05-2340 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00002340
Property Address:
7'9"8 0 PAR KWA ESPLA-DE N
APN:
609-380-998-72. -293232-
Application description: STRUCTURES OTHER THAN BUILDINGS
�• Property Zoning;
LOW DENSITY RESIDENTIAL
Application valuation:
2000
Applicant:Archit-
r Engineer:
FF&_�a
C(6`)1v17-PAC17_0J U JUN 17 2005
CJTY_OF ► (dUINTA
------------------
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Spdon 7000) of Division 3 of the Business and Professionals Code, and my Lam' ansa is in full force and effect.
icense Class: '' License No.: / _[.�
�et 44
-49ContractJ : C.s �✓ 4 / I%C t%�� s
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 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 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
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/14/05
Owner:
LENNAR HOMES OF CALIFORNIA
78401 HIGHWAY 111, STE C
LA QUINTA, CA
T,A OTTTT�TTA, ('A g7-�S'2
Contractor:
MCINTYRE POOLS & SPAS, INC.
WCC: STATE FUND
WC: 1769111 01/01/06
CSLB: 614611 09/30/05
------------------
WORKER'S COMPENSATION DECLARATION
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
v Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier C53 Policy Number
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 subject to the workers' compensation provisions of Section
' /"' 3700 of the Labor Code, I shall forthwith comply with those provisi
Diff .,: Appli nL� t:�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER GE IS UNLAWFUL, AND SHALL .
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 wi all
city and county ordinances and state laws relating to building'construction, and hereby authorize represent es
of this my to enter upon the above-mentioned property or inspection purpos s.
DateeJ � Signature (Applicant or Agent): f
Application Number .
. . . . 05-00002340
Permit . .
BUILDING PERMIT
Additional desc .
Permit Fee
45.00. Plan Check Fee
29.25
Issue Date . . . .
Valuation . . .
. .2000
Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
15.00 2.0000
----------------------------------------------------------------------------
HND BLDG 501-2,000
30.00
Permit . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
30.00 Plan Check Fee
7.50
Issue Date . . .
Valuation . . .
. 0
Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00' 7.5000
----------------------------------------------------------------------------
EA ELEC PWR APP >1 TO <=10
15.00
Permit . .
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
BBQ UL#Z21558199; 38"
TURBO GRILL;
GAS LINE; 3/4" RUN ELECTRIC LINE.
-----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
2.93
Fee summary Charged Paid Credited
Due
Permit Fee Total
93.00 .00 .00
93.00
Plan Check Total
41.25 .00 .00
41.25
Other Fee Total
2.93 .00 .00
2.93
Grand Total
137.18 .00 .00
137.18
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A fNSrtCii�iv ILOF
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WILL BE CHARGED IF THE APPROVED `
PLANS AND JOB CARD ARE NOT ON
• THE SITE FOR A SCHEDULED
58,E fwiv61n uG~rr(I�,dtage) INSPECTION.
5500 M15,
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVE®
FOR CO
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By
DATE `3 0� ST
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A fNSrtCii�iv ILOF
-30
WILL BE CHARGED IF THE APPROVED `
PLANS AND JOB CARD ARE NOT ON
• THE SITE FOR A SCHEDULED
58,E fwiv61n uG~rr(I�,dtage) INSPECTION.
5500 M15,
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVE®
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