12-0380 (RPL)0
P.O. BOX,1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
`Application Number:
-12-00000380
Property Address:
81196 LAGUNA CT
APN:
764-280-004-7 -35996 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
27500
T4'it .4 4v Q"
Applicant: Architect or Engineer:
n „��0 IIIA
IN
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: C27-053 Lic a No.: 964474
r Date:. Contractor:
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.).
(_) 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.).
( ) 1 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/12
Owner:
ROSE RESIDENCE
81196 LAGUNA CT
LA QUINTA, CA 92253
D°
Contractor: APR 012
10'
DESERT OUTDOORS INC
79405 HIGHWAY 111, P.M 4 awOFL-A QUINTA
LA QUINTA, CA 92253 FINANCE DEPT.
(760)399-9600
LiC. No.: 964474
----------------------------------------------—
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 DEWC229889
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 -
700 of the Labor Code, I shall forthwith comply with those provisions.
i Date, l �� Applicant:
� r
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 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 co ty iLtter upon the above-mentioned property for inspection purposes. '
Signature (Applicant or Agent): .
Application Number . . . . . 12-00000380
Permit . . .. BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 271.50 Plan Check Fee
176.48
Issue Date . . . . Valuation
27500
Expiration Date 10/07/12
Qty Unit Charge Per
Extension
BASE FEE
252.00
3.00 6.5000 THOU BLDG 25,001-50,000
--------------------------------------------------------7-------------------
19.50,
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 24.00 Plan Check Fee
6.00
Issue Date . . . . Valuation . .
. . 0
Expiration Date . 10/07/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
' 1.00 9.0000 EA MECH FURNACE <=100K
-----------------------=----------------------------------------------------
9.00
Permit . . . PLUMBING
Additional desc .
_ Permit Fee 24.00 - Plan Check Fee
6.00
Issue Date Valuation . .
. . 0
- Expiration Date 10/07/12
Qty Unit Charge Per
Extension.
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
1.00 3.0000 EA . PLB GAS PIPE 1-4 OUTLETS
3.00
-
•-------------------------=--------------------------------------------------
Special Notes and Comments
NEW SPA, ALARMS/BARRIERS•SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION
EQUIPMENT ENCLOSURE NOT INCLUDED. GAS
ELECTRIC FOR FUTURE BBQ.
--------------------------7------------------------
'Other Fees . . . �. . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited.
--------------=---------------
Due
----------
-----------------
Permit Fee Total 319.50 +' .00 .00
319.50
Plan Check Total 188.48 .00 .00
188.48
Other Fee Total 1.00 .00 .00
1.00
Grand Total. 508.98 .00 .00
508.98
LQPERMIT
#
Cray. of- La Quin: t'i
Building 8t Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet :
Permit #
r�
01
Project Address: -� Q 1p (_ G�- .
Owner's Name:. pcJ-
A P. Number. ..
Address:
Legal Description:
Contractor. Desert OutdoorsTelephone
City, ST, Zip.
Address: 78-065 Main St. Ste. 205
Project Description:
City, ST, Zip: La Quinta, Ca. 92253 .•.•c-�
Telephone: 760-399-9600
State Lic. # : --c-53 964474 City Lia #;
!.b
Arch., Engr., Designer Flying Buttress
Address: - 77725 -Enfield Ln. Ste. 130
city,sT,zip: Palm Desert, CA. 92211
Telephone: 760-772-4411
State Lic. #: 33446 ::......
Name of Contact Person: V (SV -6Z VV
Construction Type:. occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#Stories: # Units:
Telephone # of Contact Person: 275 —7 357q
I Estimated Value of Project: 2-1
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
Recd
TRACKING
PERMTPFEES
Plan Sets
Plan Check submitted. a
"w2
Item Amount
Structural Celts.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calce.
Plans picked up
Construction
Flood ptafnpian
Plans resubmitted.'.
Mechanical
Grading plan
V Review, ready for correctionsressue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7i° Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P. '
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Bin
`
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-70.12
Building Permit Application and Tracking Sheet
Permit #
Project Address: J 1
Owner's Name:
Address:
City, ST, Zip:
A. P. Number: 35" (A
Legal Description:
Contractor: �
Telephone:s�s'••??>`::''ti„
.?e:„Y;^:ci'w::::><;::¢`::
c7
Address: �q l �
City, ST, Zip:
Project Description:
Telephone:
>4a>r g>r•«;.:,;:,::;:;:::;..{ ;:;
State Lic. # :
City Lie. #;-E
Arch., Engr., Designer:
n� (1
d✓ T
Address:
City, ST, Zip:
L
Telephone:
P
State Lic.
Construction T e40
YP Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Q . D
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person--(,r,d--,., �'1� —(4 �,3 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 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 correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
il
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- BOX BAY 7300 I
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5'I LOT 7 j
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6,496 SF ✓ 15'
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PL
I PRODUCT 1
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I FF=476.97 1
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GF=476.00
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$ 4 5R
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
DATE BY
SIGI
J s — S/w
LAGUNA COURT
s- - Lci (P