj i A L Le O
Owner's Name: Te LY #,A C
A. P. Number.
Address: d S. AJ&IJ ICA k LL r,. CC)
Legal Description:
Contractor. F0 A P 0` 6P_
/1 4A
City, ST, Zip: L-A QU l ^(TA A -1 ?-2-5 3
Telephone:_70.157. ('3 1
Project Description:
City, sT, zip: do E Ca-
GuN tTr S w
Telephone: bO 2,7,517 11
State Lie. #: 9 O CityLic. # 1 1 �2
PPLO i�Pt► 6 GAcg 11114* C
p21
6 S L �. .& . 1�LN W AL.l.
Arch., Engr., Designer:L
/ _n `%N W ` L
VI -i
Address:
City., ST, Zip:
Telephone:
Statc Lic. #: _w
Constructi6a Type:. Occupancy:
Project type (circle one)• ow Add'n Alter. Repair Demo
Sq. Ft.: # Stories: # Univ
l
Name of Contact Person: & 1-1 s L,p )
Telephone # of Contact Person: 760 .2? ?
Estimated. Value of Project 2.,01000
APPLICANT: DO NOT WRITE BELOW THIS UNE
N Submittal Req'd Beed TRACKING PERMrr FEES -
Plan Sets
Plan Check submitted 1 %
Item Amouat
S"ctuial Cabs.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
Called Contact Person Pian Check Balance
Title 24 Calci.
Plans picked up Construction
Flood plain ptao
Plans resubmitted Mecharilcal
Grading plan
Z' Review, ready for correctionsfissue Electrical
Subeontactor List
Called Coutact Person Plumbing
Grant Deed
Plans picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
3" Review; ready for eorrectionsfissae Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CITY OF LA QUINTA'SUB-CONTRACTOR LIST
S CCLA(LBUILDERQ�GJl0A L1�3O PERMITNUM u�O�lA�00L��ST
JOB ADDRESCL
This form shall be posted 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 each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade / Classification
Cont rector
...:............
;..: State:.Contractor .s. l�cerls8.... .;... .....:.
::...... Workers.Com erlsation;Insurance:°`.::'
City i3us ness
License:
.
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
Ixx/xx/xx)
License Number
(xxxx)
Exp. Date
Ixx/xx/xxl
EARTHWORK (C712)..:
(r
1
CONCRETE ► '
A L CSU rJ 'i -
O 6
—I
31
T �i
vJGo . 7 2
� 2_s 13
1028 2
19/31/15
FRAMING IC -5)
STRUCT::STEEL td -61)
MASONRY -(C-29)
PLUMBING* IC -36).
_7( '
PLASTER
2AM M (G C�N� (
C —�
6 6 56
2 ! 3
(:J C 5'r t4A110aAL
760 o CO 850 l21
DRYWALL (C-9) .:..:
HVAC. (C720)::: :.
ELECTRICAL. (C=10)' ...
ROOFING" IC 391:::;
.:SHEET -METAL (C43)
FLOORING (C`.15):.'''.
GLAZING (C-17):
INSULATION'(C-2) .
SEWAGE DISP; (642) .
PAINTING (C=33)
CERAMIC TILE IC -54) '
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING IC=271.::`.
POOL 1C-53)
Gi�1.10�N1A O
C 5�
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1 3� (WA
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DOOR -
54805 AVENIDA VALLEJO
LA QUINT& CA 922.53
CONCRETE GATE
DECK
EXISTING FOOTIN 15'4 I ' GAS LIN i
- . j1.5" POLY I
'GARDEN WAL5PA +18" I 'GARDEN WAL I P
I 0a
0 U
LI
I I
' GARDEN WAL
i I
I P
SPA 8.
8 I DRIVEWAY
'GARDEN WALLI E
I
" GA j PROPANE
FOUNTAIN WAL'L:+418' i I ACCE% GATE
I I
12'0
CURB I