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11-0794 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: C11 00000794"` 81139`LAGUNA CT 764-280-004-14 -35996 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 41500 Tay/ " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engi er: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I icensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business tdyr ssi s Code, and my License is in full force and effect. License Class: C27 icense No.: 898417 L2A - � ate• ractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of p jury th I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Bu ' ass d Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, air 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).: (_) 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 burdenof proving that he or she did not build or improve for the purpose of sale.). 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 am exempt under Sec. , BAP.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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/25/11 Owner: BRUCE GOFORTH 81139 LAGUNA COURT LA QUINTA, CA 92253 Contractor: DESERT LANDSCAPE ASSOCIATES 79405 HWY 111, STE #9, PMB 427 LA QUINTA, CA 92253 (760)399-9600 LiC. No.: 898417 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'.NORGUARD INS Policy Number DEWC122591 I certify that, in the performance of the wor�octwo r hich this permit is issued, I shall not employ any person in any manner so t be a tewrkers' ompensation laws of California, and agree that, if I shoul bec e s co the workers' compensation provisions of Section 3700 of the bor Cod s I to it comply with those provisions. gate: pplicant: WARNING: FAILURE TO SECU E WOR S' C MPENSATION COVEFIAG 'I AWFUL SH SUBJECT AN EMPLOYER TO IMINAL ENALTIES AND CIVIL FINES UP E OUSAI� DOLLARS ($100,000). IN AD TION T THE COST OF COMPENSATIO _ A AGES AS PR F IN SECTION 3706 OF THE LABO CODE, J qTEREST, AND ATTORNEY'S F /t APPLICANT ACKNOWLED EM T �L. 4w Sn IMPORTANT Application is hereby made to the Director of Building an Safet ermit subject to2-0,11 conditions and restrictions set forth on this application. L/ 1 . Each person upon whose behalf this application is made, eaZ:h.p son a6se'Te1a or whose benefit work is performed under or pursuant to any permit iss•r the owner, and the applicant, each agrees to, and shall defend, indemnify an 8r - t[ City of La Quinta, its officers, agents and employees for any act or omission related to the r ' eing performed under or following issuance of this permit. 2. Any permit issued as a result of this application bac null and void if work is not commenced within 180 days from date of issuance of such rmit, o cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the a ova inf ion ' rrect. I agree to comply with all city and county ordinances ands ate laws relating to buildin con do , d ereby authorize representatives of this my to enter upon t above-mentioned grope pe ion rp es. D • '�• Si ature (Applicant or Agent): Application Number . . . . . 11-00000794 Permit BLDG POOL.PERMIT Additional desc . Permit Fee . . . . 362.50 Plan Check Fee 235.63 Issue Date . . . . Valuation . . . . 41500 Expiration Date 1/21/12 Qty Unit Charge Per Extension BASE FEE 252.00 17:00 6.5000 ---------------------------------------------------------=------------------ THOU BLDG 25,001-50,000 110.50 Permit MECH POOL Additional desc . Permit Fee . . . . 26.00• Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/21/12 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 1/21/12 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 1/21/12 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 1.00 3.0000 EA . PLB GAS PIPE 1-4 OUTLETS 3.00 -------------------------------------------------------- ------------------- Special Notes and Comments POOL/SPA, BBQ (NO SINK), FIREPIT.• LQPERMIT 1 . Application Number . . . . . 11-00000794 ' -----------------------------------=----------------------------- Special Notes and Comments ----------- ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010 CODES. ------------------------------------------7--------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 466.50 .00 .00 466.50 Plan Check Total 261.63 .00 .00 261.63 Other Fee Total 2.00 .00 .00 2.00 Grand Total 730.13 .00 .00 730.13 LQPERMIT GTM CWM AT VOM AP SrA d m elm or WAMM FWWW AT 47 NM WM W MD PAW MM *UbVM G1D LAT11M PATO - SYMCR a OW A PARE OP IM POOfD 10'1 AUIMGCD 1.ATMe MflO - 5111MIM OW A PMR a lM �eo�D .IsaPAellr.►,m rawfAYI RM - sslOtEmLa wM I019XTAH SMIM M ATOW ISM 51171! GOUIIOIT P AND 8=40 PAM .¢tors ears. 7 7- PP)di WOOOAM �► ��WW PAVM LAYER / e>wtv19 dow eclaf T oCPOD TO . �% Acct» V LAMA GOMT I CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION DAT 'a�0"f BY_y_ C-�f-166- exwnm no"$TOmvm "in 70 9"Gufr D MH ew CLAM , 93P LAICH M ICJVV®L 6QGRi1FLAMRL �BYL ZfW . org S u. PAdX At 56!,wprr d V. .tplr tawg u. parr d AL w u. povrrr d .a. = 44 2N s/. paws d aur CD MI r/. pg r a Inst mor p at u. r�ow1 d rror IM u. ao11c IrnaNea d Mor O EXISTING RESIDENCE .¢tors ears. 7 7- PP)di WOOOAM �► ��WW PAVM LAYER / e>wtv19 dow eclaf T oCPOD TO . �% Acct» V LAMA GOMT I CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION DAT 'a�0"f BY_y_ C-�f-166- exwnm no"$TOmvm "in 70 9"Gufr D MH ew CLAM , 93P LAICH M ICJVV®L Bin #City of LQ Qu►nta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # n, ` Project Address: A � ame: V A. P. Number: 7Addres7s: Legal Description: Contractor: iiC City, ST, Zip: Telephone: %'> :<s:«:>.>:<'>.:<;.:•::.<'::_":': ,: Address: LOS E 1� 1 !N� a Project Description: �. City, ST, Zip: LP, (IXA "--A CA ql Z z-5- 3 l Telephone. State Lic. # : City Lic. #: Arch., Engr., Designer: V Address: City, ST, Zip: Telephone: � •�:zxs�� ��:;�'��;.: •.:.. •�: >�.. ti:�.:, State Lic. #: Name of Contact Person: J . I-� . Construction Type: Occupancy:.. Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Proiectm y 1 APPLICANT: DO NOT WRITE BELOW THIS LINE 4 Submittal Req'd Rec'd 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 Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`d 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