05-5567 (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:
05-00005567
79290 DESERT WIND CT
604-332-014-19 -23935
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Architect or
T,iht 4 4 a"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
(tr
r�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am I' en d under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d P ofes ionals Code, and my License is in full force and effect.
License `(Class: C53 License No.: 692059
Date:- + Q Contracto
OWNE 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 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 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: _
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/27/05
Owner:
LAWSON W DON
79290 DESERT WIND CT
LA QUINTA, CA 92253
Contractor:
CAHUILLA POOL CONSTRUCTION INC
P 0 BOX 2569
PALM DESERT, CA 92261
(760)360-6602
Lic. No.: 692059
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
T Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 0010153-2005
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to be orae subject to the workers' compensation laws of California,
and agree tHR
bec me subject to the workers' compensation provisions of Section
p� 700 of thsh I o hwith comply with those provi ons.
te: 1 1 , A
WARNING: FAILURE TO SECURE WORK 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES 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 work for 180 days will subject
permit to cancellation. 11
I certify that I have read this application and state that the above infof ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin co tr ion, and hereby authorize representatives
of this c!p^ ty t enter upon the above-mentioned property in ti n purposes.
p1F 1 t; ', �gnature (Applicant or Agen -
Application Number . . . . . 05-00005567
Permit BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 252.00 Plan Check
Fee
163.80
Issue Date . . . . Valuation
. . .
. 25000
Expiration Date 6/25/06
Qty Unit Charge-* Per
Extension
BASE FEE
45.00
23.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
207.00
Permit . . . MECH POOL
Additional desc .
Permit. Fee 26.00 Plan Check
Fee
6.50
Issue Date . . . Valuation
. . .
. 0
Expiration Date 6/25/06
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 6/25/06
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 6/25/06
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
----------------------------------------------------------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application
Number . . . . . 05-00005567
-------------=--------------------------------------------------------------
Special Notes
and Comments
BE IN PLACE
PRIOR TO PRE -PLASTER
INSPECTION.
EQUIPMENT.ENCLOSURE NOT
INCLUDED.IN
PERMIT.
Fee summary
-----------------
Charged Paid
--------------------
Credited
--------------------
Due
Permit Fee
Total 356.00 .00
.00
356.00
Plan Check
Total 189.80 .00
.00
189.80
Grand Total
545.80 .00
.00
545.80
LQPERMIT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
OS' SS6,
Project Address:
740wner's Name:
A. P. Number:
Address: 20
Legal Description:
City, ST, Zip: L -las V �`
Contractor: ( f WL CG T
Address: 7i�
Telephone:
Project Description:
City, ST, Zip:NA
k �— YOoL
Telephone: _
State Lic. # : � City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: M �(�S`—
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: � -
Estimated Value of Project. 00 O
APPLICANT: DO NOT WRITE BELOW THIS LINE
It
Submittal
Req'd
Recd
TRACIMG .
PERMIT FEES
�erl—Plan
Sets
Plan Check submitted
)Z 1j7
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
Z" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.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. A.ppr
Date of permit issue .
School Fees
_-
Total Permit Fees