05-5204 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00005204
Property Address: 47930 WIND SPIRIT DR
APN: 658-140-999-36 -29436
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 26900
Architect or
T ao!t 4 4 "
BUILDING &SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ADAMS WADE
47-30 WIND SPIRIT DRIVE
LA QUINTA, CA 92253
a
200 Contractor:
��r: a�� �. '� MC CAECUM POOLS
_ _ 46576 VIA CELESTE
CITY OF�`OUI�TINDIO, CA 92201
swA-ICEDEAPT (760)275-6403
Lic. No.: 818835
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/29/05
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the ' ass and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C53 License No.' 8835
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-�
issued.
I -y
- Date: 5(J Contractor:
- _ 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
' OWNER -BUILDER DECLARATION
insurance carrier and policy number are: -
�,t 1 hereby affirm under penalty of perju at I am exempt from the Contractor's State License Law for the
Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' com ensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that d become subject to the workers' com nsa 'on provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the L bor Code, hall forthwith co ly wit p visio s.
. 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).:
te:pplicant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
100
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SEC RS' COMPENSATION CO AGE. IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
(_) 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.).
1 _ 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: Pik
LQPERMIT
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 sf'a't'ello t the above information is correct. I agree to comply with all
city and county ordinances and state laws rel mg to ilding c truction, and hereby authorize representatives
of thjs //county to enter upon the a ove-mention prope y f r inspecu r -_
DaDate. l S' ture (Applicant or
Application Number
. . . . 05-00005204
Permit -
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
265.00 Plan Check
Fee
172.25
Issue Date
Valuation
. . .
. 26900
Expiration Date
5/28/06
Qty Unit Charge
Per
Extension
BASE FEE
252.00
2.00 6.5000
---------------------------------------
THOU BLDG 25,001-50,000
------------------------------------
13.00
Permit . .
M uki Puui,
Additional desc .
Permit Fee . . . .
24.00 Plan Check
Fee
6.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
5/28/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
----------------------------------------------------------------------------
EA MECH FURNACE <=100K
9.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
0
Expiration Date
5/28/06
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
5/28/06
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
L
3.00
---------------------------------------
Notes and Comments
POOL/SPA. ALARMS/BARRIERS
SHALL BE'IN
LQPERMIT
Application Number . . . . . 05-00005204
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
----------
Paid
Credited
--------------------
Due
---------------------------
Permit Fee Total 367.00
.00
.00
367.00
% Plan Check Total 197.75
.00
.00
197.75
Grand Total 564.75
.00
.00
564.75
9
LQPERMIT
+18" RAISED SPA W/STAKED
STONE SPILLWAY
QUARTZITE STONE FINISH
- - ON OUTSIDE OF SPA -
;�
=: SPECTION FEE OF 30. BUILD ,SAFETY
I
.LL BE CHARGED IF THE APPROVED AppROVED
"'LAMS AND JOB CARD ARE NOT ON FOR CNMUCT oN
THE SITE FOR A SCHEDULED 1139�� -`�
INSPECTION. ®�fi
-- hiEyrli:PTlONS! -- -- -- -- --
TONE QUARTZITE
WATER, LINE
POOL
NEW CONC
COLORED '
Nov 27 05 09:24p
Joseph McCallum
7607755E85
Bin#
City of La Quinta
Building and Safety Division
P.O. Box 1504
78-495 Calle Tampico
La Quinta, CA 92253
Building Permit and Application Tracking Sheet
Permit#
Proiect Address: 47-930 WINDSPMff
Owners Name: WADE ADAMS
A. P. Number:
Address: 47-930 WINDSPIRIT
Legal Description:
City, ST, Zip: La Quinta, UA 92253
Contractor: MCCALLUM POOLS
Telephone: 200-8707
Address: 46-576 VIA CELESTE
Project Description: •
City, ST., Zip: INDIO, CA 92201
Pool and Spa
Telephone: 775-5685
G
Af
State Lic. # 818835
City Lic.# 1604
Arch., Engr., Designer:
NEW
Address:
It
ft X
City, ST. Zi
Telephone:
eaction Type: Occupancy
State Lic. #:
Project Type: New Add'n Alter Re Demo
Contact Person: JOE
Sq. ft. #Stories: #Units:
Telephone of Contact: 275-6403
Estimated Value: $26,900A0
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