05-5492 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00005492
Property Address: 52285 VIA CASTILE
APN: 772-410-998-12 -32453 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5000
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 C299ttat
License No.: 656128
DaiB!/Z�d — (TontraToer:
s
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjam 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 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.).
(_) 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:
LQPERMIT
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: 12/19/05
------------------
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
issued.
X 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 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 I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, ph forthwith comply with those provisions.
Date: M-410 Applicant:
WARNING: FAILURE TO SECURE WORKER 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.
I . 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 above information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi construction, and hereby authorize representatives
of this county to enter upon the above-mentioned pr tty inspection purposes.
Da *0 Signature (Applicant or A nt):
Application Number . . . . . 05-00005492
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 72.00 Plan Check Fee 46.80
Issue Date . . . . Valuation . . . . 5000
Expiration Date . 6/17/06
Qty Unit Charge Per Extension
BASE FEE 45.00-
3.00 9.0000 THOU BLDG 2,001-25,000 27.00
----------- -----------------------------------------------------------------
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
ELEC-MISCELLANEOUS
16.35
6/17/06
Plan Check Fee
Valuation . .
4.09
0
Qty Unit Charge Per Extension
BASE FEE 15.00
3.00 .4500 EA ELEC DEVICE/FIXTURE >20 1.35
-------------------------------------------------------------------- ------
Permit . . PLUMBING
Additional desc .
Permit Fee . . . 24.00 Plan Check Fee 5.25
•Issue Date . . . . Valuation . . . . 0
Expiration Date 6/17/06
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 Z21-55-1995 AND FIREPIT AGAL
496.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68
Fee summary
-----------------
Permit Fee Total
Piah LYieck Totai
Other Fee Total
Grand. Total
LQPERMIT
Charged Paid
112.35 .00
56.'14 .00
4.68 .00
173.17 .00
Credited Due
.00 112.35
.00 56.14
.00 4.68
.00 173.17
Bin # '
City of La Quints
Building €t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �� Z�� U; -
A. P. Number:
Owner's Name:
Address:
City, ST, Zip:
Legal Description:
Contractor`. `
Address: -O1;�,oy2'90
Telephone: '
T:,ti
Project Description:
\
City, ST, Zip: c��
Telephone:.76Q 3W012-2 2-
State Lie. #: Of-& ( 2- Y'
City Lie. #:
— — ------------------------.—._.---
Arch., Engr., Designer—
Address:
City, ST, Zip:
Telephone:
State Lie. #:
/.:.
Name of Contact Person: t�G�� Jew
Construction Type: Occupaicy:
Project type (circle one): New Add'n AtIter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:6-0--S/y� s,275-02
Estimated Value of Project: -�,- Q o 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
l
Req'd
Recd
TRACKING
PERMIT FEES
Plan Check submitted
�ItemAmount
al Calcs.Reviewed,
rEnergy
ready for corrections
Plan Check Deposit
tes.
Called Contact Person
Plan Check Balance
Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready Cor corrections/issue
Electrical
Subcontactor List
Grant Deed
Called Contact PersonPlumbin
Plans picked up
!- JAAW
CAS
S.M.I.
.404191u"�!'
!—y s�7rEzs
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d 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