06-2523 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicatjon Number:
0-6=0.0002523
Property Address:
79883yPARKWAY ESPLANADE N
APN:
609-3807999-9 -293234-
Applicationdescription:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
32000
Applicant: Architect or Engineer:
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
Section 7000) of Division 3of the Busin s'SR11 fessionalsCode, and myLicenseis in full force and effect.
License Class: B ,C29 C5.3 License No.: 455121
Date: . !. ontractor:
r OWNER -BUILDER DECLARATION
I hereby affirm under penalty of p rjury iha am exempt from the Contractor's State License Law forthe
following reason (Sec. 7031 .5, B 'ness a Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, o air 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).:
(_) 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.).
(_ 1 .1, 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:
LQPEM11T
Owner:
RAFFI JENANIAN
79883 PARKWAY ESPLANADE
LA QUINTA, CA
LA QUINTA, CA 92253
Contractor.
TOPMAN BUILDERS
P.O." BOX 10202
PALM DESERT, CA 92255
(760)772-7296
Lic. No.: 455121
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/06
Nfr i
JUN 2 9 2006
CITY OF LA QUINTA
FINANCE DEPT.
WORKER'S COMPENSATION bECLARATION . .
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 CLARENDON Policy Number 01KR-0030-842
I certify that, in the performance of the work for which this permit is issued, I•shall notemploy any
person in any manner so become subject to the workers' compensation laws of California,
and agree that, if I sho d beco su ctto the workers' compensation provisions of Section
3700 of the Labor C , I shall rt i h comply with those provisions.
Date:�1,�.pplic� an71
t J
WARNING: FAILURE TO SECU E WORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C MINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. IN ADDI N TO T E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR!CO REST, 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 constr io nd hereby authorize representatives
of this county to enter upon the above-mentioned property f inspecti nbi rrposes. _
Signature (Applicant or Agent): g
Application Number .
. . . . 06-00002523
Permit. . . . BLDG -POOL PERMIT
Additional desc .
Permit Fee . . . .
297.50 Plan Check Fee
193.38
Issue Date . . . .
Valuation . . .
. 32000
Expiration Date
12/23/06
Qty Unit Charge
Per
Extension
BASE FEE
252.00
7.00 6.5000
THOU BLDG 25,001-50,000
45..50
Permit .. . . MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
'Issue Date
Valuation . . . .
0
Expiration Date
12/23/06
Qty Unit Charge,
Per
Extension
BASE -FEE
-.15..00
1.00 11.0000
---------------------------
EA MECH FURNACE.>100K
------------------------------------
11.00.
------- - - - - -- a
Permit ELEC.POOL PERMIT -RES
Additional desc'.
Permit Fee . .
45.00 Plan Check Fee
11.25
Issue.Date
Valuation
.0'
Exp'ir.at•i6h Date
12/23/06
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 .
12`/23/06
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 ALARMS/BARRIERS SHALL BE IN
LQPM11T
Application Number . . . . . 06-00002523
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURES NOT INCLUDED.
Fee summary Charged
----------------- ----------
Permit Fee Total 401.50
Plan Check Total 219.38
Grand Total 620.88
LQPERMIT
Paid Credited Due
---------- ---------- ----------
.00 .00 401.50
.00 .00 219.38
.00 .00 620.88
Bin #
City of La .Q uinta
Building & Safety Division
P.O. Box 1504, .78-495 Calle Tampico
La Quirita, CA 92253 - (760) 777-7012
Building Permit Application and.Tracking Sheet
Permit #
Project Address:'
Owner's Name:
A. P. Number:
Address:'79 •� �W �,E
Legal Description:
Contractor. �.p M1P�t i I3U
City, ST, Zip:
(A • S2z�
Telephone:. -7(p, •"j 3a5
Address: •Sl0`i L..i P. )Coz.
Project Description:
City, ST, Zip .aan ►J 1: 11
Telephone:
City Lic. #:
State Lic. # :
Arch., Engr., Designer;
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
' Cor6mction Type: Occupancy:
Project type_ (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: 6-" •_1195- -735
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE,
#
Submittal
Req'd
Rec'd
TRACKING -
PERMIT FEES
Plan Sets
Plan Check submitted .
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked. up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading.plan'
2°d Review, ready for corrections/issue
Electrical .
Subcontactor.List
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<ssue.
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
a