06-1903 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T -&t 4 4 Q"
Application Number: 06-00001903
Property Address: 48800 LEGACY DR
APN: 658-130-011-1 -31379 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
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 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C53License No.: 856835
Date:s::��7i;// 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 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 buildor
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 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:
LQPERi\1IT
Owner:
CENTEX HOMES
2275 CORPORATE CIR #230
HENDERSON, NV 89074
Contractor:
VACATION POOLS
83900 AVE 45 ST
INDIO, CA 92201
(760)775-0468
Lic. No.: 85683
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
D Q 0
I
E T 7MAY 4 2006
5' CITY OF LA QUINTA
FINANCE DEPT.
Date: 5/10/06
-----------------------------------------------
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.
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 STATE FUND Policy Number 1795938-2006
I certify that, in the performance of the work for which this permit is issued, I 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
3770//0 of the Labor Co , I h f fort h comply with those provisions.
Datetr4-T-Z OApplicam: T
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 (5100,000). 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, an hereby authorize representatives
of this county to enter upon the above-mentioned property .i ction pu ses.
DateS�ignature (Applicant or Agen.- .!
LQPCRDIIT
Application Number 06-00001903
Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 207.00 Plan Check
Fee
134.55
Issue Date . . . . Valuation
20000
Expiration Date 11/06/06
Qty Unit Charge Per
Extension.
BASE FEE
45.00
18.00 9.0000 THOU BLDG 2,001-25,000
---------------------------=------------------------------------------------
162.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 22.50 Plan Check
Fee
5.63
Issue Date . . . . Valuation
.. . .
. 0
Expiration Date 11/06/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA ELEC PWR APP >1 TO <=10
7.50
----------------------------------------------------------------------------
Special Notes and Comments
FOUNTAIN #43 WITH UTILITY VAULT. POWER
FROM 77-790 HERMITAGE DR FOR EQUIPMENT
--------------------------------------------7-------------------------------
Other Fees . . . . . STRONG MOTION (SMI)
- RES.
2.00
Fee summary 'Charged Paid Credited
Due
Permit Fee Total 229.50 .00
.00
229.50
Plan Check Total 140.18 .00 ..00
140.18 .
Other Fee Total 2.0.0 .00
.00
2.00
Grand Total 371.68 .00
.00
371.68
LQPCRDIIT
Bin #
Permit #
Project Address:
A. P. Number:
Contractor: VACArr ta+
Address:
City, ST, Zip:
Telephone:
State Lic. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic..#:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Cales.
Flood plain plan
-Grading.plan,
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:
Planning Approval
Pub. Wks. Appr
School Fees -
i�jv ✓�
L'
City of La Quinta,
Building u Safety Division
P.O. Box.
1504, 78-495 Calle Tampico
La Quinta, CA 922.53 -.(760) 777-.7012
Building Permit Application and Tracking Sheet
±TL-� Owner's Name: ell, I
Address:
City, ST, Zip: Art I"
L ,j L Telephone: ( .
Project Description:
Total Permit Fees
EA -
Construction Type:
Occupancy,
Project type (circle one):
New Add'n Alter 'Repair Demo
Sq. Ft.:
#Stories:
# Units:
Estimated Value of Project:
APPLICANT:
DO NOT WRITE -BELOW
THIS UNE
Rec"d
TRACM NG
PERMTT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans, picked, up
Construction
Plans resubmitted
Mechanical
2°' Review, ready for•correctiond issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Flans resubmitted
Grading
7rd Review, ready for correct* s/issue
d
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
EA -