11-0744 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000744
Property Address:
53641 VIA PISA
APNi
772-530-048- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
^,ppliaation valuation:
49000
T4'�l 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RAY
53641 VIA PISA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/07/11
Contractor: (' I' Ii
J I
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, I;r ---"� i
83695 AVENUE 45 (# n'� 1
INDIO, CA 92201 JLC tfllI
(760)342-3612
\I�X Lic. No.. 614611T
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LICENSED CONTRACTO DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licen d under o isions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Prof e ionals C , and my License is in full force and effect. _ I have and will maintain a certificateof consent to self -insure for workers' compensation, as provided
Lic se Class: C53 Lice s No.: 614611 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�/ issued.
Date: 7`g ( ontractor: 7-1 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
OWN -BUI ER DECLARATION insurance carrier and policy num er are:
I hereby affirm under penalty of perjury hat I am exe pt from the Contractor's State License Law for the Carrier GOLDEN EAGLE IN o" y Nu er 2 01001013 90 97Z
following reason (Sec. 7031.5, Busines and Profes ons Code: Any city or county that requires a permit to _ I certify that, in the performance the work or hich this permit is issued, I shall not employ any
construct, alter, improve, demolish, or r air any str cture, prior to its issuance, also requires the applicant for the person in any manner so as to ecome s je to the workers' compensation laws of California,
permit to file a signed statement that he r she is Ii nsed pursuant to the provisions of the Contractor's State and agree that, if I should be me sub' t t the workers' compensation provisions of Section
License Law (Chapter 9 (commencing wit ectio 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I s It fort h omply with those provisions.
that he or she is exempt therefrom and the b ' or 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).: to: A scant:
(_ 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 ISec.
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 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 ISec. 3097, Civ. C.).
Lender's Name: J
Lender's Address: 1PF
—
LQPERMIT
WARNING: FAILURE TO SEC RE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD TION7TIE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABO COD , 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 pV
i
2. Any permit issued as a result of this application a d v d if work is not commenced
within 180 days from date of issuance of sucsatin of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ality is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi, and hereby authorize representatives
off IN counttyto enter upon the above-mentioned property purposes.
Date: �v Si ature (Applicant or 99//�n
I
Application Number . . . . . 11-00000744
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
414.50 Plan Check Fee
269.43
Issue Date . . . .
Valuation .
. 49690
Expiration Date . .
1/03/12
Qty Unit Charge
Per
Extension
BASE FEE
252.00
25.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
162.50
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
1/03/12
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
1/03/12
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
1/03/12,
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, WATER FEATURE. ALARMS/BARRIERS
LQPERMIT
Application Number . . . . . 11-00000744
----------------------------------------------------------------------------
Special Notes and Comments
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 518.50 .00 .00 518.50
Plan Check Total 295.43 UU .00 295.47
Other Fee Total 2.00 .00 .00 2.00
Grand Total . 815.93 .00 .00 815.93
LQPERMIT
Bin #
Permit #
\
City of LaQ Uinta . .
Building U SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (7¢0) 777-7012-
77-7012Building Permit Application and Tracking Sheet
Building
Project Address; ? — 6 4 os
Owner's Name:
ca� e
A. P. Number:
Address:. ?S _
Legal Description. O r:
City, ST, Zip: v i �O 5
Contractor: r D�
Telephone:
Address: S 3 S S
City, ST, Zip:. ' O CC,_
Project Description:. . GG ,(t
v
Telephone:
City Lic. #:.
State Lie. # 0,c53— 6 f-61 I
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lit. #:
Construction Type: Occu an
P cY:
Project type (circle one): NewAdd'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: —
Estimated Valiie.ofProject :49 A 9n
APPLICANT: DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd -
Rec'd
TRACMG
PERMIT FEES'
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan,
Plans resubmitted
Mechanical
Grading. plan
:
Zed Review, ready for corrections .rnsue
Electrical
SubcontactorList
CalledContact Person
Plumbing
Grant*oeed
Plani.picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading.
IN ROUSE:-
'"' Review, ready for correctiongliissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees