07-1513 (RPL)P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001513
Property Address:
49130 EISENHOWER DR,
APN:
658-290-042- - -
Application description:
POOL - RESIDENTIAL
Property zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
32000
T4&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
0�
V
--------------- _.
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of,perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code; and my'License is in full force and affect.
LicenseClass: C27 C53 License No:: 801813
Date:,A/'ss�Contractor:
���---777777 �
OWNER -BUILDER DECLARATION
llherebyaffirm under penalty_of perjury that Lam exempt-from,the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Coda: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any strueture,,prior to its issuance, also requires'the applicant for the
'permit to file a signed statement that he or she is licensedpursuant to the provisions of the Contractor's State
License Lew (Ctiapter,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:applicern to a civil penalty of not more than five hundred dollars (8500)::
I _)
[,as owner of the property, ormy employees with wages as their sole compensation, will do the work, and
the structure isnot 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 aie,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, as owner of the property,: am exclusively contracting with licensed contractors to construct the project (See.
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 forthe projecmwith a contractoris) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B:&P:C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that;thereis a construction lending agency for the performance of the
work for which this permit. is issued (Sec. 3097, Civ: C.I.
Lender's. Name: _
Lender's Address:
LQPERMIT
Owner:
BIRDSELL ROBERTA D
PO BOX 630
LA QUINTA, CA 92247
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/22/07
Contractor: d
VICTORIA LANDSCAPES/WA
99145 LOOKOUT DRIVE
MECCA, CA 92254
(760)393-363'0 MAY 231057J,
Lie. No.: 891813
-----------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm underpenalty of perjuryone 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 thework: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 forvihich this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
I- certify that, .in the performance of thework for which this permrt,is issued, l 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
3700 of the Labor Code, I shall forthwith comply with those. provisions.
Date: 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions: and restrictions serf forth on this application:
1. Each person upon whose behalf this application is made, each person;et 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 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 oflsuch permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that t have.read thisapplieation and state that t ie above information is correct. I agree to comply with all
city and county ordinanaea,and state laws relating•to building, construction, and hereby authorize representatives
of this county toenterupon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Application Number . . . . 07-00001513
Permit
. . BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 297.50
Plan Check Fee
193.38
Issue Date
. . .
Valuation
32006
Expiration
Date 11/18/07
Qty Unit Charge Per
Extension
BASE FEE
252.00
7.00
6.5000 THOU BLDG 2:5,001-5.0,000
45.50
Permit
. . . MECH POOL
Additional
desc .
Permit Fee
. . . . 26.00
Plan Check Fee
6.50
Issue Date
Valuation
0
Expiration
Date 11/18/07
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 . 11/1$/07
Qty Unit Charge. Per.
Extension
BASE FEE
15.00
1.00
.30.0000 EA ELEC.PRI-VATE
SWIMMING POOL
30.00
Permit
. . . PLUMBING
Additional
desc .
Permit Fee
. . . . 33.00
Plan Check Fee
8.2.5
Issue Date
. . . .
Valuation
0
Expiration
Date 11/18,/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/REP
3.00
1.60
3.0000 EA PLB GAS PIPE
1-4 OUTLETS
3..00
-------------------------------------------------------------
Special Notes and: Comments
POOL, SPA,
ALARMS/BARRIERS SHALL BE IN
WFEnMrr
Application Number . . . . . 07-0.0001513
------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
-----------------------------------------------------------
Permit Fee Total 401.50 ..00 .00 401.50
Plan Check Total 219.38 .00 .0.0 219.38
Grand. Total 620.88 .00 .00 620.88
LQPE kmrr
CITY OF LA IQUINTA SUB -CONTRACTOR LIST
JOB, ADDRESS PERMIT NUMBER OWNER BUILDER \JttPK0V40V I -A -%&j
This form shall be posted on the job with. the Building Inspection Card at all times in a cons picuous-gla place. Only persons appearing on this list or their employees are authorized to Work
on this
jobi Any changes to this list must be approved by the Building Division prior to Commencement of work. Failure to comply will result in a stoppage of work' and/or the voidance
of building -permit. For each applicable trade, all information requested below Must be complet6d by applicant. "On File* is not . an acceptable response.
Trade I Ciasw'fication.
U
ttaiAontiact6e
'Cit4, Bu n:o3
License
Company Name
ClaWfication
License Number
Exp. Date
Carrier Name
Policy Number
Exp. Date
Exp.
License Number
Exp. Date
d:
(e.g. A, B, C-8)
(xxxxxx)
(xx/Xxlxk)
(e.g,. State Fund, CalComp)
(Format Varies)'
jxx)
(xxlxxlxx)
(XXXX)
lxxlxxlxx)
tARTHWORK . 11 P-4 2)
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DRYWALL
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ELECTRICAL (0.40)
RQOFING-(C
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GLAZING (C.!17.
PAINTING (0331)
CERAMIC TILEL(C-54)
CABINETS (0-6)
FENCING
LANDSCAPING (C;.27.);-..-.,:-.
'POOL IC -53 rou*wz
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' ' 'J'- LA QUINTA
BUILDING & SAF
ETY DEPT.
FOR
STRUCTION
DA BY
Bin GV of LQ Qu,inta
Building tC 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: E 1CO AJ Ownex's Nair: V o —L
A.. P. Number: Address: s`I-Tn,o
Legal Description` City. ST, Zip:
Contractor. Vf ft Ar L+LJ /.A (! Telephone
Address:
City, ST; zip:.`A)G' A- �j ZZa-
Telephom 3 CVd%
State Lica# : FMADIrts
Arch.. EW., Designee:
Address:
City; ST,, Zip:
Telephone:
State Lie. #:
- NameofContadPason:
Teleohoae # of Contact Persons
#t
Coasttuaron Type: UocupanCT
Projed type (circle one): New Add'n Alter Repair Dano
Sq. Ft: # Stories: `# Units:
Estimated' Value of Project tM
APPLICANT: DO NOT WRITE BELOW THIS UNE
S
Submittal
Rey'd
Reed
TRACIMG _ PERIMLLT FEES
Plea Set .
Plus Check submitted
Item Amopnt -
Structural Coles.
Reviewed, ready for correction
Plata ChVek Deposit
Ttuis Cates.
Called CoataetPerson
PlawCheek Balance
Energy Calea.
"am kicked cep
CousbWtion .
1140" plain plan
Plum resubmitted
Mechanical
Grading plin'
2'' Review, ready for am ullonv issue
Electrical
SubeontaeterVA :
Called Contact Person
Plembing
Grant Deed
Plans picked cep
SALL-
ILOJL Approval
Plana resubmitted
Grading
IN HOUSE-,-
Review, ready for.correetiooalissne
Developer Impact Fee
PlanniagApproval
CaUed Contact 'Person
A:LP.P.
Ppb. Wks. Appr
Date of permit Bane
School Rees
Total PermltFees