06-0750 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
06-00000750
Property Address:
78691 DEACON DR E
APN:
770-230-009- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licens. Cla s: C53 Licensq/1�1o.: 598681
D Z% Contractor li/L fir'/��
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he 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.).
(_ 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
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
Owner:
CLARK CLIVE A
55531 OAK HILL
LA QUINTA, CA 92253
Contractor:
AINSWORTH POOL CONSTR,
40900 GLENMORE DRIVE
PAT. -M DESERT., CA 92260
(760)568-4993
Lic. No.: 598681
VOICE (760) 777-7012
FAX (760) 777-7011 ►1
INSPECTIONS (760) 777-7153
Date
FEB 2 2 1006
OF
2/22/06
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.
XI 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 AU INS Policy Number 46-0030110101
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
nd agree that, if I should become subject to the workers' compensation provisions of Section
a --t
0 of the Labor Crodde'e II shall
forthw�ifth comply v/Gi h t1hose provisions.
te. APPlicefSt: Y I� '"01 ✓Q/` P�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO 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 a4 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 Quints, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance nbuilding
mit.
2. Any permit issued as a result of this apomes null and void if work is not commenced
within 180 days from date of issuance mit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state tv information is correct. I agree to comply with all
city and county ordinances and state laws relating tc struction, and hereby authorize representatives
of this co .ty tenter upon the above-mentioned pr i specti n purp es.Da O Signature (Applicant or Agent)
Application.Number . . . . 06-00000750
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
207.00
Plan Check Fee
134.55
Issue Date
Valuation . . .
. 20000
Expiration Date
8/21/06
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
8/21/OG,
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 .
8/21/06
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 . . . .
27.00
Plan Check Fee
6.75
Issue Date . . . .
Valuation
0
Expiration Date ..
8/21/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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
SPA ONLY & ADDITION TO POOL UNDER
LQPERMIT
►1
Application Number . . . . . 06-00.000750
----------------------------------------------------------------------------
Special Notes and
Comments
CONSTRUCTION.
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
305.00
.00 .00
305.00
Plan Check Total
159.05
.00 .00
159.05
Grand Total
464.05
.00 .00
464.05
LQPERMIT
A„
Bin #
City of. La Quinti
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinti, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
O � — 7-
Project Address: OA/
l..
Owner's Name: 710M(lv y4/1 Ci Ot�Q
A. P. Number:
Address:
Legal Descripti
City, ST, Zip:
Contractor: ) nt56.i 62W
OD L 9Aj5T"1 1 oN
Telephone:
Address: I ^{ 0 - Q(J 6 L4 ,v j `
Project Description:
/
City, ST, Zip: 41" � Si q C� `1 � � '6
(�
S(� 4 POOL OO L
Telephone:
State Lic. # :
City Lie. #:
d07,o5--
Arch., Engr., Designer:
Address:
){p -44
City, ST, Zip:
Telephone:+�
State Lie. #: Ll
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
r—
Name of Contact Person: 1 b 4
Sq. Ft :
#Stories:
#Units:
Telephone # of Contact Person: %�j �.
Estimated Value of Project: 00j -
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading_plan
2od 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:-
3' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STEPPING STONES
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