11-0689 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 11-00000689
Property Address: 80635 VIA PORTOFINO
APN: 777-150-026- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Applicant: Architect or Engineer:
---------------------------
LICENSED C NTRACTC
I hereby affirm under penalty of perjury that I am "cen ed under r
Section 7000) of Division 3 of the Business and Prof sionals C
Lice Class: C53% Lic sc
Date: ��/ C.10
oy actor:
01P
----------------------
ECLARATION
ns of Chapter 9 (commencing with
my License is in full force and effect.
614611
O NER-BUILDER DECLARATION
I hereby affirm under penalty of perj y that I am xempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Busi ss an/asrissfe0srl
sions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, o repaistucture, prior to its issuance, also requires the applicant for the'
permit to file a signed statement that a or licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing ith on 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and th 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 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.).
1 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.).
I—) 1 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/24/11
Owner:
CHARLES MCNERNEr
21768 SE 4TH PL; L) .
SAMMAMISH, WA 98I� t} 9., i
: --j
At Ify If1 f
Contractor.". r r! ^i %i ±•
MCINTYRE POOLS &—SPA', INC.
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic. No.: 614611
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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.
I 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 GOLDEN EAGLE IN P icy Number 0 0010139097Z
_ I certify that, in the performance of a work for w ich is permit is issued, I shall not employ any
person in any manner so as to come subjec to a workers' compensation laws of. California,
and agree that, if I should bec a subject t th orkers' compensation provisions of Section
3700 of the Labor Code, I shal forthwith o ly with those provisions.
WARNING: FAILbRE TO SEC E WORK RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD
IT
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR 09 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 cessation of w f r 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor anon is cor act. agree to comply with all
city and county ordinances and state laws relating to building constru ion, and,b reb uthorize representatives
of t,04 county to enter upon the above-mentioned property for inspe ion pure s.
�t Plglnature (Applicant or Agent):
I
LQPERMIT
Application Number . . . 11-00000689
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 252.00 Plan Check Fee 163.80
Issue Date. Valuation . . . . 25000
Expiration Date 12/21/11
Qty Unit Charge Per Extension
BASE FEE 45.0.0
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 12/21/11
Qty Unit Charge Per Extension e
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
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Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Expiration Date 12/21/11
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 12/21/11
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
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Special Notes and Comments
POOL/SPA, BBQ & FIREPIT. ALARMS/BARRIERS
c
LQPERMIT
Application Number . . . . 11-00000689
----------------------------------------------------------------------------
Special Notes and
Comments
SHALL BE IN PLACE
AT PRE. -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
.INCLUDED. 2010 CODES.
7 ---------------------------------------------------------------------------
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 'Dotal
189.88
UU
UU
189.88
Other Fee Total
1.00
.00
.00
1.00
Grand Total
546.80
.00
.00
546.80
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701
.Building Permit Application and Tracking Sheet
Permit #
Lo
` ll'
Project Address: _ S r "
°
Owner's Name: e
A. P. Number:
Address:
Legal Description:
Contractor: rylC -ireS 5 .irS J?C
City, ST, Zip:��—
t
Telephone: k y �,r
Address: - U le
Project Description:
City, ST, Zip:
Telephone:
State Lic. # : 61 %6l
city Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
9
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New AddFn Alter Repair Demo
Name of Contact Person: <
Sq. Ft.:
#Stories:
#Units: .
Telephone # of Contact Person:p2 `- 48;, 6
Estimated Value of Project: p
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Chec6 Deposit
Truss Calcs.
Called Contact Person
Plan Chec6 Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanican
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 llmpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees