06-3175 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1 06-00003175
Property Address: ] 51950 VIA BENDITA
APN: 772-270-010-1 -311232-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000
Applicant:
Td4t 4 4 Q"
Architect or Engineer:
I JA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 License is in full force and effect.
License Class: C53 I License No.: 6146111p
0K ER -BUILDER DECLARATION
I ereby affirm under penalty of perjury that I am xempt 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 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
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 _ 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
Owner:
JOHNSON
51950 VIA BENDITA
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS &
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
LiC. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
p La
S S, Ip 0 12006
CITY
rOF LA QUINTA
FINANCE DEPT.
Date: 8/30/06
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 HRH INS Policy Number 020060333601
I 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 become suN t to the workers' ompens ion provisions of Section
3700 of the bor Code, I shall fort ith comply with ose pro 'ions.
�at pplicant: NG: FAILURE TO SECURE WORK S' COMPENSAT N COVERAGE IS UNLAWFUL, AND SHALL
ECT AN EMPLOYER TO CRIMINAL PENALTIES AND AVIL 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.
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 buildin nstructia, and hereby author' a representatives
of/t/his A�yt upon eabove-mentioned proper spec 'ripurposef aJ te: ? nature (Applicant or Agent
In
Application Number . . . . 06-00003175
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check Fee
134.55
Issue Date . . . .
Valuation . . .
. 19675
Expiration Date
2/26/07
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 . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/26/07
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
2/2.6/07
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
2/26/07
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
Permit• . . . . WALL/FENCE PERMIT
LQPERMIT
. LQPERMIT
Application Number . . . . . 06-00003175
_
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan -'Check Fee
.00
Issue Date . . . . Valuation . . .
. 325
Expiration Date 2/26/07
Qty- Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 15 L.F. 5' EQUIPMENT WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION
Fee -summary Charged Paid Credited
-----------------
Due
-7 -------- ---------- ---------- ----------
Permit Fee Total 326.00 .00 .00
326.00 "
Plan Check Total 160.55 .00 .00
160.55
Grand Total - 486.55 .00 .00
486.55
Bin it
Permit
J
Project Address:
A. P. Number: __L41
Contractor:
G
Address:
Cil)', ST, Zip:
i
Telephone: •� '.� 3
State Lic. 11 : L
Arch., Engr., Designer:
Address:
City, ,ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
I1ll Submittal
v Plan Sets
Structural Calcs.
Truss•Calcs.
Title 24 Cates.
Flood plain plan
..Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN llOuSE:-
Planning Approval
Pub. Wks. Appr
School Fees
City of La QuintA.
Building & Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Quinta, Cal 92253 - (760) 777.7012
Building Permit APPlication and Tracking Sheet
Owner's Name:
Address:'
' City, ST, Zip:
Telephone:
Project Description:
ZY> S'• .-• fyY:::` :ri'<:'3Si-ti;J•.tfi::4"tr?+.!f y
01
City Lic. #: / a; 2
E
5
r.C:t,:j.,:t{ i•,:•f:55.C+ -
f,F<s;3.:f:;:. f:f<gi`` si'r;xr's Construction Type: Occupancy:
w•• Yom• .. r
;s}:;}3:'•.r;rte:f::�%:°<'`•'yv�:C.7Y�'':?�Sffr:.
Project
type (circle one ew Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Estimated Value of Projcc
APPLICANT: DO -NOT WRITE BELOW THIS LINE
d Rec'd
TRACKINC
Plan Check submitted
Reviewed, ready for corrections
.Called Contact Person
Plans picked'up
Plans resubmitted
2" Review, ready for correctionsrssue
Called Contact Person
Plans picked up
Pians. resubmitted
Review eady for corrections/issue
Called Contact Person
Date of permil•issue
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
-------------
5.111.1.
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees
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