09-0608 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4 -ht 4 X� & Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09700000608 'I LAIA4EL VAC1-1
� 4 9 Q =s
�
Property Address: 4—WRaE% Ails ;__'6 5
9 _ 5— a"f 5 Y r
APN:
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 14000
ADolicant:
Architect or Enqineer:
110
LARATION
of Chapter 9 (commencing with
y License is in full force and effect.
166518
4TION
tor's State License Law for the
r 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).:
(_) 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 whobuildsor 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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 contractorls) 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:
NELSON
55245 LAUREL VAL
LA QUINTA, CA 92
Contractor:
GARY & SONS
67621 CACTUS AP
DESERT HOT SPRIN
(760)251-8945
Lic. No.: 866518
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/10/09
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
e��11 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 DELOS INS CO Policy Num r 02DKRM220010101
I certify that, in the performance of the work f which this permit is issued, I shall not employ any
person in any manner so as to become subi ct to the workers' compensation laws of California,
and agree that, if 1 shou become subje t t the workers' compensation provisions of Section
3700 of the Labor I shall forthwi c mply with those provisions.
plicant:
WARNING: F ILURE TO SECU E WORKERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 Quima, 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 ' f work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information . orrect. I agree to comply with all
city and county ordinances and state laws relating to buildin',�l,lconstruction, a ereby authorize representatives
of this co4my 1P enter upon the above-mentioned propeg:y Ya` inspection pur o s.
(Applicant or Agent):
Application Number . . . . . 09-00000608
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 153.00 Plan Check Fee 99.45
Issue Date . . . . Valuation . . . . 14000
Expiration Date 12/07/09
Qty Unit Charge Per Extension
BASE FEE 45.00
12.00 9.0000 THOU BLDG 2,001-25,000 108.00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date Valuation . . . . 0
Expiration Date 12/07/09
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 12/07/09
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 . . . . 27.00 Plan Check Fee 6.75
Issue Date . . . . Valuation 0
Expiration Date 12/07/09
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.0000 EA PLB FIXTURE 6.00
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
SPA, BBQ, FIREPIT & 8 L.F. 4' EQUIPMENT
LQPERMIT
Application Number
. . . . .
09-00000608
----------------------------------------------------------------------------
Special Notes and
Comments
SCREEN WALL, CITY
STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION.
----------------------------------------------------------------------------
Other Fees . .
. . . . : .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
----------
Paid
----------
Credited
--------------------
Due
Permit Fee Total
251.00
.00
.00
251.00
Plan Check Total
123.95
.00
.00
123.95
Other Fee Total
1.00
.00
.00'
1.00
Grand Total.
375.95
.00
.00
375.95
LQPERMIT
r-mt Dom
NELSON
RSI -
Outdoor
Patio
Zero Lot Luu., Shared
common wall
CITY OF LA QUI . NT
BUILDING & SAFETY DE71---,
FOR CONSTRUCTiON
DATE 6" /0 - 0 9 BY 9F- I
and amt boulders. in Grasslcomrnon Area
o
+14° Fire Mt
Shared
W -O* N to
Stone 24" Tcmhg •Shclf
Patio
Equipment Sound
(14'X4] with
Wall with qbjc,,-0
Umbrella Sleeves.
FIntsh to match
reskignee
Existing
Patio column
Outdoor.
C:1
Spa E* 'be. b
Ilmyeent shall. Pentair
C'0okhig..C,6ht4r.--&qlth 50,
Pool nfodurts.
Gounter#oP. Stucco
1*ISPCrPlo variable spead_
vom`:t& or to
'Mas tertawnp 400
lem" Clear filter
mcUh
r-mt Dom
NELSON
RSI -
Outdoor
Patio
Zero Lot Luu., Shared
common wall
CITY OF LA QUI . NT
BUILDING & SAFETY DE71---,
FOR CONSTRUCTiON
DATE 6" /0 - 0 9 BY 9F- I
°�
05
5
P.O. BOX 1504
BUILDING & SAFETY DEPARTMENT
OFT19�
78-495 CALLS TAMPICO
(760) 777-7012
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
September.21, 2009
Ms. Esther Sanchez
Riverside County Assessor's Office
3255 E Tahquitz Canyon Way, Ste 114
Palm Springs, CA 92262-6962
Dear Ms. Sanchez,
Please be advised of an address correction for the previously issued permit, #09-
.608. The application formerly addressed as 54-961 Laurel Valley, APN: 775-
120-058 should be corrected in your files to 55-245 Laurel Valley, APN: 775-181-
080.
Please note this change and contact me directly at (760) 777-7084 if I may be of
further assistance.
Sincerely,
Kay Hensel
Counter Technician
a
1
p o:., is
..,
Qty of La QuInt'a
• 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 # , ^
p lY
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Project Address: �r ••` Ll
A. P. Number:Address:
Legal Description:
Owner's Name: AlJ
S '''-6
City, ST, Zip: L
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Contractor
>
4�'
Telephone:
Address: QG�U _
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City, ST, Zip: �A/L C �,
Project Description: -
L�J 2UC•�r on.
` Q :+fr•�::::p:vti93<'': ''i}:;x:: it ter:.
Telephone: C'o (� ` ;,.:::. }::,::.*,,,::::;�:• ..;;}
State Lic. # : City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: sf�. „�,,.«..,n .-,.•;..}�; •cam.. .}
c
State Lic. #: f h `•✓ilk{�'
-
Construction Type: YP Occupancy.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: !2t
Sq. Ft.: # Stories: #Units:
Estimated Value of ProjMOO—(
WRITE -BELOW THIS LINE
Telephone # of Contact Perso
APPLICANT: DO. NOT
#
Submittal
Req'd'
Recd
TRACIUNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Truss Cales.
Called Contact Person
Title 24 Calcs.
Plans picked no
-
Construction
Mechanical
Flood plain plan
Plans resubmitted
Grading plan
2"a Review, ready for correctionsRssue
Electrical
Plumbing
S.M.I.
Grading
$ubcontactor List
Called Contact Person
Grant Deed
Plans picked up.
H.O.A. Approval
Plans resubmitted
IN HOUSE:-
7rd Review,.ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks: Appr
Date of permit issue
School Fees
Total Permit Fees