10-0336 (RPL)P.O. BOX1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/20/10
Application Number: 10-00000336 Owner:
Property Address: 53540 VIA PALACIO DEWEY PAUL C.
APN: 777-220-019- - - PO BOX 12793
Application description: POOL - RESIDENTIAL PALM DESERT, CA 922
Property Zoning: LOW DENSITY RESIDENTIAL t5C1TY0FLAQ;U1NTTAJ e
Application valuation: 30000
Contractor:APR 22Applicant: Architect or Engineer: SUNLITE DEVELOPMENP.O. BOX 10668
PALM DESERT, CA 92
I (760) 340-9800 FMIANCFEQEPT .
LPrLic. No.: 655874
--------------------------------------------------
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 Bu iness and Professionals Code, and my License is in full force and effect.
License dassl B ! f License No.: 655874
'ViVte: � O ractor:
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 1$500).:
1 _) 1, 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.).
(_ I 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: 91 A
LQPERMIT
--—————————————————————————————————————————————
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty,of perjury one of the following declarations:
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 EXEMPT Policy Number EXEMPT
I cat, 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 sAo Id become subject to the workers' compensation provisions of Section
3700 of the labor ,r y I shall forthwith comply with those provisions.
,Pe -e D cant:
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 county ordinances and state laws relating to buld'rr)g construction, and hereby authorize representatives
offtthis co my to enter upon the above-mentioned pro or i spection purposes.
bate: Si ature (Applicant or Agent(:
Application Number . . . . . 10-00000336
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
284.50 Plan Check
Fee
184.93
Issue Date . . . .
Valuation
30000
Expiration Date . .
10/17/10
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
32.50
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
10/17/10 .
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
Permit . . . IELEC
POOL PERMIT -RES
Additional desc . .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
10/17/10
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 . .
10/17/10
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 . . . . 10-00000336
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE, FIREPIT,
BBQ,
WATERFEATURES NOT INCLUDED IN
THIS
PERMIT. 2007 CODES.
----------------------------------------------------------------------------
.Other Fees . . . . . . . . .
BLDG STDS
ADMIN (SB1473)
2.00
Fee summary Charged
----------
Paid
----------
Credited
--------------------
Due
-----------------
Permit Fee Total 388.50
.00
.00
388.50
Plan Check Total 210.93
.00
.00
210.93
Other Fee Total 2.00
.00
.00
2.00
Grand Total 601.43
.00
.00
601.43
LQPERMIT
• I
Bin #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # 1 n
Project Address: 5 -3 VJ,6 PALAc- i 1 (0
Owner's Nam'
e-. D
L
A. P. Number: -777 -a2Q-Q1q
Address: 6XI V C-1
Legal Description: LOT13*3-- aUj S6 Z8'
City, ST, Zip:
jkon
Contractor: S U AJ LU T�Jc
Address:Project
— EA-BOX M961?
Telephone-
Description:
SP8
City, ST, Zip: fk-f CA 0 2Z5S'
V
Telephone:7
. . .......
State Lie. # 5 5(L2
City Lie.
Arch., Engr., Designer:
Address.
City, ST, Zip:26LM 0fSrJCV,, CIA (q 2-5 5
Telephone:Construction
.................................
................... ................ ?� .............
State Lie. #: 3 . ........ .............. .............
Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Name of Contact Person: Pou —0 tw f"Y
Sq. Ft.:
I # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Reqld
Rec1d
T9U—aQ1EJ-VF;1E: i PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount'
Structural Calcs.
Reviewed, ready for correctiAP R 202)10
plan check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up BY:
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.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
-[Total Permit Fees
CITY OF LA QUINTA SUB -CONT 'OA �TOR LIST
JOB ADDRESS 'a —PERMIT NUMBER -OWNER71 -D&Jjj -BUILDER tm
This form she ie iob with the Building Inspection Card at all times in a conspicuous olace. Unly 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
M.
7�—
For each
(C -36Y
TS iG-ti)
IG (G-131
licaDle trade, all intormation requested below Must be completed by aPPI[Cant. -L)n File" is not an acceptable
64
111,00
$6, C
0
Codipany Name Classification License NumberFExp. Date Carrier Name Policy Number
(e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) I
I
4
Exp. Date License Number Exp. Date
fxxlxx/xxl (xxm) I (xx1xx/")
LFA
'I 1 { CITY OF
JOB ADDRESS FA54 u�1 Q' ��I�L��' PERMIT NUI
on this job. Any changes to this list must be approved by the Building
LA QUINTA SUB -CONTRACTOR LIST
ABER OWNER V e(k),e BUILDER
at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
Division prior to commencement of work. Failure to rmmnly will racndt in a stnnnane of wnrdr and/nr the vnirlanra
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APPROVED (1009.90 FL •8 1009.70 TG
•I
FOR CONSTRUCTION - - (1010) 1 8. 70 INV ti
(1010.00 LIP)
DATE a4lO f3Y +i EXISTING WEDGE
o I N CURB & GUTTER
Inderground Service -Aksur _
^all: TOLL FREE
1-800
227-2600
fWOI�WORKING DAYS BEFORE YOU DIG
I � �
(1009.64 TC)
I
N11'05'22"W O(1009.20
FL) (1009.30 LIP)-
-' - I I �
7(1010.20 TP) - I (1009.85 TP)
VIA
PALACIO
_ (1009.53 TP
_