11-0650 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ifl-1-00000650
Property Address: 80769—VIA PESSARO
APN: 772-500-069- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25.000
BUILDING.& SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PAPWORTH
80769 VIA PESSARO
LA QUINTA, CA 922
Contractor:
Applicant: Architect or Engineer: MCINTYRE POOLS &
83695 AVENUE 45,
INDIO, CA '92201
(760)342-.3612
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/15/11
53
S �1S INC�e.� 2:� 201! •i
L/�+GI/TY OF Ulk 4Uihl fA
�I� n
Lic. No.. 614611 .
-- -- — — — —
— — — — —77 — — — — _ — — — — — — — — —
-- --- LICENSED CONTRACT%% DECLARATION — -- — — — - -
_ — - — — — -- -- -�
_ - - - -
A WORKER'S COMPENSATION DECLARATION -,
.I hereby affirm under penalty of perjury that'l am 'ice d uhdergro Bions ofChapter 9 (commencing with -
I hereby affirm under penalty of perjury one of the following declarations
Section 70001 of Division 3 of the Business and Profe onals C e and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C53 - Ltse o.: 614611
_
for by Section 3700 of the Labor Code; for the performance of the work for which this permit is
... Date: -
�Vbntraci:or:
issued.
.. -� 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 ermit is issued. My workers' compensation
OWNER -BUILDER DECLARATION.
insurance. carrier and policy number are:
' I hereby affirm under penalty of perjury t t I am a empt from the Contractor's State License Law for the
Carrier GOLDEN EAGLE IN Policy Number 20 0010139097Z -
following reason (Sec. 7031.5, Business nd Prof _Bions Code: Any city or county that requires a'permit to .
_ I certify that, in the performance of the w rk for which t is permit is issued, I shall not employ any
California,
construct, alter, improve, demolish, or rep it any tructure, prior to its issuance, also requires the applicant for the,
person in any manner so as to become subject t/th workers' compensation laws of -
permit to file a signed statement that he or he i licensed pursuant to the provisions of the Contractor's State
`., and agree that, if I should become.su act to the w rkers' compensation provisions of Section -
License Law (Chapter 9 (commencing with ion 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
3700 of the Labor Code,'I shall fort ith comply ith those provisions.
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Xplcant: -
. 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
WARNING: FAILURE TO SECURE WOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMIIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
rN
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITIOOST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is�sold within
SECTION 3706 OF THE LABOR COT, AND ATTORNEY'S FEES.
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' 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:
LQPERMIT
v 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 €1�ted to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application become null.and vo' if ork is not commenced
within 180 days from date of issuance of such permit r cessatio of ork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above' ormatio s c rect. I agree to comply with all
city and county ordinances and state laws relating to building co ructio , nd ereby authorize representatives
of this county to enter upo the above-mentioned property for ' ectio r ses.
g0QCCL ignature (Applicant or Agent):
Application Number
11-00000650
Permit
BLDG POOL PERMIT
Additional-desc .
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date . . . .
Valuation . . . .
25000
Expiration Date
12/12/11
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
12/12/11
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
12/12/11 -
Qty Unit Charge
Per
Extension, .
BASE FEE15:00
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
12/12/11
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
--------------------------------------- ------------------------------
Special Notes and Comments
DEMO EXISTING POOL & REBUILD POOL & SPA,
LQPERMIT
Application Number . . . .
11-00000650
-
---------------------------------------------------------------
Special Notes and Comments
BBQ. ALARMS/BARRIERS SHALL BE
IN PLACE
AT PRE-PLASTER INSPECTION. EQUIPMENT TO,
REMAIN IN EXISTING LOCATION.
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
Bin #
City of La Quints
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253,-:(760) 777-7012 `
Building Permit Application and Tracking Sheet
Permit #
Project Address:Q 76CI
Owner's Name:
A. P. Number:
Address: - 6" aSv -"
Legal Description:
City, ST, Zip:
Contractor: C,r'
ZS 3nC
Telephone:
w
Address: -. . Uff ' • _1•
Project Description:
City, ST, Zip:011-0, C
Telephone:
"City Lic. #p i
State Lic. # : 61 'YO
Arch., Engr., Designer:
Address:
City, ST, Zip:
1 ,
Telephone:
State Lic. #: a
Name of Contact Person:S
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
: q Ft.: .'_77#
Stories:
# Units:
Telephone # of Contact Person: �j (`j - �j
Estimated Value of Project: O25
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
T
PERMIT FEES
Plan Sets
Plan Check submitted..'.
Item
Amount
Structural Calcs. r
Reviewed, ready for correWo
Plan Check Deposit
Truss Calcs.
Called Contact Person. "7
Plan Check Balance
:l
Ener Calcs.
Energy
Plans picked up
C-
Construction t
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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:
3d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
-
Total Permit Fees