10-0621 (RPL)u r ,P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000621
Property Address: 80330 VIA CAPRI d
APN: 772-440-075- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 27000
Ta!t 4 4v Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSE • CONT CTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am I ensed n er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P fessiq6k Code, and my License is in full force and effect.
License Class: C53 icense No.: 614611
/ate: l - tractor:
NER-BUILDER DECLARATION
-. I hereby affirm under penalty of perju y that I a exempt from the Contractor's State License Law for the,
,following reason (Sec. 7031.5, Busin sand P fessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or r air y 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
'6cerise 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
auy 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
t"7;r 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 I am.exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERIMIT
Owner:
ROSEN
80-330 VIA CAPRI
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & SPAS,
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/10
tCffy
5 2010
[C OF LA QUINTA
FINANCE DEPT.
• 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 is permit -is issued. My workers' compensation
insurance carrier and policy number are:
Carrier GOLDEN INS P Iicy IVumbe 2 01001013 9 0 97Z
I certify that, in the performance of a work for ich this permit is issued, I shall not employ any
person in any manner so as to be ome subj o the workers' compensation laws of California,
and agree that, if I should beco subject t e workers' compensation provisions of Section
3700 of the Labor Code, I shall orthwit ply with those provisions.
-1 -61 plicant:
WARNING: FAILURE TO SECUR WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI INAL PE LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDIT N TO E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO EREST, 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 i ork is not commenced
within 180 days from date of issuance of such permit, or cessation or for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor ation is o ect. I agree to comply with all
city and county ordinances and state laws relating to building constru tion, a eeby authorize representatives
of this county to enter upon the above-mentioned property for inspe ion pu es.
- l�!/ //SignatWid'(Applicant or Agent):
Application Number . . . . . 10-0000.0621
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 265.00 Plan Check Fee 172.25
Issue Date . . . . Valuation 27000
Expiration Date 1/09/11
Qty Unit Charge Per Extension
BASE FEE 252.00
2.00 6.5000 THOU BLDG 25,001-50,000 13.00
-------------------------------------------- -------------------------------
Permit . . . MECH POOL'
Additional desc
Permit Fee . . . . 26.00 -Plan Check Fee 6.50
Issue Date . . . Valuation . . . . 0
Expiration Date 1/09/11
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >1OOK. 11.00
--------------------------------------------------------------------------
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date Valuation . . 0
Expiration Date 1/09/11
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 1/09/11
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, 51X5' FIREPIT INCLUDES 1 1/2"
LQPERMIT
Application Number . . . . . 10-00000621
-------------------------7--------------------------------------------------
Special Notes and Comments
GAS LINE. ALARMS/BARRIERS SHALL BE IN
-
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE & BBQ NOT INCLUDED
IN THIS PERMIT. 2007 CODES.
----------------------------------------------
Other Fees . . . . . . . BLDG STDS
------------------------------
ADMIN (SB1473)
2.00
Fee summary Charged Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total 369.00
.00
.00
369.00
Plan Check Total 198.25
.00
.00
198.25
Other Fee Total 2.00
.00
.00
2.00
Grand Total 569.25
.00
.00
569.25
LQPERAIIT
Bin #
City of LA Quinta } .
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: - 3 Q a
Owner's Name: os e
A. P. Number:
Address: S0 - 3/ U
Legal Description: -
Contractor: IQ
City, ST, Zip: cJ G Zo s—
Telephone:
Address: 93. CgS �V S
Project Description:Q]nj S
City, ST, Zip: On 2 Zd
ir
S
Telephone: (7 0 342- 361:2.
State Lic. # ; S _
City Lic. #;
Arch., Engr., Designer:
Address: ;
City., ST, Zip:
ist+ri4•{+'{:vv}`,:ti•<i:•iT:.'J i:viiiii?t ti�h}Gi ii:>:
Telephone:
State Lic. #: :<:•;;;>::>,•, :.::.:::•;:•::.::>;.;;;>:.x.:........:.;:.
?t<z?# <%%>z'•':•.'>> >':••':<> ss"
::....:..:h....:.:::::.::..:.:..:...........v.:
Name of Contact Person:
Construction Type: Occupancy:
type a circle one): New Add'n Alter Repair Demo
J )'
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: % - �
Estimated Value of Project: 7,000
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.
i
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
211 Review, ready for correctionsrissue
Electrical
Subcontactor List
i
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
i
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
I
Date of permit issue
School Fees
C -ry n EPT.
Ll�]
Total Permit Fees
FOR CONSTR
LTA— B
L
2R
-1 5/16" TANNING x
�?
0" Xry -5
FRENCH GREY
PLASTER
-36" 2 SPA
3'-6»
Pa1�e Pad �F _ 4'
U
TILE BORDER