05-2472 (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:
0
05-00002472
8118,9_DESERT-SAGE ,:CT
764-270-999-149 -300234-
POOL - RESIDENTIAL
MEDIUM HIGH DENSITY RES
17000
CD N Fe,\ C, 7-0 /e
Tiht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
III JUN 212 2009
--------------------------------------------------
LICENSED NTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic se rider provisions of Chapter 9 (commencing with
_Section 7000) of Diy+�n 3 Business and Pr a io Is Code, and�e Ig ii f fkand effect.
�✓ License Iqs : L'' License No.: (p lj
ate: // .i_Contractor: `
OW R -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 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: 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.).
(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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/20/05
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
---------------7-------------------------------
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.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which s permit iisssiiissu�ed�-M� rkers'_compensation
insurance carrier and policy number are:
Carrier C8 C27 C29 C53 Policy Number LC�q
I certify that, in the performance of thew rk for which this permit is issued, I shall note ploy any
person in•any manner so as to becom su le the workers' compensation laws of California,
and agree that, if I sh come subj t to th workers' compensation provisions of Section
3790of tttr labor de, I s all fo th y with those provisions.
ate: �Applicant
WARNING: FAILURE TO SECURE WO <ERS' COMPEo`S�AT�ION C VERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND�61ai7 INES 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 becomes null and 'f work is not commenced
within 180 days from date of issuance of. such permit, or ces t n of rk for 180 days will subject ,
permit to cancellation.
I certify that I have read this application and state chat the ve informati is rre . I agree to comply with all
city and county ordinances and state laws relating to ;Tin onstruction, and h y authorize representatives
of this c n to er upon the above-mentioned p p pay inspec on r
//i�p 0"S
Dat' � �� Signature (Applicant or Agentl: i
Application Number . . . . . 05-00002472
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .. 180.00 Plan Check Fee 117.00
Issue Date . . . . Valuation . . . 16680
Expiration Date 12%17/05
Qty Unit Charge Per Extension
BASE FEE 45.00
15.00 9.0000 THOU BLDG 2,001-25,000 135.00
----------------------------------------------------------------------------
Permit . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee-. 6.50
Issue Date . . . . Valuation 0
Expiration Date 12/1.7/05
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 12/17/05
n 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 . . . . 30.00 Plan Check Fee 7.50
Issue Date . . . . Valuation . . . . 0
T Expiration Date 12/17/05
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
----------------------------------------------------------------------------
Permit . . . WALL/FENCE PERMIT
Additional desc . .
LQPERMIT
Application Number . . . . . 05-00002472
Permit . . . . . . WALL/FENCE PERMIT
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
.
. 320
Expiration Date 12/17/05
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. 20 L.F. 4' EQUIPMENT
BLOCK WALL, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE PRIOR
TO PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited
-----------------------------------------------
Due
Permit Fee Total 296.00 .00
----------
.00
296.00
Plan Check Total 142.25 .00
.00
142.25
Grand Total 438.25 .00
.00
438.25
LQPERAIIT
Bin tK'
City of La Quints
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 it
Project Address:$
Owner's Name:
A. P. Number:
Address:
Legal Description:
r: C s�
City, ST, Zip:
Tele
hone:
Address: C)
Project Description:
City, ST, Zip: C e 10 92-9340
ooL 5A -
Tele hone: pp' p
P O
State Lic. # : 465 60 44 2r City Lic. #:
Arch., Engr., Designer:
s
n•
Address: �'
(� r
t 8 1 �C?L,,�LK Ll.% l�L L.- J� T�
City, ST, Zip:
pC//
92zzlk 4'tl & OP—CO
Telephone: ne:
'
Construction Type:
State Lic. #:
Alter Repairair Demo Project hPa circle one): Add'n
Name of Contact Person: DAN Z1�5v
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:%�� `> = �
Estimated Value of Project: dd
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 Calcs.
Plans picked up
Construction
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.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Mrd 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
P� sPA
C) OL o
f
o "i S�
7� �7 Jaz