07-0110 (ELEC)P.O. BOX.1504
78-495 CALLE TAMPICO
LA 'QUINTA, CALIFORNIA 92253
T4w't 4 4 Qulk&
Application Number: 07-00000110
Property Address: 79100 KAYE CT
APN: 604-371-006-98 -27899 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6000
Applicant:
Architect or Engineer:
. IIA,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t I am license der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine an rofessionals ode, and my License is in full force and effect.
License Class: C8 C53 icense No.: 431055
r
t. Date"f ) r"/ Contractor:/
T�OWN - UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exe 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 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 t6 -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, hqwever, 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.).
(_ I I am exempt under Sec. , BAP.C. for this reason
Date: Owner: 1
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:
1
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/11/07
Owner:
JEFF & ELIZABETH MOE
79-100 KAYE CT.
LA QUINTA, CA 92253
(
Contractor.
PARZINSKY POOL, INC. ICH
P.O. BOX 897 JAN 1? _. Jfy
PALM SPRINGS, CA 92263
(760) 324-5827 CITy0F
Lic. No.: 431055 911JA LA QUINTA
^_____
WORKER'S COMPENSATION DECLARATION
1 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.
1 -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 STATE FUND Policy Number 0000328-2006
1 certify that, in the performa he work for which this permit is issued, I shall not employ any
person in any manner o as to beco ubject to the workers' compensation laws of California,
and agree that, if I shoul become subje to the workers' compensation provisions of Section
3700 of the Labor Co 'sl. all forthwi comply with those provisions.
rDate: ( Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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 info r n is correct. I agree to comply with all
city and county ordinances and state laws relating to building cojj++� etion, a hereby authorize representatives
of this county to ent�er—upon the above-mentioned property for fis ion pu,po as. .
Date: 1 Signature (Applicant or Agent): M
L-- '-
C
J
LQPERMIT
Application Number .
. . . . 07-.00000110
Permit . . .
BUILDING PERMIT
Additional desc . .
-
Permit Fee . . . .
81.00
Plan Check Fee
52.65
Issue Date . . . .
Valuation . . .
. 6000
Expiration Date
7/10/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
4.00 9.0000
---------------------------------------------------
THOU BLDG
2,001-25,000
------------------------
36.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
17.25
Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
7/10/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00 1.7500
----------------------------------------------------------------------------
PER ELEC
DEVICE/FIXTURE 1ST 20
2.25
Permit. . .
PLUMBING
Additional*. desc .
Permit Fee
18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
7/10/07'
Qty Unit Charge
Per
Extension t
BASE
FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
--7 -------------------------------------------------------------------------
Special Notes and Comments.
BBQ PER APPROVED PLAN
ONLY.
"
Fee summary Charged
---------------------------
Paid Credited
Due
Permit Fee Total
----------
116.25
--------------------
.00 .00.
116.25
Plan Check Total
61.46
.00 .00
61.46
Grand Total
177.71
.00 .00
177.71
F
Bin #
City of La Quinta
Building U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico.
1,110.LaQuinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 7 i 0c) ra ` u A� Owner's Name: '
,�c �- - I ;
A. P. Number: Add
#
Legal Description:
cess. 19 _ i pa K F.. 4 1 = C-4
City,'ST, Zip: L Jr C a qi-L 3
Telephone:
Project Description:
(� i
Contractor. �� �� �z . L j _P0 c., 1 S
Address: p `J. o x
City, ST, Zip: Y a I n S ;a '; C 4% C4
Telephone: (-I , ) 3 2_y - 51.3 7 .1
State Lic. # : y3 10 g S City Lic. #:
Arch., Engr., Designer:,
Item
Plan Check Deposit
Plan Check Balance
Address: Q . O . `l �1
Structural Cates.
Cita. ST, Zip: p.* i .� S. iz 97_-LC,3
Telephone: �7.> 3 �i : 5 27
State Lic. #: LI 3 k Off-, j
Name of Contact Person: C r
Construction Type: Occupancy:
p cy:
Project type (circle one): New ..Add'n Alter Repair Demo
Sq. FL:
#Stories:
#Units:
Telephone # of Contact Person: 2.75
Estimated Value of Project: G , 000'
Energy Cates.
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd : •
Reed
TRACIQNG
PERMIT FEES
Plan Sets
Pian Check submitted /SO
Item
Plan Check Deposit
Plan Check Balance
Amount
Structural Cates.
Reviewed, ready for ft% ections
Truss Calcs.
Called Contact Person
Energy Cates.
Plans picked up
Construction
SoT.g
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
Subcoutactor List
Grant Deed
V Review, ready for correcdonsrusue
Called Contact Person
Plans picked up
Electrical
Plumbing
S.M.I.
�i 1CCWG
0
H.O.A. Approval
Plans resubmitted
Grading
Developer Impact Fee
A I P P.
IN HOUSE:-
Review, ready for.correctionsrusue
Planning Approval
Called Contact Person
Pub. Wks. Appr
of ermit issue
CITY O C ' p U
IN FA
T
School Fees
BUILDIING &LS�AFETY D T,
Total Permit Fees
-DATE--.By
F �
93 �+�� R �b �f lY�
# j
"Stone o r Tile c o 1_t r. t e r
Stt.1CCO or C I
Stone Veneer _
j
} 00
A 9 -JF I Oul; E DgO
swi fish ,W(1?r, Pr 00 f,'
I're-Hung S/S Doc,— > B T J ----- --- --- - -- ----
ED
LE�nc� t Tr IeS
j r,'-ree jtatlCllt� j_ Kjfr:f"1en Fy_rOr't Eli'3tiOt?
E
at
each 'dVqy utli
r C c) ? t_iul-}I
6 8x10 CMU; GROUT ELLIS V!ITH :STEE'_
#4 BARS '', FRT NT 4 ^, T YP',
rt. - LL
1 I
A i i r p
BBQ 1_AYC.'Ul S triAY `vAWY
r ; n. i— 1
nJU; I;�lv
SIZE a REIP�aI-. �t �Pc 1YCit,�a.(_
!tw_-,,h SurTar:P 1
�...._.—..ter fY..�..,..�_....�—��.....•�..�.._.....�.-..__..._ ,.o.._.,...� '� � a. _ ____._� � -
4 -�))
#- + BAR', turn. A C).i}, 'f �; I,I lel �iwl� ti
----
.F.___e_e_._ `tandinc Kits_;en-- Foundation Plan
I �,
�- a >_ ,-• .� �.-�-n--� �._ `._- .��
t
J
2"
a Y
l
F
i
r 51A I IM 2
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00000110
Property Address: 79100 KAYE CT
APN: 604-371-006-98 -27899 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6000
Applicant: Architect or Engineer:
a�
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that 1 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: C8 C53 License No.: 431055
Date: Contractor:
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 then five hundred dollars ($500).:
(_ 1 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:
LQPERMIT
Owner:
JEFF & ELIZABETH MOE
79-100 KAYE CT.
LA QUINTA, CA 92253
(
Contractor:
PARZINSKY POOL, INC., RI
P.O. BOX 897
PALM SPRINGS, CA 92263
(760)324-5827
Lic. No.: 431055
VOICE (760) 77.7-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/11/07
D°
JAN 12 2001,
CITY 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.
_ (-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 STATE FUND Policy Number 0000328-2006
_ I certify that, in the performance of the work for which this permit is issued, 1 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 provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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 Quints, 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.building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Application Number . . 07-00000110
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
81.00
Plan Check Fee
52.65
Issue Date . . . .
Valuation . . .
. 6000
Expiration Date
7/10/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
4.00 9.0000
-----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
36.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
17.25
Plan Check Fee
4.31
Issue Date
Valuation . . .
. 0
Expiration Date
7/10/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00 .7500
----------------------------------------------------------------------------
PER ELEC
DEVICE/FIXJ'URE 1ST 20
2.25
Permit. . .
PLUMBING
Additional*. desc .
Permit Fee . . . .
18.00
Plan Check Fee
4.50
Issue Date
Valuation . . .
. 0
Expiration Date
7/10/07
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 PER APPROVED PLAN
ONLY.
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
----------
116.25
---------- ----------
.00 .00.
116.25
Plan Check Total
61.46
.00 .00
61.46
Grand Total
177.71
.00 .00
177.71
WPERMrr -