05-5374 (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:
05-00005374
52165 VIA CASTILE
772-410-.998-4 -32453 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
T,i&t 4 4 w
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
.BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION .
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
�Date:114-11-0 Contracto
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury the 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 1, 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. gutiino§§ and Prgfv§§ig 15 %449: Thg Qontractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) 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:
LQPERMIT
Owner:
ND LA QUINTA PARTNERS
375 N FRONT ST STE 200
COLUMBUS, OH 43215
Contractor:
CALIFORNIA POOLS
P.O. BOX 1280
COACHELLA, CA 922.
(760)398-9222
Lic. No.: 656128
IA
VOICE (760) 777-7012
FAX (760) 777-7011 _
INSPECTIONS (760) 777-7153
Date: 12/09/05
WORKER'S COMPENSATfoF
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' compensa provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
x I have and will maintain workers' compensation insurance, as required by -Section 3700 of the Labor
T— Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier SEABRIGHT INS Policy Number 'BB1050510
_ 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 Ishould ecome subject to the workers' compensation provisions of Section
37100 0, the Labor Code all forthwith comply with those provisions.
atD" e: �-� '� J Applicant:
WARNING: FAILURE TO SECURE WORK S' 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 wh63a b6half tn15 appllcavon is ma0e, eaCn person eL wnusu iuyuesi. auu (ui
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 co truction, and hereby authorize representatives
of this cou ty to enter upon the above-mentioned property for i ection purposes.
Date*� Signature (Applicant or Agent):
Application Number . . . . . 05-00005374
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
189.00 Plan Check Fee
122.85
Issue Date . . . .
Valuation
17177
Expiration Date
6/07/06
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 . . . .
24.00 Plan Check Fee
6.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
6/07/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
----------------------------------------------------------------------------
EA MECH FURNACE <=100K
9.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc . .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation
0
Expiration Date
6/07/06
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 . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
6/07/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
ER PLB FIXTURE
6.-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
Application Number . . . . . 05-00005374
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 23.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 823
Expiration Date 6/07/06
-Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 2.0000 HND BLDG 501-2,000
8.00
----------------------------------------------------------------------------
Special Notes and Comments
SPA ONLY. 20 LF 42" EQUIPMENT WALL & 8
LF 4- BLOCK WALL, CITY STANDARD. 15 LF
6' BLOCK WALL.ORCO SYSTEM.
ALARMS/BARRIERS SHALL BE IN PLACE PRIOR
TO PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited
----------
Due
-------------------------------------------=---
Permit Fee Total 308.00 .00
.00
308.00
Plan Check Total 146.85 .00
.00
146.,85
Grand Total 454.85 .00
.00
454.85'
LQPERMIT
Bin #
Permit #
ds --6-3%f
Project Address::5,2- !65
A. P. Number:
Legal Description:
Address: _ o
City, ST, Zip: -
Telephone:766 3D'y'222
State Lic. # : CO5,�O T
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:Q01-CA, t
Telephone # of Contact Person: 21;-0
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
Address:
City, ST, Zip:
Project Description:
.223 �C�a
0
t1.Raavr Im v� C C --C-\ :l( /1.
City Lic. #: G, ) g� P i<-.-
,l/1 f GN [A&y / ' o
Total Permit Pees
MaiConstruction
Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
D l 0,51!f 10 Sq. Ft.: # Stories: #Units:
'�y�S71 Estimated Value of Project: `�a)
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING .
PERMIT FEES
Plan Check submitted
4 0�
Item
Plan Check Dtposit
Amount
Reviewed, ready for corrections
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2nd Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Grading
Plans resubmitted
3' Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Pees