07-1143 (RPL)T
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00001143
81964 ELYNOR CT
764 -040 -025 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Tdy
4Q"
BUILDING & SAFETY DEPARTMENT
Rllll Mr, RE
D a o
APR 18 2007
CITY OF LA QUINTA
AN
FINCE l5chh
'Architect or Engineer: .
d /A
--------------------------------------------------
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.:
Date: Contractor:
OWNER -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 of 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 contractor(s) licensed
pursuant to the Contractors' State Licens Law.l. ^
1 _) I am efiempt un,0er Sec. , B.&P.Cor this ;eMon / 1
Date: O wrier:
CONSTRU ION 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:
LQPERi111T
RMIT
Owner:
HOCHFELD
81964 ELYNOR COURT
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
7 --------
WORKER'S COMPENSATION DECLARATION
Date: 4/17/07
1 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 Policy Number 01
I certify that, in the performance of the work for which is ermit is issued, I shall not employ any
person in any manner so as t become ubject toI/-,,,rkars' compensation laws of California,
rid a ree that, if I should ome ct to them ensation rovisions of Section
9 P P�of the Labor 9D, all th complyose provisions.
WARNING:'FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 have read this application and state that the above ' f rmatio is c rect. 1 agre to comply with all
city and co my o i=e:s and stat ws relating to buildi o uction, nd reby autho representatives
of this c tyPtor upon the ove-mentioned propert cti o S.
D Siture (Applicant or Agent):
Application Number . . . . . 07-00001143
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . .
252.00 Plan Check Fee
163.80
Issue Date
Valuation . . .
. •25000
Expiration Date
10/14/07
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 ..
10/14/07
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
10/14/07
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 P1an,Check Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
10/14/07
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. ALARMS/BARRIERS
SHALL BE IN
LQPERMIT
Application Number 07-00001143
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
----------------- ----------
Permit Fee Total 356.00
Plan Check Total 189.80
Grand Total 545.80
LQPERMIT
Paid Credited Due
---------- ---------- ----------
.00 .00 356.00
.00 .00 189.80
.00 .00 545.80
CITY OF LA QUINTA SUB-CONTRACTOR LIST
JOB ADDRESS — lurD U PERMIT NUMBER OWNER BUILDER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuousplace. 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
..::..:..:.:
::..; . ; Stat e:.Contractor s. ::.
:.:. ir
Workeis:C.om erlsation;Irisurance:°':< ;::.- .
....` city. Business
Licensg> ::
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)(Format
Policy Number
Varies)
Exp. Date
Ixx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK 1C-121/c1NAC(i!HWA
4f sj
87 554,?
16Af —
D%
24
eo( 75
CONCRETE (C-8)':.
( C r
FRAMING :(C-5) ..;:
STRUCT::STEEL-('C-51)
<<
MASONRY (C-29) `,.
PLUMBING' (C-361
/ r rr
LATH; PLASTER 1035
Ci) <
DRYWALL (C-9) ..:..:
HVAC.
ELECTRICAL. (C=10)' ::...
4'r
ROOFING, (C39)': :
SHEET METAL(C'-431
FLOORING (CA 5),
GLAZING IC-171:
INSULATION (C-2) .
SEWAGE DISP (0-42)
PAINTING (C=33)'
CERAMIC TILE (C-54)
CABINETS (C-6)
;...,
FENCING (C-13)
LANDSCAPING (C=27.)
POOL (C-53)
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 #
Project Address:
Owner's Name:.
A. P. Number:
Address: �!O
Legal Description:
City, ST, Zip: 2-2 �3
Contractor:
Address:
Telephone: ,
Project Description:
City, ST, Zip:
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
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: �Q
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal .
Req'd
Recd
TRACIMG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan. Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans Picked up
Construction
Flood .plain plan.
Plans resubmitted
Mechanical
Grading. plan
Zed Review, ready for correctionstissue
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 correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees