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12-0210 (RPL)t' - _ P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 cei`�t 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/07/12 Application Number: �12--0000 Owner: Property Address: 52725 HUMBOLDT BLVD EAST OF MADISON LLC 'APN: 767-200-091-14 -34968 - PO BOX 1482 Application description: POOL - RESIDENTIAL LA QUINTA, CA 92247 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Contractor:.rjl� n Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, INC — U 83695 AVENUE.45 1� ` /Q� (tfiit INDIO, CA 92201 MAR <� 2012 f LI (760)342-3612 /P, Lic. No.: 614611 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — LICENSED CONTRACTOR'S DECLARATION WORKER'S. COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Licen a Class: C53 License No.: 614611 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 1 'e� V ISSIIP.d. ate: ✓ �� ontractor: (Y}�'�jPj j��S �5 �1 i1 t �(�- h 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 OWNER -BUILDER. DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier COMMERCE WEST I Policy Number 00330843590 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to - _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. that he or. she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by r 1 �(� _ „ _ �� n� �`• any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: � "' Applicant:-�''YfL�TCJ !- (_ I 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 � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ' and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 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. , 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 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 building construction, and hereby authorize representatives of this csu�ty to enter upon the above-mentioned property yffor �inspection purposes. Bate: nature (Applicant or Agent): F Application Number .. . . . . 12-00000210 Permit . . . BLDG POOL PERMIT Additional desc. Permit Fee . . . . 252.00 Plan Check Fee 163.80 Issue Date . . Valuation 25000 Expiration Date 9/03/12 , Qty Unit Charge Per' Extension BASE FEE 45.00 23.00 9.0000 ---------------------------------------------=--- THOU BLDG 2,001-25,000 ------=-------------------- 207.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/03/12 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 9/03/12 - 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 9/03/12 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, FIRE PIT, FRONT WATER FEATURE. LQPERMIT LQPERMIT Application.Number . . . . . 12-00000210 ---------------------------------------------------------------------------- Special Notes and Comments ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee.summary Charged Paid Credited Due Permit Fee Total 356.00 .00 .00 356.00 . Plan Check Total 189.80 .00 .00 189.80 Other Fee Total 1.00 .00 .00 1.00 Grand Total 546.80 .00 00 546.80 LQPERMIT I I a 0 �l 0. 0 0 iLu lop& It UON 0, 6" Bin # City of La Quinta Building 8r 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: !Sp - . A. P. Number:— (� Owner's Name: i* Address: Legal Description: City, ST, Zip: Contractor: C � S •Zc>.....„> Telephone: •rz'�� '��:irrhgr;��a;^��xf�+}3 Address: 8 c7 — �C�S S Project Description: 5' City, ST, Zip: T Telephone: 7z �-` t: nwaf` City Lie. #, State Lic. # : CIS 3 6 ,611 Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: •; Name of Contact Person: I” �` Construction Type: Occupancy: project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone* of Contact Person: Estimated Value of Project: 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. Called Contact Person Plan Check Balance Title 24 Calcs. Plans .picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2° Review, ready for corrcctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval - Plans resubmitted Grading 1N HOUSE:- '"' Reylew, ready for correctionvIssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees