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05-3508 (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: �q5- 0003508 � 78970 DRY CREEK 772-011-005-4 -26016 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 13495 Architect or Engineer: Allay BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: MECHAN 0 5 78-970 DRY CREEK ROAD AUGUtz J LA QUINTA, CA 92253 OF LA QUINTA LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: - 6,6ate:S4_1(-Os ContractorXz 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).: (_ 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 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 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 Contractor: LOZANO PROF POOL WCC: EXEMPT WC: EXEMPT CSLB: 840397 CONST, MIKE VOICE (760) 777-7012r FAX (760) 777-7011k. INSPECTIONS (760) 777-7153 07/31/06 06/30/06 Date: 8/10/05 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 C53 Policy Number - - - - - - - - - - - - - - - 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 become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sell�f,d thwit comply with those provisions. D3t� S `il-o5 Applicant � N/ �✓�li WARNING: FAILURE TO SECURE WORKERS' COMP SATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND 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. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this cou to enter upon the above-mentioned property fo in act, purp es. Date �� l SUS Signature (Applicant or Agentl: •� Application Number . . . . 05-00003508 Permit . . . BLDG POOL PERMIT Additional desc Permit Fee 153.00 Plan Check Fee 99.45 Issue Date . . Valuation . . . . 13062 Expiration Date 2/06/06 Qty .Unit Charge Per Extension BASE FEE 45.00 12.00 9.0000 THOU BLDG 2,001-25,000 108.00 ------------------------------------------------------------=--------------- 17 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00Plan Check Fee 6.50 Issue Date . . . . Valuation . . 0 Expiration Date 2/06/06 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 2/06/06 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 . . . . 27.00 Plan Check Fee 8:25 Issue Date . . . . Valuation 0 Expiration Date 2/06/06 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 ----=------------------------------------------------------------------------ EA PLB GAS PIPE .1-4 OUTLETS 3.00 Permit . . . . WALL/FENCE PERMIT LQPERMff Application Number . . . . . 05-00003508 Permit . . . WALL/FENCE PERMIT Additional desc �3 Permit Fee . . . . 15.0.0 Plan Check Fee ..00 Issue Date Valuation . . . . 433 Expiration Date 2/06/06 .Qty Unit Charge Per .Extension BASE FEE 15.00 ---------------------------------------=------------------------------------ - Special Notes and Comments POOL ONLY. 20 L.F. 5' BLOCK WALL, ORCO SYSTEM. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid ------------------------ --- ---------- Credited ---------- ---------- Due. Permit Fee Total 266.00 .00 .00 266.00 Plan Check Total 125.45 .00 .00 125.45 Grand Total 391.45 .00 .00 391.45 LQPERMIT CITY OF LA QUINTA SUB -CONTRACTOR LISTr� JOB ADDRESS -`�� 'Jli�r C,2c:,k-�'' PERMIT NUMBER 0S-3so� .OWNER MEC--ldAPV BUILDERLj This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant: "On File" is not an acceptable response. Trade /Classification Contractor : ;::: ;.: : Stat6':Contractor's Licens6 : Workers Com ensatio i.Insurance: City Business license Company Name AL !V Classification ( A, B/ License Number (xxxx 1 Exp. Date xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (x /xx/ x) EARTHWORK IC-12)JVC c o .4 C-53`-3 S 3c -J5 5 3Yo3 CONCRETE (C-8)SC vR. 6o�L �t1�'�L�AS L -S FRAMING (C-5) ' STRUCT..STEEL (C-51) tks„ Lo z"Ao /�o ;ZSb t oN•+ c-' c.3 C G' MASONRY (C-29) 5-opr ad PLUMBING (C-36).= t I.JL� FiLOiC�S. y�1 e/- S 1 9-fU 3CJ LATH; PLASTER (C735) DRYWALL (C-9) . . . HVAC IC -201' - ELECTRICAL.IC-10►: .. �U,�IC:J rcl.(=c.aKi L' -v S-71 2qv 0 C-4E'W1111S (-(-G(, (-2-S ROOFING (C=39)`.;: SHEET METAL (C43) FLOORING fC'!:15): GLAZING (C-17): ' INSULATION (C-2).. SEWAGE DISP; (C-42) PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) PEN:CING (C-13) LANDSCAPING (C-27) POOL (C-53) l --S3 333 Z 3''3`63 ML CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE[ FOR CONSTRUCTION DATE -8 t o O Y BY gr Bin # City of La Quinta Building at Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit #La Quinta, CA 92253 - (760) 777-7012 QS-- 35-0,F Building Permit Application and Tracking Sheet J� Project Address: Oµrer's Namc: The tG /L( rte,( v A. P. Number: Address: '7 8- Y-1 0 Legal Description: Cite. ST. Zip: X Contractor: Kks, Leyq10�1v(� ISIdn/r�C Poo(., CJNS (Telephone: x Address: '9 S �� Project Description: X Cit), ST. Zip: (-A- -'W f .'F►�-iO cS ��Sw �o r v� S � c�c�Cc) X X Telephone: 760- 31a_-7-716 -� r -• .. Submittal State Lic. # : ?-10 3 City Lic. #: 000 SQ c(tj 7 3/ lQf Arch., Engr., Designer: 2 Address: City. ST. Zip: i Telephone: - Construction Type: Occupancy: State Lic. #: _ Project type (circle one): New Add'n Alter Repair Demo A Name of Contact Person: �; �� Lc Sq. Ft.: ,2 � S ' # Stories: # Units: X Telephone # of Contact Person: 97S- Value of Proiect: (j q95- APPLICANT: s APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES 2 Plan Sets Plan Check submined Item Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Cala. Pians 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:- ''' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.1.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees X33 l3 G'G 2 �3 y9S