06-0678 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4&t 4 4 Q"
Application Number: 06-00000678
Property Address: 52165 VIA CASTILE
APN: 772-410-998-4 -32453 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5000
Applicant: Architect or Engineer
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
FFB 1 ---W,
?'oW ?'046
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 ofthe Business and Professionals Code, and my License is in full force and effect.
License Class: C8 C27 C29 LicenseNo.: 656128
Data: Contractor:
O ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am axe pt 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.).
(_ 1 1, as owner of the property, am exclusively contracting with.licensed contractors to construct the project (Sec.
704 4, Buainaee end Prrfeooiono CodQ1 Tho t: nntr ntnrr' Ctntn I irnnro 1 2- rinar not 2pp1V to an nwnar 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:
LQPERMST
Owner:
ND LA QUINTA PARTNERS
375 N FRONT ST STE 200
COLUMBUS, OH 43215
Contractor'.
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012 .
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/15/06
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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 HRH INS Policy Number B131060510
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 ,come subject to the workers' compensation provisions of Section
3700 of the Labor Code hall forthwith comply with those provisions.
ate: _ /. '-�IApplic
WARNING: FAILURE TO SECURE WORKkELTIES
OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). INADDITIONTOOST 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
nnnrlitinns and restrictions set forth Qn this ageljGatign_
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 abo information is correct. I agree to comply with all
city and county ordinances and state laws relating to bu'I . g truction, and hereby authorize representatives
of this county t -enter upon the above-mentioned prope pec ion purposes.
Date: 1 �gSignature (Applicant or Agent).
Application Number . . . . 06-00000678
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
72.00 Plan Check Fee
46.80
Issue Date . . . .
Valuation . . .
. 5000
Expiration Date
8/14/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001.-25,000
27.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation . .
0
Expiration Date
8/14/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 .7500
----------------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST 20
3.00
Permit . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
24.00 Plan Check Fee
5.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
8/14/06
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
BARBEQUE & FIREPIT ONLY.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
4.68
Fee summary Charged Paid Credited
-----------------
Due
----------
Permit Fee Total
------------------------------
114.00 .00 .00
114.00
Plan Check Total
56.55 _00 .00
56.55
Other Fee Total
4.68 .00 .00
4.68
Grand Total
175.23 .00 .00
175.23
LQPERMIT
f
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City of La QuInta
Building U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
C/ Building Permit Application and Tracking Sheet
Project Address---5j—
Owner's
ddress: Owner's Name:
01.x, � ac
A. P. Number: Address:
Legal Description: City, ST, Zip:
Contractor`. Telephone:4
Address:a _,.,
-0• o Project Description:
City, ST, Zip:
Telephone: 7(od) -59 22—
State
2State Lic. #: (o-5-& ( 2—,�K City Lic. #:
Address:
City, ST, Zip:
Telephone: Construction Type: Oce anc :
� Y
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:............. .
IQOtiG�o Je S Ft.:
q• # Stories: # Units:
Telephone # of Contact Person: 26-0 —vc/-2 Estimated Value of Project: Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
EERMIT FEES
Plan Sets
Plan Check submitted
q-7
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Ballance
Energy Calcs.
Plans picked up
ConstructionYQ
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical4e
- Axvees
Subcontactor List
Called Contact Person
GA$
Plumbing 4r_
-,q 0071675
FjJ�'YuR.6'
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
ans resubmitted
N t1
Grading
IN HOUSE:-
CI�w
Rey�e}v, r�adg�Cor corrections/i-i;a.
Developer Imp.ut Fee
Planning Approval
V
Ca • v w �' /
lled Contact.Person ,
Pub. Wks. Appr
I
Date of Emil is ue RUCTION
"
School Fees
Total Permit Fomes