11-0416 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000416
Property Address: 80247 VIA PESSARO
APN: 777-210-033- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Applicant:
LICENSED
I hereby affirm under penalty of perjury that 1 am lic i
Section 7000) of Division 3 of the Business and Pr fe
License Class: C53
/Date:4"/ (� ntractor:
T,it(t 4 4 Q"
Architect or Engineer:
Alp
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
RA O DECLARATION
n r pr inions of Chapter 9 (commencing with
it C , and my License is in full force and effect.
ice a No.: 614611
OWNER -'BUILDER DECLARATION
I hereby affirm under penalty of perj ry that Itnyo,
exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Busi ass and fess on
Code: Any city or county that requires a permit to
construct, alter, improve, demolish, repair structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that a or s e is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing ith action 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and he asis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the ap icant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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, 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:
LQPER.MIT
Owner:
GRAHAM TRICIA
ppr
80247 VIA PESSARO
gD
LA QUINTA, CA 92253
;u
Contractor:
MCINTYRE POOLS & SPAS -,-
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/26/11
m IL LJ
APR 2 2011
Cio' >(c;.c;A'�)il)NT'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.
KI 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 mit is issued. My workers' compensation
. insurance carrier and policy number are:
Carrier GOLDEN EAGLE IN. Policy Number 2 0010139097Z
I certify that, in the performance of the rk for hic this permit is issued, I shall not employ any
person in any manner so as to beco subje to a workers' compensation laws of California,
and agree that, if I should become bject t workers' compensation provisions of Section
3700 of the Labor Code, I shall f hwit o ply with those provisions.
WARNING: FAILURE TO SECU WORKER COAPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC IMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDION TONE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR QODE,} TEREST, 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 emd�y
or any act or omissio related to the work being
performed under or following issuance omit.2. Any permit issued as a result of this appecomes null an voi f work is not commenced
within 180 days from date of issuance er ' , or ces do f work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state thinfor atio s correct. I agree to comply with all
city and county ordinances and state laws relating toonstr ' do and hereby authorize representatives
of t ' county tto enter upon the above-mentioned prinsp cti purposes.
Date" G /—// ature (Applicant or A
Application Number . . . . 11-00000416
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee 252.00 Plan Check Fee 163.80
Issue Date . . . . Valuation . . . . 25000
Expiration Date 10/23/11
Qty Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG 2,001-25,000 207.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date Valuation- 0
Expiration Date 10/23/11
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 10/23/11
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 10/23/11
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 --------- =--------------------------------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . . . 11-00000416
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2010
CODES.
-------------------------------=-------------------------------------=------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
----------- ----------
Paid
Credited
------- - -- ----------
Due
Permit Fee. Total
356.00
.00
.00
356.00
Plan Check Total
189.80
00
.00
189.80
Other Fee Total
1.00
.00
.00
1.00
Grand Total
546.80
.00
.00
546.80
LQPEENIIT
B'° #
City of La Quinta
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
Permit # , I^
�C� W
Project Address: 4 (assKIN11)Owner's
Name:
A. P. Number:
Address: �30 - 5.t -•I-7 U(U Q rte
Legal Description:
ki��-
City, ST, Zip: Qu ut
Contractor: e�jU S • 5 •Z5 nL
Address:- S
Telephone:
Project Description:
City, ST, Zip: C'•
Telephone: 1-3 611
•r
State Lic. # : 61 � 61
City Lic. #: L7 L/S
Arch., Engr., Designer:
Address: i
City, ST, Zip:
Telephone:
.Q
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add`.n Alter Repair Demo
Name of Contact Person: I k -�-t 1
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: D " 48;,3 6
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Chech Deposit
Truss Calcs.
Called Contact Person
Plan Checl; Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanica
Grading plan
2nd 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 _mpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees