06-0017 (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:
06-0.0000017
81245 LEGENDS WY
762-420-027- -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
30000
Architect or
LICENSED CONTRACTOR'S DECLARATION
T,i&t
4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT.
p e —
JAN 17 2006 D
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: C8 C27 C29 License No.: 656128
ate: Contractor.
O NER-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 155001.:
(_ )- 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 _) 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 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:
LQPERMff
Owner:
WELCH
81-245 LEGENDS WAY
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS & SPAS
P.O. BOX 1280 �.
COACHELLA, CA 92236 j
(760)398-9222 .
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-70 HIF
INSPECTIONS (760) 777-7153
Date: 1/04/06
t
WORKER'S COMPtWSATION 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
X• 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 HRH INS Policy Number B13106OS10
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
3700 of the Labor Code, I Fl3fr' ith comply with those provisions.
ate: j Applicants
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN . TIES 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 p4orn of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abcorrect. I agree to comply with all
city and county ordinances and state laws relating to buildingereby authorize representatives
of this count?y to enter upon the above-mentioned proppeeray fo
Dd: `� 7 Signature (Applicant or Agenti+'
Application Number .
. . . . 06-00000017
Permit . . .
BLDG.POOL PERMIT
Additional desc .
Permit'Fee
284.50 Plan Check•Fee
184.93
Issue Date . . .
Valuation
. . .
. 29920
Expiration Date
7/0.3/06
Qty . Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
--------------------------------------------•--------------------------------
THOU BLDG 25,001-50,000
32.50
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . .
: 0
Expiration. Date
7/03/06
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
7/03/06
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
7/03/06
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
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
K
LQPERMIT
Application Number . . . . . 06-00000017
Permit WALL/FENCE PERMIT
-.. Additional desc
'
Permit Fee . . . . 15.00
Plan Check
Fee
00
Issue Date . . . .
Valuation
. . .
. 80
Expiration Date 7/03/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------
Special Notes and Comments
POOL & SPA ONLY. 5 L.F. 4- EQUIPMENT
BLOCK WALL; CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE PRIOR'
TO PRE -PLASTER INSPECTION.
r
- -- Fee summary. Charged Paid
---------- ----------
Credited
Due
-----------------
Permit Fee Total 403.50
.00
.00
403:50
Plan Check Total 210.93
.00
.00
210.93
Grand Total 614.43
.00
.00
614.43
LQPERMIT
Bin #
City ®f 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:�(,Z ���
e�� S c.sc�
Owner's Name:
Address: ::,&` A C/ S
A. P. Number:
Legal Description:
City, ST, Zip:
Contractor`.. `
Telephone:`
Address:
Project Description:
City, ST, Zip :
2
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�JG �j`
Telephone:76037 D' % 2
/
r:
.L x
State Lic. # : (0 -Co ( 2
City Lic. #:
Li
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: occupancy:
: P Y
State Lic. #:
_
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: S Ft.:
9 # Stories: # Units:
Telephone # of Contact Person: 26-0--7' 7 �2 S � -t��y Estimated Value of Project: Ono�
APPLICANT: DO NOT WRITE BELOW THIS LINE
f/ Submittal Req'd Recd TRACIQNG PERMIT FEES
Plan Sets
Plan Check submitted I Y Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2nd 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 corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
I ! Total Permit Fees I 1
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