05-1522 (RPL)I - ;,
N oz
U ry
CD BUILDING & SAFETY DEPARTMENT
P.O. BD 9(760).777-7012
OF78-495 RM`P.1702005 FAX (760) 777-7011
LA Qut I INSPECTION REQUESTS (760) 777-7153
FINANCE DEP?
BUILDING PERMIT
.Application Number . . . . . 05-000015.22 Date 4/22/05
Property Address . . . . . . 78371 DEACON DR W
APN: 770-210-024- - -
Application description POOL - RESIDENTIAL
Property Zoning . . . . . LOW DENSITY RESIDENTIAL
Application valuation 18000
Owner Contractor
--------------------------------- ---------------------------------
TRADITIONS CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
CCC: C8 C27 C29 C53
----------------------------------------------------------------------------
IF
P.O. BOX 1504 • ,�C��� VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING.& SAFETY DEPARTMENT -
Application Number: 0-5, — / S7.2 -Z Date: —L 7 - 0J_
Applicant:
Applicant's Mailing Address:
Bohr 7-le,4 CrotC
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
/V14
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 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
Cgde, and my Lice is i orce and effect. /CC
icense Class Lic nse No. 17_61 Z
VdDate / Z Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
L) I am exempt under Sec. . BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
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.
f have and will maintain w rkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
iss orkers' mpensation insurancecarp
am r Policy Number! �_
certify that, in the pe ormance 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, and agree t should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
�7forthwith comply with those provisions.
Da" to G'o Applicant
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.
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
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 Ouinta, 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 work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is c ct. agree to comply with all city any county ordinances and state laws relating to building
const on. and hereby authorize representatives of this county to enter upon a ov -mentioned property for inspection purposes.
Date Signature (Applicant or A ent):
----------------------------------------------------------------------------
Application Number . . . . . 05-00001522
----------------------------------------------------------------------------
Permit . . . . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
BLDG POOL PERMIT
ee
10/19/05
Plan Check Fee 122.85
Valuation . . . . 17892
Qty Unit Charge Per Extension
BASE FEE 45.00
16.00 9.0000 THOU BLDG 2,001-25,000 144.00
----------------------------------------------------------------------------
Permit . . . . . . MECH POOL
Additional desc . .
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/19/05
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
----------------------------------------------------------------------------
Permit . . . . . . ELEC POOL PERMIT -RES
Additional desc
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/19/05
e
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 . . . . 30.00 Plan Check Fee 7.50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/19/05
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
----------------------------------------------------------------------------
Permit . . . . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date
WALL/FENCE PERMIT
15.00
10/19/05
Plan Check Fee .00
Valuation 108
Qty Unit Charge Per Extension
BASE FEE 15.00
-------------------------------------------- -------------------------------
Special Notes and Comments
POOL & SPA. 5 L.F. 5' BLOCK WALL, CITY
STANDARD. ALARMS/BARRIERS SHALL BE IN
PLACE PRIOR TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
----------------------------------------------------------------------------
Application Number
----------------------------------------------------------------------------
. . . . .
05-00001522
----------------------------------------------------------------------------
Special Notes and
Comments
PERMIT.
Fee summary
-----------------
Charged
----------
Paid
----------
Credited
--------------------
Due
Permit Fee Total
303.00
.00
.00
303.00
Plan Check Total
147.60
.00
.00
147.60
Grand Total
450.60
.00
.00
450.60
Bin #
City Of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 377- pg. WW1
Owner'sName:-p-jo1 f Q)
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: C o s
Address: c) .Z(z�
tphone:
ect Description:
City, ST, Zip:eca CA e [C4 ;L;L 3 0
Doot .5A-
TelePh one:
Title 24 Calcs.
State Lic. # :
City Lin. #;
e
Arch., Engr., Designer:
) Xgt
Address:
S, 60 L L 5 %w
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
ancY
State Lic #.
ProJe t Add'n AlterRe Pair Demo
tYP �circle one :
Name of Contact Person: DAN 1J;05;54:-
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact
Estimated Value of Project: 9900
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIONG
PERMIT FEES
Z
Plan Sets
Grant Deed
Plan Check submittedry
2.
Item
Amount
IStructural
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
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
I
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
Total Permit Fees