09-0431 (RPL)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-70'11
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/08/09
Application Number: 09-00000431 Owner:
Property Address: 60614 DESERT SHADOWS DR VERN MOORE
APN: 764-270-999-8 -300231- 60614 DESERT SHADOWS DRIVE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 12500
nContractor:
Applicant: Architect or Engineer: D �l GARY & SONS
67621 CACTUS APPLE
/ ^ _ HAY L � !�
2{► - DESERT HOT SPRINGS, CA '92241
fit 9 (760)251-8945
CE;'y Lic. No.: 866518
� f
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LICENSED CONTACTOR'S DECLARATION
I hereby affirm under penalty of perjury th I am licensed yr{'_�'der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu4nel and Professi is Code, and my License is in full force and effect.
License Cl1 C53 / icense No.: 866518
�- OR -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am fybmpt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Pro ssions 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).:
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 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 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: IV I IX
LQPERMIT
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 DELOS INS CO Policy Number
I certify that, in the performance of the work for wh' this permit is issued, I shall not employ any
person in any manner so asto become subject t the workers' compensation laws of California,
and agree that, if I sho lit come subject t trkers' compensation provisions of Section
/3700 of the Labor Coje all forthwitf) om ly with those provisions.
WAR NGF FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
MINAL
SUBJECT AN EMPLOYER TO CRIPE LTIES 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 becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of w k for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is rr t. I agree to comply with all
city and coup y or inances and state laws relating to building onstruction, an er y authorize representatives
of this cou%to -ter;;theve-mentioned grope inspection pur ores.
Da �`� Slicant or Agent): /
/ .
Application Number . . . . . 09-00000431
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
144.00 Plan Check Fee
93.60
Issue Date . . . .
Valuation . . .
. 12500
Expiration Date
11/04/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
11.00 9.0000
------------------- 7 ------------------------------------------------
THOU BLDG 2,001-25,000
99.00
=-------
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee ..
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
11/04/09
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
11/04/09
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 . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
11/04/09
.Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000
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EA PLB GAS PIPE 1-4 OUTLETS
3.00
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
Application Number . . . . . 09-00000431
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 15.00 Plan Check Fee
.00
Issue Date Valuation . . .
. 160
Expiration Date 11/04/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
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Special Notes and Comments
SPA, 10 L.F. 4- EQUIPMENT ENCLOSURE,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
----------------------=-----------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------- ---------- ---------- --- - ------ ----------
Due
Permit Fee Total 257.00 .00 .00
257.00
Plan Check Total 118.10 .00 .00
118.10
Other Fee Total 1.00 .00 .00
1.00
Grand Total 376.10 .00 .00
376.10
LQPERMIT
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Chuck Cooper Environmental Planning + Desit
81720 Daniel Drive La Quinta CA 922
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE 9- 7 -A gy Jae
VERN & TAMI MOORE
60614 bESERT SHAbOW.3
TRILOGY LOT 8
307 359 0486
Richard Rodriguez Landsca
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # `
0�
Project Address:
Owner's Name: a OG
A. P. Number:
Address:606 e
Legal Description:
City, ST, Zip: all
Contractor.
Telephone: — ` r}
Address: �.2_ v
Project Description:
City, ST, Zip:
Telephone: -700
State Lic. #:
City Lic. #;
v t,
Arch., Engr., Designer:.
Address:
City., ST, Zip:
+;Ff:y.?i`? .•'iJ±{ j{iii:; ;i: \�i:: iy:�::%.:
Telephone: .::.. :}::•:>;%<;:::..
•:i:�?iC;:ii}. �'F:''yi{;i:i: t:ii:
State Lic. #: ,::, > %•
Construction Type:AAI-) Occupancy:
Project type (circle one): New . Add'n Alter Repair Demo
Name of Contact Person: I,4
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:—
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 Cales.
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:-
'"' Review,.ready for correctionstissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees