06-4072 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00004072
Property Address:
80185 VIA CAPRI
APN:
772-440-058- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
60000
T4hf 4 - 4Q"
Applicant: 0,Architect or Engine Cr
a .W 1A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
R:7_A�n�
MELLO RESIDENCE
80185 VIA CAPRI
LA QUINTA, CA 92253
NOV 29 29g6 ID
------------------------------ --------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pernUusin
t I a ' ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of thes Pr fessiona -Code, and my License is in full force and effect.
License Qlass: C53 License No.: 598681 .
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perju that.l 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 isexempt 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.).
(_) 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 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:
t
LQPERMIT
Contractor:
AINSWORTH POOL CONSTR, ROBERT
40900 GLENMORE DRIVE
PALM DESERT, CA 92260
(760)200-2800
Lic. No.: 598681
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/27/06
-----------------------------------------------
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 CALIF INS Policy Number 460030110102
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
l person in any man as to become subject to the workers' compensation laws of California,
and agree that, if shoV
subject t the workers' compensation provisions of Section
( L 3700 of the Labo Codrthwit omply with those provisions.
Date: `� L 6� Applicant:
WARNING: FAILURE TO SECURE MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI I AIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITI 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.
I . 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 o permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state t at the a I
mation is correct. I agree to comply with all
city and county ordinances and state laws relating t buildin t>�e
by authorize representativeof this co lmy a terupon the above-mentioned p perty f ro
Date: I� V Signature (Applicant or Agent):
a
Application Number . . . . . 06-00004072
Permit . . .
BLDG POOL PERMIT•
Additional desc
-
Permit Fee
459.50
Plan Check Fee
298.68 .
Issue Date . . . .
Valuation . . .
. 60000
Expiration Date
5/26/07
Qty Unit Charge
Per
Extension
BASE FEE
414.50
.10.00 4.5000•THOU
----------------------------------------------------------------------------
BLDG 50,001-100,000
45.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00
Plan Check Fee
6.50
Issue Date . . .
Valuation . . .
. 0
Expiration Date
5/26/07
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
5/26/07
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
45.00
Plan Check Fee
11.25
Issue Date . . . .
Valuation
0
Expiration -Date .
5/26/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 6.0000
EA PLB FIXTURE
24.00
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
LQPERMIT
Application Number . . . . . 06-00004072
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
FOUNTAINS PER APPROVED PLAN. EQUIPMENT
ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
-------------------------------'--------------------------
Permit Fee Total 575.50. .00 .00 575.50
Plan Check Total 327.68 .00 .00 327.68
Grand Total 903.18 .00 .00 903.18
LQPERMIT
Bin #
City of La Quinta . =
Building u Safety Division
Permit ff
P.O. Box 1504, 78-49S Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: U- ��� U�p -rLA Owner's Name: /"t11, /AS Lt 6
A. P. Number.
GBi Address:
Legal Description:
City, ST, Zip--
ip:Contractor:
Contractor:R j
�p,l foa/$9 s
NA2
(A( T1 W Telephone:
Address:
Project Description: p d
1"ij0 � Sf � f'Qhr1IY"v/J '
.City, ST, Zip: ?P U4� A554 T Vl+ `
1
Telephone: 6 0o - l io b
in/TSR�R. PtN/JTA-
Y'� W ✓ �e
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City,. -ST, Zip:
Telephone:
Construction Type: Occupancy:
P c7': .
State Lic. #:.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq: Ft: #Stories: 1'# Units:
Telephone # of Contact Person:
. Estimated Value ofProject: 6•i 6 db.
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal
Req'a. Recd TRACKING. PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contac! Person Plan Check Balance
Energy .Calcs.
Plans picked up Construction
Flood plain plan
•
Plans resubmitted Mechanical
Grading plan'
214 Review, ready for eorrectionsrissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted. Grading
IN HOUSE:-
'`' Rcview, ready for correctionsrssue Developer Impact Fee: ;
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
V.
Total Permit Fees . .. .
_z5\
77 Z,
L I
_j
-a
U
7- 0'
1 T-1
112-
T-8-
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.7
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A4k.". 2'
7 ' , . I J
U Courtyard +2"
CourtY,
;D
6
A
TI.
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ou§e b
si-I
ISHED
1019.0
R,
j 0
C, 1 j .
-0
0
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