06-4088 (RPL)I
P.O. BOX 1504^� VOICE (760) 777-7012
78-495 CALLE TAMPICO 4 4.QFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/27/06
,Application Number: 06-00004088 Owner:
Property Address: 44395 FOXTAIL CIR LONG RESIDENCE
_ APN: 604-081-046-83 -22982 - 44395 FOXTAIL CIR
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 24000
Contractor: tCM
Applicant: Architect or Engineer: CALIFORNIA POOLS & SPAP.00OA BOX 1280OV 2COACHELLA, CA 92236 tlg �00"�`((760).398-9222
`Lic. NO.: 656128 OFLAQW1NTA
LICENS CON CTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic ed u er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin and Pro ass s Code, and my License is in full force and effect.
License Claps:
ry 8 C27 C29 / LicenseNo.: 656128
Date://Lr3 �n-f tor:
I 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 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 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
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 SEABRIGHT Policy Number BB1060510
_ I certify that, in the performance of for which this permit is issued, I shall not employ any
person in any manner so as to Vomect to theworkers' compensation laws of California,
and agree that, if I sho becothe workers' compensation provisions of Section
3700 of the Labor C d , I shalmply with those provisions.
i Dat, /Z ere -Applicant:
WARNING: FAILURE ,TO SECURE ORKERSCOMPENSATION 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 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 perm&ationi
k for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above I agree to comply with all
city and county ordinances and state laws relating to building conuthorize representatives
of this county to enter upon the above-mentioned propert or in
Date: —Signature (Applicant or Agent):
Application Number . . . . . 06-00004088
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 243.00 Plan Check
Fee
157.95
Issue Date . . . . Valuation
. . .
. 24000
Expiration Date . . 5/26/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
22.00 9.0000 THOU BLDG 2,001-25,000
7 ------------------------------------------------------------------
198.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check
Fee
6.50
Issue Date Valuation
. . .
. 0
Expiration Date 5/26/07
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 5/26/07
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 5/26/07
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/REF
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 . . . . . 06-00004088
----------------------------------------------------------------------------
Special Notes and Comments
PLACE PRE -PLASTER INSPECTION. FUTURE
GAS STUB PER APPROVED PLAN. EQUIPMENT
ENCLOSURE NOT INCLUDED.
Fee summary 'Charged Paid Credited Due
-----------------------------------------------------------
Permit Fee Total 347.00 .00 .00 347.00
Plan Check Total 183.95 .00 .00 183.95
Grand Total 530.95 .00 .00 530.95
LQPERMIT
u"'tt City of. La Quinta
Building U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: �y-�,� �d\L Gam—
Owner's Name:
A. P. Number:
Address: y Ll_ Cl
Legal Description:
City, ST, Zip:
Contractor` ` vc
lS
Telephone:
Address: �� � Z
(p
Project Description:
( P�
City, ST, Zip• '
Telephone: '76C3c JZZ �-
State Lic. # : Z
City Li,. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone.
State Lie. #:
Construction Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Name of Contact Person: p
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
A Z 1-1 p p d
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACKING.
PERMIT FEES
Plan Sets
Plan.Check submitted
t L
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Cales.
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
Plans resubmitted
Grading
IN HOUSE:-
'," 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