07-0612 (RPL)�A
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/27/07
Application Number: 07-00000612 Owner:
Property Address: 53552 VIA PISA ANDREW PIERCE CORP.
APN: -772-530-060- - - PO BOX 3420
Application description: POOL - RESIDENTIAL PALM DESERT, CA 92261
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 24500
Contractor: D /F-
Applicant: Architect or Engineer: AZURE POOLS AND SPAS
P.O. BOX 10641 , 200T
PALM DESERT, CA 92255 MAR :?.l 1
(760)322-7665 _
1l�r Lic. No.: 802919 GIF INTA
DIP
----------------------------h-�--------------------------------------------------------------------
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.
Licens Class: C53 License No.: 802919"
Date ntractor:
OWNER -B ILDER 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).:
(_) 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.).
(_ 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.).
(_ 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: Oil A
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 STATE FUND Policy Number 0028619-2006
_ 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
' ?^0 of the Labor Cod sh orthwith comply with those provisions.
te: II pplicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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 building construction, and hereby authorize representatives
of this cou ty tQ er upon the ove-mentioned pr rt r ction purposes.
Da Si upon;
(Applicant or Agent):
M.,__1
Application Number . . 07-00000612
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 252.00 Plan Check Fee 163.80
Issue Date . . . . Valuation . . . . 24500
Expiration Date 8/26/07 .
Qty Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG 2.001:-29..on(1 307..00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 8/26/07
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 8/26/07
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 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/26/07
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
---------------------------------7------------------7-----------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . . . 07-00000612
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 356.00 .00 .00 356.00
Plan Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 nn 515.80
LQPERMIT
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Permit I#
�l
Project Address: C
A. P. Number:
Legal Description:
Contractor.
Address:
P� box ►Dt�
City, ST, zip:
Telephone: -7-.) Z2 -
State Lic. # A Z-/,? I
Am, Engr., Dwtar;
Address: J 2-N�J . 7
City, ST, Zip:
Telephone--7/4-�
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person: "-7
# Submittal Req'd
Plan Sets
Structural Cities.
Trues Cities.
Energy Cales.
Flood plain plan
Grading. plin'
Subcoutactor Ust .
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
A
Rec..'
City Of La Quints
Building ec Safety Division
P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
Address: 1 L
City, ST, Zip: Ate,
Project Description:
Lic. C ifln l i A
� 20 7
0
d
Construction Type:
,e f,,� Oompancy: -
Project type (circle onitNew Add n Alter Repair eP Demo
Sq. Ft.: .
Stories:
.
:# Units:
2. D
Estimated value of pct:
APPL.lCANT:
DO NOT WRITE BELOW THIS
UNE
TRAC[CINC ,
PERMIT FEES
Plan Check submitted
Item
Amount .
Reviewed, rtatdy for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans Picked.up
Construction
Plans resubmitted
Mechanical
2" Review, ready for eorrections/usae
Electrical
Called Contact Person
Plumbing
Plans picked up
SALL
Plans resubmitted
Grading
Review, ready for.correetiowusae
Developer Icapaet Fee
Called Contact Person
A.LP.P.
Date of permit issue
Total Permit Fees