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09-0831 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:, Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 09-00000831 80720 VIA PORTOFINO 777-150-007- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 23000 T-iht °F4Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby affirm under penalty of p rjury t t I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, B iness nd Professions Code: Any city or county that requires a permit to construct, alter, improve, demolis or r air any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement th 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).: 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 _ 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: l Lender's Address: LQPERA11T Owner: POTERFIELD & 80720 VIA POR LA QUINTA, CA Contractor: MCINTYRE POOLS & 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: 7/30/09 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. 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 insurance carrier and policy number are: Carrier DELOS INS CO Policy Number 02DKRM120001870 I certify that, in the performance of the work for ich this permit is issued, I shall not employ any person in any manner so as to come sub' t to the workers' compensation laws of California, and agree that, if I should be a subjec the workers' compensation provisions of Section �� 3700 of the Labor Code, I s I forthwit amply with those provisions. ,Hate: T�plicanC , WARNING: FAILURE TO SECURE OR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI IN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITI O 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 as fanerre ork for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above mfor ant. I agree to comply with all city and county ordinances and state laws relating to building consti tionauthorize representatives of this county to enter upon the above-mentioned property forinsp tion p (Applicant or Agent): LICENSED CONTRR'S DECLARATION I hereby affirm under penalty of perjury that I licensed u der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a Professio Is ode, and my License is in full force and effect. License lass: License No.: 614611 ate:J`�C53 — -L ontractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of p rjury t t I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, B iness nd Professions Code: Any city or county that requires a permit to construct, alter, improve, demolis or r air any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement th 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).: 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 _ 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: l Lender's Address: LQPERA11T Owner: POTERFIELD & 80720 VIA POR LA QUINTA, CA Contractor: MCINTYRE POOLS & 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: 7/30/09 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. 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 insurance carrier and policy number are: Carrier DELOS INS CO Policy Number 02DKRM120001870 I certify that, in the performance of the work for ich this permit is issued, I shall not employ any person in any manner so as to come sub' t to the workers' compensation laws of California, and agree that, if I should be a subjec the workers' compensation provisions of Section �� 3700 of the Labor Code, I s I forthwit amply with those provisions. ,Hate: T�plicanC , WARNING: FAILURE TO SECURE OR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI IN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITI O 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 as fanerre ork for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above mfor ant. I agree to comply with all city and county ordinances and state laws relating to building consti tionauthorize representatives of this county to enter upon the above-mentioned property forinsp tion p (Applicant or Agent): Application Number . . . . . 09-00.000831. Permit . . . BLDG POOL PERMIT INV FEE Additional desc . Permit Fee . . . . 468.00 Plan Check Fee 152.10 Issue Date . . . . Valuation . . . . 23000 Expiration Date 1/26/10 Qty Unit Charge Per Extension BASE FEE 90.00 21.00 18.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 378.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/26/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ------------------------7--------------------------------------------------- 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 . . 1/26/10 . 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 . . 1/26/10 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. ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number . . . . . 09-00000831 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE 9304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. 2007 CODES Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary ICharged Permit Fee Total 572.00 Plan Check Total 178.10 Other Fee Total 1.00 Grand Total 751.10 LQPERMIT Paid Credited Due .00 .00 572.00 .00 .00 178.10 .00 .00 1.00 .00 .00 751.10 Bin # City of La Quinta Building U SafetyDivision Box 1504, 78-495 Calle Tampico U Quirita, CA 92253 - (740) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. Project Address:' 80 _ M U r O Owner's Name: ease-. A. P. Number: Address: gG _7?0CAi11 Legal Description: O S City, ST, Zip: T• . 2 �5 CJ Contractor: Address: 3—. S 4 S Telephone: Project Description:. 0 C odd -5pg City, ST, Zip:. Telephone: 34e2 _ 36 City Lie. #:. State Lic. # : l S - �j ¢�j Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lit. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:Sq. Ft: #Stories:. #Units: Telephone # of Contact Person: Estimated Value.of Project: �— APPLICANT:. DO NOT WRITE BELOW THIS LINE . # Submittal Req'd Recd TRACKING. PERMTT FEES ' Plan Sets Plan Check submitted .� Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Cales. Called Contact Person Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan, Plans resubmitted Mechanical Grading. plan 2-" Review, ready for correctionsAssue Electrical'. Subcontactor List Called'Contact Person Plumbing Grant Deed Plans. picked up S.M I. MO.A. Approval Plans resubmitted Grading. IN PIOUSE:- Review, ready for correctionslissue Developer Impact Fee Planning Approval ' Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees W L►-� — — — 145.19 �Fd—I S:�w / OL C) --- — M. _ ___ I � 5D—I,11— � � 00M ° .\ IN I\ \ N00K / G ePF-A T °a I • ' / ROOM — — DINING s= I ;PA RAI I m I 101830 Cr I. /.. I `� rr < D11 �l N 5r PTID . a { . 2 a l oy1/11} \//,J1) WALL a g A� � SP—I I FALL o :.. • .�.� ° _ \� ;'�; .o 11 A q C =s POOLq. I SD- W I c- . q � �- QI.� '.. Gl• •°:, anti - I. �, 101 .10 101 -10 6? t i . • LJ r I ffpRoom \ \ DEN I I r pAND ATt't 4 �5 W161 -L .40 p G I Pons J5 I - � 10220 Tw w,v1 N04'11 '11 'I W V) o PROPOSED 5-G' ' I \ 101 20 �` IF LOr p4 DOE NOT- PROCEED p o on I � � I PATIO