09-1128 (RPL)f
M
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
9_ _ — ET
L:09-000-01128
Property Address:
52990 AVENIDA. VILLA
APN:
773-334-013-14 -000000- r
Application description:
POOL - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
19500
Owner:
RICHARD SCOTT
52990. AVENIDA
LA QUINTA, CA 5
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/26/09
Contractor:
Applicant: Architect or Engineer: PACIFIC HOMES
42335 WASHINGTON ST S '+
PALM DESERT, CA 92211 �?�.�q
kI„_ (760)408-3495
f� Lic. No.: 782324
CIOS
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -----------------
LICENSED
- - - - - - - - - - - - - - - - -
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION '
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 ProfessiLLSi.enseN
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 C ss: 13 : 782324 -for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate:/ issued.
1 Contractor: -� 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
t I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1576557-2009
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 he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I sh Id become subject t the orkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or *URE
e Labor Cod , I sh fort ith m with those p visions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
,that
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - te:cant
(_) 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: ECURE 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS 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 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.).
1 _ 1 1, 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
t
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.).
t
Lender's Name: - -
Lender's Address:
r '
LQPERMIT
APPLICANT. ACKNOWLEDGEMENT
IMPORTANT Application is herebymade 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 actor omission related to the work being
performed under or following issuance of this permit. I ,
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, orcessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to tiui ding.construction, and hereb uthorize representatives
of this u ty tee ter u n the above-mentioned'prop ;�, -'for Pe
pur
e: Q ignature (Applicant or Agent):
_ Application Number, 09-00001128.
.,Permit BLDG POOL PERMIT"
Additional desc .
Permit.Fee . . . . 207.00 Plan Check
Fee
134.55
Issue Date Valuation
. .
. 19500
Expiration Date 4/24/10
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 4/24/10
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 4/24/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
" 1.00 30.000O.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•. 4/24/10
Qty Unit Charge Per
Extension
BASE FEE
25.00
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
. . . . .09-00001128
-----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE= PLASTER
INSPECTION.
'EQUIPMENT ENCLOSURE
NOT INCLUDED.
.2007
CODES.
Other Fees
BLDG STDS ADMIN
(SB1473)
1.00
--Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
311.00
00
00
.311.00:"
Plan Check Total
160.55
.00
.00
160.55
Other Fee Total.
1.00
.00
:00
1.00
Grand ...Total ,. _
_ 472.55
.00
00 .. ....
472.55
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Bin #
Qty of La Quinta
Building 8r Safety Division -
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
A " l
Project Address:— z _ t_
Owner's Name: (C, -�AveCD ' I
A. P. Number:
Address: 52 d L)6
Legal Description:
City, ST, Zip: C .
2Z
Contractor:
C
Telephone:
Address:
Project Description:
City, ST, Zip:
sW M
Telephone:
State Lic. # :
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
-Telephone:
Construction uctCon T Y P e: Occupancy:ancY
State Lic. 4:
ProJect type (circle rc1e ne• New Ad ' n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
'Telephone # of Contact Person: 9
Estimated Value of Project:
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 Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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:-
'^' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
17
Total Permit Fees
Wd
50
91