07-0139 (RPL)P.O.Qg
BOX 1504 VOICE (760) 777-7012.
78-495 CALLE TAMPICO FAX (760) 777-7011
LA-Q40INTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 77777153:
BUILDING PERMIT
Date: 1/17/07
Applicitiori Number:07-00000139 Owner:
Property Address:-- "-8"0820 VIA . PORTOFINO KESSLER RESIDENCE
AM: 772-490-002- - - 80-820 VIA PORTOFINO
Application description: POOL - RESIDENTIAL 'LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000 D
Contractor:
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, IN, . � � z 2 2007
83695 AVENUE 45
INDIO, CA 92.201 CIYY®FL��11�6i�9T�!•
(760) 342-3612 F9Pl�,9dCG�i _
►lU 1 LiC. No.: 6146.11
LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions 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 Professionals Code, 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, as's: C 3 License No.: A14611 - for by Section 3700 of the Labor Code, for the performance of the work for which this. permit is
issued.
J Date:'H7 Contractor: V _ _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
L--- -- - V `- - - -) - Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are: ,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier MAJESTIC INS -CO " Policy Number 020060333602
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any -
construct, alter, improve, demolish, or.repair any structure, prior to its issuance, also requires the applicant for the " - person in any manner so as to become subject to•the workers' compensation laws -of California,
permit to file a signed statement that heorshe is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the. Business and Professions Code) or .. 3700 of the Labor(((�`���•''``'',,,1�11��,,,,,e��/// I shall forthwith comply with those provisions.
- that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - - r --'--� I t h /t h
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1"Date: Applicant: ( 1 V IbC.�/b .4 �-
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. 7644, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND '
and who does the work himself or herself through his or her own employees, provided that the DOLLARS 1$100,000). _ IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offeied for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, 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:). APPLICANT ACKNOWLEDGEMENT -
1 — 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law doesnot apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). _ whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ 1 I am exempt under Sec. B.&P.C. for this reason 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.
Date: Owner: _ 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 '
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that ) have read this application and state that the above information is correct. f agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to build' rg construction, and hereby authorize representatives
of thi c my to enter upon the above-mentioned pr f inspection, pDses.
Lender's Name: _ �- _ IV/I✓—` -
- Dater Signature. JApplicant or Agent): ..
_-_
Lender's Address: ' -
LQPERMIT
LQPERMIT
Application Number ,
07-00000139
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.00 Plan Check Fee
134.55
Issue Date
Valuation . . . .
20000
Expiration. Date
7/16/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00''
*18.00 9.0000
THOU BLDG -2,001-25,000
162.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
- 0
Expiration Date .
7/16%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
7/16/07
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
7/•16/07
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
------------------------------------------I--------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
t
Bin #
Permit # ,�/�
A,!
Project Address:
A. P. Number:
Legal Description:
Contractor:
Address: —
City, ST, Zip: / 01 �
Telephone: l(L_ 3frj 2
_State Lic. # : �n/ `(61 r —
Arch., Engr., Desiper.
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person: c—
# Submittal Req'd
Plan Sets
Structural CRICS.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
4Pub.Wk:s.Appr
School Fees
City of La Quinta s
Building 8T Safety Division `
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 s
Building Permit Application and Tracking Sheet
w Owner's Name:
Address: v-- V l C
City, ST, Zip/ to
Is Telephone: ;.;�•>
Project Description:
Lic. M �\
Total Permit Fees
a
: : fi s, 3;;j{.:#}< •`•> �`v >?< >''€ h<'>'
Construction type:Occupancy:
Project type (circle one):
New Add'n Alter Repair Demo
J�
Sq. F2tt,214
# Stories:
#Units:
"—
Estimated Value of Project: 2
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'.d
TRACKING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2ad Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
Review, ready for corrections/issueDeveloper
Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
a
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