05-2350 (RPL)1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Application Number:
OS -00002350
Property Address:
81375 LEGENDS'WY'
APN:
762-420-038=` -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
18000
Applicant: Architect or Engineer:
Co TkA C ,`0�?
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am I'cen d under provisions of Chapter 9 (commencing with .
action 7000) of is io the Business and Profe Is Code, antt•fity1.ice�,se�is�n fill force and effect.
�
icense Clas cense No/
ate: is Contractor:
1SWDERl LDER 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 1$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.).
(_ 1 1, 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
propertywhe 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
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:
LQPERAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/15/05
Owner:
SRHI
C/O RIELLY HOMES INC
3 CORPORATE PLAZA DR 210
NEWPORT BEACH, CA 92660
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
-----------------------------------------------
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.
1 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 are:
Carrier CS C27 C29 C53 Policy Number - - - - - - - - - - - - - --
_ 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 shout ecome s ct the workers' compensation provisions of Section
37 0 of the Labor C I hall fort wit mply with those provisions.
65te: Applicant: *'
WARNING: FAILURE TO SECURE W,4RKERS'tQX7MSATION 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 ss 'on of work for 180 days will subject
permit to cancellation. -
certify that I have read this application and state that the above infor tio,-i correct. I agree to comply with all
city and county or nances and state laws relating5�17,u
buildonstrct n, hereby authorize representatives
of s cou y to nter upon the above-mentioned pr,cti oses.
aU te: V� d Signature (Applicant or Agen
LQPERA1IT
Application Number . . . . . 05700002350
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 189.00 Plan Check
Fee122.85.
Issue Date Valuation
.. . .
. 17920
Expiration Date 12/12/05
Qty Unit Charge Per
Extension
BASE FEE
45.00
16.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
.144.00
Permit MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check
Fee
6.50
Issue Date . . . . Valuation
0.
Expiration Date 12/12/05
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 . . . . 15.00 Plan Check
Fee
3.75
Issue Date Valuation
. . .
. 0,
Expiration Date 12/12/05
Qty Unit Charge. Per
Extension
BASE FEE
------------------------------------------=---------------------------------
15.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 33.00 Plan Check
Fee
8.25
Issue Date . . . . Valuation
. .
. 0
Expiration Date 12/12/05
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
Additional desc .
LQPERA1IT
s
LQPERMIT
Application Number . . . . . 05-00002350•
Permit . . . . . . WALL/FENCE PERMIT
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
80
Expiration`Date 12/12/05
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.
Fee summary Charged Paid Credited
Due
- --- ---�' Permit Fee Total 278.00 .00
.00
278.00
Plan Check Total 141.35 .00
.00
141.35
Grand Total 419.35 .00
.00
419.35
s
LQPERMIT
Bin #
City of LQ Quints
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
S 3 O
.
-
Project Address: — 3r ✓ - Lgq& IDS
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: C L tJD LS �
City, ST, Zip:
Tele hone:
P ne.
Address: C)
Project Description:
City, ST, Zip: to
-
toL PA-
Tel h n
Telephone:
e o e.
P 2
.........................................::::::::::
State Lic. # 4) City Lic. #;
Arch., Engr., Designer:
Address: �s WA -U,.
l 00K W it L L.- $ %-1i
City., ST, Zip:
Telephone: hone:
...
Construction Type: Occupancy:
State Lic. #:
Project (circle le
one :
o
type Ad ' Alter Repairai
r Demo
Name of Contact Person: DAM 1���4C7
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:; ;� "/:$I� .S'� i
Estimated Value of Project: 1 0(D
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKINGPERMIT
FEES
Plan Sets
Plan Check submitted
6/1,4//
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
2ed 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
Total Permit Fees
�O
duo