05-3021 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00003021
81148 DESERT SAGE CT
764-270-999-150 -300234-
POOL'- RESIDENTIAL
MEDIUM HIGH DENSITY RES
18000
a/\/r)CA'CT01f
Architect or Engi
T4:&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
D D
JUL 2 1 20Q5
nee :
CITY OF LA QUINTA
FINANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a li en under provisions of Chapter 9 (commencing with
Section 7000) of peetlsia f the Busin sand r ssi mals Code, and my 'cQpc@,is in fyl ,tgrce and effect.
License Class: license
License No.: ��Ef X
D - 2 'ontra
OW -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).:
(_ 1 1, 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.).
(_) 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 contractorls) 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:
LQPERAITT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: ' 7/19/05
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
-----------------------------------------------
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. M workers' compensation
insurance carrier and policy number are: _
Carrier C8 C27 C29 C53 Policy Number 4-1
-
_ I certify that, in the performance f e work for which this permit is issued, I shall n employ any
person in an414uld
to a subject to the workers' compensation laws of California,
and agree theco e s ct to the workers' compensation provisions of Section
37tOof thes II rt comply with those provisions.
Dai;�—$DPlic
WARNING: FAILURE TO SERS' C ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 becomeAdv if work is not commenced
within 180'days from date of issuance of such permit,f work for 180days will subject
permit to cancellation.
I certify that I have read this, application and state that the ab infr t. I agree to comply with all
city and county ordinances and state laws relating to bud in c strreb authoriz .representatives
of this count o en rruuppon the above-mentioned prop y r i spa.
Date: Z/ Signature (Applicant or Agent):
Application Number . . . . . 05-00003021
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
189.00
Plan Check Fee
122.85
Issue Date . . . .
Valuation . . .
. 17420
Expiration Date..
1/15/06
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
16.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
144.00
Permit . .. .
MECH POOL
Additional desc .
Permit Fee . . . . .
26.00
Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
1/15/06
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
1/15/06
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
1/15/06
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
LQPERMIT
Application Number . . . . . 05-00003021
Permit . . . WALL/FENCE PERMIT
Additional desc . . .
Permit Fee 17.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 580
Expiration Date . . 1/15/06
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 2.0000 HND BLDG 501-2,000 2.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. 20 L.F. 6' BLOCK WALL
CITY STANDARD & 5 L.F. 4' EQUIPMENT
BLOCK WALL, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE PRIOR
TO PRE -PLASTER INSPECTION.
Fee summary Charged
----------------- ----------
Permit Fee Total 310.00
Plan Check Total 148.85
Grand Total 458.85
LQPERAIFT
Paid Credited Due
---------- ---------- ----------
.00 .00 310.00
.00 .00 148.85
.00 .00 458.85
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
3DB
Project Address: �—
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: CL l O Ls �
O
Tel ho
phone:
ne:
Address: C)
Project Description: .�
City, ST, Zip: 14 ii,;( 3 0
DooL �5 1- � c u 0 (-t
Telephone: p
RCity
State Lic. # Lic.
Arch., Engr., Designer:
Address: �.
/
Q01z 6 / 8/ 4 0&k w �t L c
City, ST, Zip:
e:
Telephone: hon
#:
State Ltc.
FENNO=
Construction Type: Occupancy:.
YP
Project type one): Ne Add'n Alter Repair Demo
Name of Contact Person: LAN ,J r1455, C-
Sq. Ft.:
—7
# Stories:
# Units:.
Telephone # of Contact Person: - :�. , / � ��
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
7 IB[
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
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d 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
SB 0