07-2043 (RPL)P.O: BOX 1504,
78-495 CALLE TAMPICO
LA QUINTA,"CALIFORNIA 92253
BUILDING& SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
- 07-00.002043 1
Property Address:'
54695 WINGED FOOT
APN:
775-110-007- -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Applicant: Architect or Engineer:
r
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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 Cla :. C53 License No.: 614611
Date: Contractor:
oQS
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 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 155001.:
(_ 1 1, as owner of the property, or my employees with wages as their sale 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 himselfor 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.).
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:
LQPERAIIT
'Owner::
CHAPIN/MALLOY. RESID
.54.,695 WINGED FOOT.
LA QUINTA; CA 92253
Contractor:
MCINTYRE POOLS &
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
LiC. No.: 614611
------------------
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 MAJESTIC INS CO Policy Number C20060333602
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 rovisions of Section
T 3700 of the Labo o e, shall forthwith comply with ose pro�onsi _ � w�
_Date;,; � Applicant
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 ($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 cou y ordinances and state laws relating to buildin construction, and hereby authorize representatives -
of thi u to r ter upon the above-mentioned propert q n I'fection pur ses
Dater Signature (Applicant or Agent): i L/
Application Number .
. . . . 07-00002043 "
• .'::" ; '. -,:Permit . ... . . .
BLDG POOL PERMIT
Additional desc
Permit -Fee'.
207.00 Plan Check Fee
134.55
Issue :Date •-c
Valuation
- 20.000
-Expiration Date
1/09/08
.. Qty Unit Charge
Per
Extension
BASE FEE
45.00'
18.00 9:0000
THOU BLDG'2,001-25,000
162.00;
Permit
MECH P66L
Additional desc .
Permit Fee:
26.00 Plan Check Fee
.6.50
Tssue Date. . . .
Valuation
0
Expiration Date
1/09/08
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
1/09/08
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
1/09/08
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
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IMOCKING PAWIF6
WUIPeNT:WA,L
Cllr( OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
DATFJ //- 07 BYLI-
GA5 & ML CRCPI,
r v v l- cx it i% A V
POOL SIZE 52' X 13'
POOL S.A.
POOL PER.. 1(W rT
DEPTHS 3' '6 TO h'
POOL PUMP
HEATER 4X,OX ;
FILTER CCP 1120
1-100'/LAff
LIGHTS 2-400y./Afr
CONTROLLER
SPA SIZE 8- X6,
SPA PER. 28 L. rr.
SPA S.A. 0 5Q, rT.
SPA DEPTH^ 611
JETS
JET PUMP
DECK AREA 90:' SC). rT.
REr LEi. " I-Til-•,rr
W.F.
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Bin #
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Permit I</
I 1/U
Project Address
A. P. Number:
Legal Description:
Contractor:
q'd
Address:
Cir)•. ST, Zip: L 1 nit -
Telephone,.
State Lic. #
Arch., Engr., Designer:
Address:
City. ST. Zip:
'Te lephonc.
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
0 Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
ITV HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La uinta
Building at Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
1 KIQ r's Namc:/e'o1.. A r, - . t/L. n
/ City. ST. Zip:
;Telephone:
Projcct Description:
"% A - -- - -
City Lic. #:
A
Construction Typo- Occup
ane) .
Project type (circr one): New ' Add'n Alter Repair Demo
Lr Sq. Ft.: S� # Stories: # Units:
Total Permit Fees
Amount
Estimatcd Value cf Proiect:
APPLICANT: DO NOT WRITE BELOW TH'S LINE
q'd
Rce'd
TRACKING
PERMIT FEES
Plan Check submitted
Item
Reviewed, read), for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2' Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
Review, ready for correctionslassuc
Developer Impact Fee
Called Contact Person
A.1.P.P.
Date of permit issue
Total Permit Fees
Amount