07-2255 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002255
Property Address: 45240 DEBBIE DR
AM 604-372-002-412 -278.99 -
Application description: POOL RESIDENTIAL
Property Zoning: . LOW DENSITY RESIDENTIAL
Application valuation: 15500
Tiht 4 0
VOICE (760) 777-7012
FAX. (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/07/07
Owner:
KINDER RESIDENCE,
45-240 DEBBIE DR.
LA QUINTA, CA 92.253
---------------------------------
.Applicant: Architect or Engineer:
- ----------------
LICENSED CONTRACTOR'S DECLARATION
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 P.rofessionals'Code, and myLicense is•in full force and_:effect.
License'Class:-. .. 'License No.:
0111-1-
111 Contractors
V�� OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that Fans exempt from the Contractor's State License Law for the:
following reason (Sec. 7031:5; Businewand 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 applicantfor the:
permjtto file.a signed statement that ficorshe is.licensed pursuant.to the provisions of ihe.Contrectorts State
License Law (Chapter 9 (commencing with Section 7000) of Division3 of ihe,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
anyapplicant for a permit subjects the applicant to a civil penaltyof not more than five hundred dollars ($500).:
1—) I, as owner of the property, or my employees with wsges�as their.,sole:compensation, will do the.work, and
the structure is not intended .or'offered'for sale (Sec. 7044, Business:andProfessions Code:, The
Contractors' State License Lew 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, liowever, the building or improvement.is sold within
one yearoCcompletion, the owner -builder will have the burden of proving that he or'she did not build or
improve_ for the purpose of'sale.).
(
111 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:orimproves thereon; and'whor 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: `� l O 'Q Owner: :'1J l &T-) `I% k IJ Q-SZT
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty�of'perjury that there is;a construction lending agency or the!Performance of the
work for which this permit ivissued (Sec. 3097, Civ. C7.
Lender's Name: -
Lender's Address:: Ii I /Or
LQPERMIT
Contractor:
Owner
AUG 10 2007
---- CITY01FLA
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penahyof'perjury oneof:the following declarations:
I.,have'and,wilfmaintain a certificate -of consent;to self -insure forworkers' 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 3700of 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 Policy Number
I_ -certify that; in the performance of thw work'for which this permit is issued,: 1 shall notemploy 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 provisionsof'Section
3700 of the 'Labor -Code, Cshall forthwith.comply with those provisions.
Date:- Applicant: C k A-rJ [—I.IV C X/
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 (5100.0001..-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 madwto the Director of Building and Safety fora 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 requesvand.for
whose benefit work ii performed under or pursuant to any permit issued as a.resultof 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.employeas for any act or omission related to the work.being
performed under or following issuance of this, permit.
2. Any permit issued as aresult of this: application becomes null,andvoid if workis,not,commenced
within 180 days from date of issuance of such permit, or -cessation of work for 180:days will subject'
permitto cancellation.
I Certify that I flava: read this application and state that the_,above information is correct. I agree'mcomply With all
cityand-aountyordinances and:state laws relating to buildingconstruction, and hereby authorize representatives
of thiscountytoey
enter upon the above-mentioned property, inspection purposes.
Date: 1014-1
`. Signature (Applicant or Agent):
Application Number . . . . . 07-00002255
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 171.00 Plan Check Fee 111.15
Issue Date . . . . Valuation. . . 15500
Expiration Date 2/03/08
Qty Unit Charge Per Extension
BASE FEE 45.00
14.00 9.0000 THOU BLDG 2,001-25,•000 126.00
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue bate . . . .
Expiration Date . .
MECH POOL
26.00
2/03/08
Plan Check Fee . . 6:50
Valuation . . . 0
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 .
Issue Date . . . Valuation
Expiration Date . 2/03/08
11.25
0
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
Issue Date . . . .
Expiration Date . . 2/03/08
Plan Check Fee . . 8.25
Valuation . . . . 0
Qty
Unit Charge Per
Extension
BASE FEE
15.00
2.0.0
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 GASPIPE 1-4 OUTLETS
3.00
------------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA,
ALARMS/BARRIERS
SHALL BE IN
LQrERMrr
Application Number . . . . . 07--00002255
------------------ -- -- --
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged
- - - - - - -- - --
Paid
Credited
Due.
- -- --- --- -
Permit Fee. Total 275.00
.00
.00
275.00
.Plan Check Total 137.15
.00
.00
137.15
Grand Total 412.15
i
.00
::00
412.15.
LQMRMff
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATES - 10 ' 07 BY K"
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CITY OF LA QUINTA- SUB -CONTRACTOR LIST
J6B-AODRE-gS I
+itiT } EjLi'55
PERM NUMBER
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OWNER • 1�. C l ACJ �1 Q VJLr- BU{LD..=.
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This.form shalt be
ed on the job with the Iddiag
hmcd* 0nrjd at times In -a cons
larraus tf ace Only pe/sorts appearing on this liSt ar thsit employees are autlmrized to work
on this job: Any changes to this' fest must be approved by, the Building Division prior to cornnmencement of work. Failure to comply W result in a stoppage of work anchor the Voidance
p
of'buJlding erniit. For each a • licable trade, all information re e"ad below must be compleated b applicant. 'On File° Is not an acc o response.,
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Bin #
City. of La Quints
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
. La Quinta, CA 92253 - (760) 777-7012
1 Building. Permit Application and Tracking Sheet
Permit #
206
Project Address:0
Owner's Name: f—I
A. P. Number:
Address: -.Z, , L�R.6 rwr
Legal Description:
City, ST, Zip: (JwWTF� �, LLS3
Contractor: 0 W nl QJ"' L• i (, j�
Address:
Telephone:
Project Description:
City, ST, Zip:
Telephone:
State. Lic. # : City Lic. #:
Arch., Engr., Designer:
4T!'7- F'f
Address:
City, ST, Zip:
Telephone: Construction. Type: Occupancy:
State Lic. # Project type (circle one): New Add'n Alter Repair Demo
Name of ContactrPerson. ((� , J �t nJ p f� f Sq. 'Ft.: --T- --T;—stones: # Units:
Telephone # of Contact Person: Estimated Value of Project: S '40 ,0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"a Review, ready for correctionsrssuc
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A.. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" 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
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified..
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing.their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following.information for your benefit and protection.
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). ,For more specific information about your obligations under State
Law; contact the Department of Benefit Payments and the Division. of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will.not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760) 777-7011
OWNER'S SIGNATURE/DATE
moo, Q -VW -N . C q LZS3
PROPERTY ADDRESS
a1- as ss
PERMIT NUMBER(S)