13-1400 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001400
Property Address:
57667 INTERLACHEN
APN:
762-230-003- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
49200
Ta�/ 1
4491ba
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine a sionaIs Code, and my License is in full force and effect.
License ass: C27-053 Licen 964474
Date: �+ Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury at I m exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business rofessions 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 70001 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 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: i 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 ISec. 3097, Civ. C.).
- Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/04/13
Owner:
BOB YOUNG
57667 INTERLACHEN-
LA QUINTA, CA 92253
(
NOV 1 A Z013
Contractor:
DESERT OUTDOORS INC
78065 MAIN ST STE #205 FIWgNCEp Pr
LA QUINTA, CA 92253
(760)399-9600
Lic. No.: 964474
-----------------------------------------------
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
ssued.
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 AMTRUST INS CO Policy Number WWC3072369
I certify that, in the performince of the work for which this permit is issued, I shall not employ any
person in any mann so s to become subject to the workers' compensation laws of California,
and agree that, if I oul become subject to the or
compensation provisions of Section
3700 if the or e, shall forthwith comply with those provisions.
Date: -tot �4ppl✓icant:
WARNING: FAILURE TO SECURE W ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI L ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION 0 HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, EREST, 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 t e ove information is correct. I agree to comply with all
city and county ordinances and state laws relating to bu din lotion, andherauthorize representatives
of th' ounty to enter upon a above-mentioned prope fo 'ns coon purposes.
Date % Signature (Applicant or Agent):
Application Number 13-00001400
Permit . . . ELECTRICAL 2013
Additional desc
Permit Fee . . . . 23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 5/03/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
----------------------------------------------------------------------------
23.83
Permit . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 5/03/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date .. 5/03/14
Qty Unit Charge Per _
Extension
1.00 11.9200 LS PLBG GAS SYS,
--------------------------- ------------------------------------------------
1-4 OUTLETS
11.92
Permit WALL/FENCE PERMIT
2013
Additional desc .
Permit Fee . . . . 47.19
Plan Check Fee
.00
Issue Date . . . .
Valuation
49200
Expiration Date . . 5/03/14
Qty Unit Charge_Per
Extension
1.00 47.1900 LS MISC WALL,
FIRST 100 LF
47.19
---------------------------------------------------------------
Special Notes and Comments
-------------
POOL, SPA, FIRE PIT, BBQ AND FIREPLACE
WITH 5 LF OF 5 FOOT HIGH EQUIPMENT WALL
[150 L.F. OF 1 1/2 INCH GAS PIPING].
EQUIPMENT SHALL BE INSTALLED IN
ACCORDANCE WITH MANUFACTURER
SPECIFICATIONS. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER
LQPERMIT
Application Number
. . . . .
13-00001400
------------------------------
Special Notes and
----------
Comments
-------------
•-----------------------
INSPECTION. 2010 CALIFORNIA BUILDING
CODE.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK,
ELECTRICAL
23.83
PLAN CHECK,
POOL
97.24
PLAN CHECK,
PLUMBING
23.83
PLAN CHECK,
WALLS
60.06 '
Fee summary
Charged
Paid
----------
Credited
--------------------
Due
-----------------
Permit Fee Total
----------
261.69
.00
.00
261.69
Plan Check Total
.00
.00
.00
.00
Other Fee Total
205.96
.00
.00
205.96
Grand Total
467.65
.00
.00
467.65
LQPERMIT
Bin #City
of La Quinta
Building a Safety Division
P.O. Box 1504,78-495 Cane Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
7
Project Address:
Owner's Name: 1�pn —1 QU
A. P. Number.
Address: `97w—1 e
Legal Description:
City, ST, Zip: LA- qv% t ' C a
Contractor: —T
Telephone-- ,.
Description:
Address: ? j(OS db— ' 2p5Project
City, ST, Zip: L A l3
` A4 IL ,�
Telephone: , 3 hpt j
G �,
City Lia
• �G /' G �..
State Lic. # 9
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lie. #{:
Construction Type: Occupancy:
project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
Y Submittal Req'd Recd TRAC MG PERMrr FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Caics.
Called Contact Person
Plan Check Balance
Title 24 Cake.
Plane picked up
Coustraction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.NLL
H.O.A. Approval/
Plans resubmitted
Grading
1!N HOUSE:-
.
'^° Review, ready for correedonslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A,LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
OF LA Q! RITIWJ
Willi I
l I" niKin 9 CA rC-r% ir%r-�.�
Total Permit Fees
APPROVED
FOR CONSTRUCTION
DATE By S