09-1265 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 XP Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00001265
Property Address: 60932 DESERT ROSE DR
APN: 764-270-999-187 -300233-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 27000
Applicant: Architect or Engineer:
LI NSED CONT
T R'S DECLARATION
I hereby affirm under penalty of perjury that am licensed ovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu es d Professioo e; and my License is in full force and effect.
License Class` C 3-053 n No.: 935936
'Date: _�/, jq' ` Contra�ofpuerjury
7rofessions
ER,BUILDER DECLARATION
I hereby affirm under penalty thatmpt from the Contractor's State License Law for the
following reason (Sec. 7031.ness anCode: 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 build or
improve for the purpose of sale.).
(_)
1, 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:
LQPERA11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/18/09
Owner:
STRILLCLHUCK
60932 DESERT ROSE DRIVE
LA QUINTA, CA 92253
Contractor: D�
CLASSIC POOLS & 6
79461 AVENUE 40T
BERMUDA DUNES, A 2204 -fl
\,
Lic. No.: 9359 6 6Y.L IF, (9
---------------------------------------------
WORKER'S COMPENSATION DECLARATT6N
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 p rmit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NATIONAL INS Policy Number 9090117388
I certify that, in the performan o the work for wh' h t is permit is issued, I shall not employ any
person in any manner so a o come subject t the orkers' compensation laws of California,
an agree that, if I should ec a subject tot wor ers' compensation provisions of Section
3 00 of the Labor Code, sh forthwith co ply wi those provisions.
Date: Applicant:
WARNING: AILURE TO SECURE WORKERS' CO NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TOT /.E ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INT ST, 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 whos request and for
whose benefit work is performed under or pursuant to any permit issued asye esult of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify an hol harmless the City
of La Quinta, its officers, agents and employees for any ac[ or omission �el e� o he work being
performed under or following issuance of this perm' 1
2. Any permit issued as a result of thiM
o a omas null and void/if ork is of commenced
within 180 days from date of issp m t, or cessation,of orkr fo 180 days will subject
permit to cancellation.I certify that I have read this application and stbo a nfarmation is or act. I a ree to comply with all
city and county ordinances and state laws relang cb struction, a h eb aut orize representatives
of this cou y o enter upon the above-mentiofor nspection p p
Date: ` Signature (Applicant or A
Application Number . . . . . 09-00001265
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check
Fee
6.50
Issue. Date . . . .
Valuation
0
Expiration Date
6/16/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH
FURNACE >100K
11.00
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
265.00
Plan Check
Fee
172.25
Issue Date . . . .
Valuation
. . .
. 27000
Expiration Date
.6/16/10
Qty Unit Charge
Per
Extension
BASE
FEE
252.00
2.00 6.5000
----------------------------------------------------------------------------
THOU BLDG
25,001-50,000
13.00
Permit . . .
ELEC POOL PERMIT
-RES
Additional desc .
Permit Fee . . . .
45.00
Plan Check
Fee
11:25
Issue.Date . . . .
Valuation
. . .
. 0
Expiration Date
6/16/:10
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
6/16/10
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'
Permit . . . . . . WALL/FENCE PERMIT
LQPEUIIT
Application Number . . . 09-00001265
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 15.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 288
Expiration Date
6/16/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and
Comments
POOL/SPA, 18 L.F-.
4' EQUIPMENT
ENCLOSURE, CITY STANDARD, BBQ INCLUDES
5
L.F. 3/4" GAS LINE.TOTAL: 100 LN FT GAS
LINE TO EQUIPMENT
2" ALARMS/BARRIERS
SHALL BE IN PLACE
AT PRE -PLASTER
INSPECTION. 2007 CODES.
- ----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary
-----------------
Charged "Paid
----------
Credited
--------------------
Due
Permit Fee Total
----------
384.00
.00 .00
384.00
Plan Check Total
198.25
.00 .00
198.25.
Other Fee Total
2.00
.00 .00
2.00
Grand Total
584.25
.00 .00
584.25
LQPERMIT
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 #
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Project Address: &Z ,
Owner's Name:CA I 1 C _J' l UG `C
A. P. Number: �, O
Address: L. 6 06c
Legal Description:
City, ST, Zip: ZANi7 -fes
Contractor(>:'>rs''a
CASSI�, ,�%(
Telephone:
Address: C Jp t 40
Project Description: ew 44 S
City, ST, Zip: E: C)A 1 C %-1 d�d
1 q ne
Telephone: Q _i:>•'sF
P p
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v:sss:. pi's.• .:s<u'r::t:.;: >s3:s,':;;:y::za:».
.City
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H
State Lic. # : ?s
Lic. #.-
6
Arch., Engr., Designer.
JT
Address:
GJod To V .2"
City, ST, Zip:
Telephone:
State Lic.
>:>::r:«<:>` >t` {€\>:;:>:
:...�u....:.. <" ::::...
�;K $:� ixl/�, <�s»h:
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Construction Type Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: i/j
Sq. Ft.:
# Stories:
# Units:
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Telephone # of Contact Person: --�
Estimated Value of Project:�2:Z,4200
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
�Z' (�
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''a 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