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