05-5348 (RPL)P.O. BOX 1504
T4ht
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00005348 Owner:
Property Address: 52285 VIA CASTILED ND LA QUINTA PARTNERS
APN: 772-410-998-12 -32453 - 375 N FRONT ST STE 200
Application description: POOL - RESIDENTIAL 4 COLUMBUS, OH 43215
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000 �[�e
�/� C 09�� ontractor:
Applicant: Architect or Engineer:/ ®f CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760) 398-9222
Lic. No.: 656128
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 C2,9 License No.: 656128
Date: 4?- 7'-C"5_ Co actor:,
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.).
(_ 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.).
I—) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/07/05
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
iss
n/Xhave
an ` 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 SEABRIGHT INS Policy Number BB105OS10
_ 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 godej shall forthwith comply with those provisions.
D _' _-1 Applicam
WARNING: FAILURE TO SECURE WORLCOM'PENSATION OAGE LAWFUL, 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. teach 0ers6R U066 wh6s6 Oehalf tRis 1100116atlOR is made, eaen person at wnose request aro 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, cons uction, and hereby authorize representatives
of this ounty to enter upon the above-mentioned prope for in ction purposes.
Date: /7-9-r- Signature (Applicant or Agent):
Application Number . . . . . 05-00005348
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
135.00 Plan Check
Fee
87.75
Issue Date . . . .
Valuation
. . .
. 11817
Expiration Date
6/05/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
10.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
90.00
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
6/05/06
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 . .
6/05/06
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
6/05/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
RA PT.R FTXTTTRR
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 . . . . . 05-00005348
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 63.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 3183
Expiration Date . . 6/05/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
----------------------------------------------------------------------------
Special Notes and Comments
SPA ONLY. 103 L.F. 6' BLOCK WALL, AND
3
L.F. 4' COLUMN, ORCO STANDARD; 35 L.F.
42" EQUIPMENT WALL, CITY STANDARD.
Fee summary Charged Paid
----------
Credited
----------
----------
Due
--=------------------------
Permit Fee Total 296.00
.00
.00
296.00
Plan Check Total 112.25
.00
:00
112.25
Grand Total 408.25
.00
.00
408.25
' 1 Bin #
Permit #
D,
Project Address:5-9_26
A. P. Number:
Legal Description:
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
V 1 GL ce"1POwner's Name:
Address:
City, ST, Zip:
Telephone: >
Project Description:
qvmFm -1z-
Address: Address:
City, ST, Zip:c6r-c` a .� `C�
Telephone: 7&0) ',2R D'y'� 2
State Lic. # : (0-5'co ( 2
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person: 26-0
# Submittal_
Plan Sets
Structural Calcs.
Truss Cates.
Energy Cates.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Lic. #:
2X6'
I Total Permit Fees I I
v' 7
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
JeSS e
Sq. Ft.: # Stori( # Units:
Estimated Value of Project: )e
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd
TRACKING. 4
Plan Check submitted l�
PERMIT FEES
Item Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check balance
Construction
Plans picked up
Plans resubmitted
Mechanical
Electrical
Plumbing
2nd Review, ready for corrections/issue
Called Contact Person
Plans picked up
S.M.I.
Plans resubmitted
Grading
'"' Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
I Total Permit Fees I I