07-0716 (SOTB)P:O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T414t 4 4Q"
r
Application Number: -07-00000716
Property Address: 81790 GOLDEN STAR WY
APN: 764-280-999-114 -300235-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1500
Applicant:
Architect or Engineer:
X) IA -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
License Class: C53 C27 LicenseNo.: 419309
Date3 b -e7 C actory/'c-.GLlS2�oJ2��'S�ryg
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 ownemployees, 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.).
(_) 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 am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
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:
MCDONALD
81790 GOLDEN STAR WAY
LA QUINTA, CA 92253
Contractor:
DESERT PARADISE POOL/SPAS
78005 WILDCAT DRIVE SUITE
PALM DESERT, CA 92211
(760)360-7400
Lic. No.: 419309
WORKER'S COMPENSATI(
I hereby affirm under penalty of perjury one of the following declar-1.,.....
_ 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 ENDURANCE WORK Policy Number WVS001347901
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
;ale
3700 of the Labor , I shall forthwith comply with those provisions.
:i-�-d7iconAND SHALL
DTHOUSAND
LLARS IS100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/08/07
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 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 building construction, and hereby authorize representatives
of this courity to enter upon th above-mentioned' property inspecti n purposes.
.f�atej "��a7 �9 nature (Applicant or Agent):
Application Number .
. . . . 07-00000716
Permit
BUILDING PERMIT
Additional desc .
Permit Fee
35.00
Plan Check.
Fee
22.75
Issue Date
Valuation
. . .
. 1500
Expiration Date
9/04/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
10.00 2..0000
------------------------------------
HND BLDG
-----------------------------------------
501-2,000
20.00
-
Permit
PLUMBING
Additional desc .
Permit Fee
18.00
Plan Check
Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
9/04/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------
Special Notes and Comments
----------------
FIRE PIT PER APPROVED
=
PLANS
-----------------------------------------
---------------------------=------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
2.28
STRONG
MOTION (SMI)
- RES
.50
Fee summary Charged
---------------------------
----------
Paid Credited
----------
----------
Due
Permit Fee Total
53.00
.00
.00
53.00
Plan Check Total
27.25
.00
.00
27.25
Other Fee Total
2.78
.00
.00
2.78
Grand Total
83.03
.00
.00
83.03
LQPERMIT
Bin # City Of La QuInt2
Building u Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Applicadon and Tracking Sheet
Project Address: r— 7'10�O Owner's Name:
A. P. Number: Address -:!l `7 :3/)
Legal Description:
Contractor.
Address: :Z t X5 (/f`%,t
City, ST, Zip:
Telenhone,,/-7/,% -M/_i - 741/7/)
City, ST, Zip:
Project Description:
/v. -TA /TY1.1LU6
I -'r- I
State Lie. # City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lie- #: Project type (circle one):
New Add'n Alta Repair Demo
Name of Contact Person: ✓ �,y. Sq. Ft.: # Stories: '# Units:
Telephone # of Contact Perso -504— Estimated Valu; of Project d
APPUCANT: DO NOT WRM BELGW T141S LINE
Submittal
Req'd
Reed TRACIdiG PERMIT FEES
Plan Sets
Plan iMeck submitted Item Amount .
Stractrrral Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cults.
Called Contact Person Plan Check Balance
Encrgy Cafes.
Flood plain plan
Plans Oicked.up Construction
Plans resubmitted Mechanical
Grading.pliin'
2" Revim, ready for correctionstissKe Electrical • Fr y j .
Subcoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.L
I0 A. Approval
Plans resubmitted Grading
IN ROUSE-
>.a Review, ready for.tormclioWassacDeveloper Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Ppb. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees