05-5029 (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:
T4'!t 4 4 Q"
SAFETY DEPARTMENT
NG PERMIT
05-00005029 C \
52305 VIA CASTILE
772-410-998-14 -32453
POOL - RESIDENTIAL C.
LOW DENSITY RESIDENTIAL
15000
cF��G�y� Os
Architect or Engineer:
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 an Professionals Code, and my License is in full force and effect.
License Class: License No.:
ate: Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury t t I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business nd 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.).
1 _ 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:
LQPERMrT
Owner:
ND LA QUINTA PARTNERS
375 N FRONT,ST STE 200
COLUMBUS, OH 43215
FContractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510
CSLB: 656128
VOICE (760) 777-7012
FAX (760) 777-7011"
INSPECTIONS (760) 777-7153
01/01/06
10/31/06
Date: 11/14/05
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.
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 number are:
Carrier C8 C27 C29 C53 Policy Number -- ------- - - - - --
_ 1 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 shoupsrthwith
ubject to the workers' compensation provisions of Section
3700 of the Labor Code, comply with those provisions.
a� te�%� �O�ApplicantWARNING: FAILURE TO SECURE WOPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAS 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 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 county to enter upon the above-mentioned propertpetqion purposes.
Datey //'��/'O Signature (Applicant or Agent):
Application Number . . . . . 05-00005029
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
144.00 Plan Check
Fee
93.60
Issue Date . . . .
Valuation
. . .
. 12860
Expiration Date . .
5/13/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
11.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
99.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
5/13/06
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
5/13/06
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
5/13/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.QQ
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 .
. . . . .05-00005029
Permit . . .
WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . .
54.00 Plan Check Fee
.00
Issue Date
Valuation . . .
. 2140
Expiration Date
5/13/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
1.00 9.0000
THOU BLDG 2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and Comments
SPA ONLY. 30 L.F. 42"
EQUIPMENT BLOCK
WALL, CITY STANDARD;
35 L.F. 4' BLOCK
WALL, CITY STANDARD;
40 L.F. 6' BLOCK
WALL, CITY STANDARD AND 4 L.F. COLUMNS.
Fee summary Charged
---------------------------
Paid Credited
Due
Permit Fee Total
------------------------------
296.00 .00 .00
296.00
Plan Check Total
118.10 .00 .00
118.10
Grand Total
414.10 .00 .00
414.10
LQPERMff
IBin #
Permit #
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D
Project Address:
A. P. Number:
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
C- * Owner's Name:
Address:
City, ST, Zip:
Address: 2�®
Project Description:
City, ST, Zip: l � 2 r,.o
Telephone: 766 ',?R D'0Z U 2—
State Lic. # : (0— 5'(0- ( 2,3-
State
Arch., Engr., Designer:
Address:
City Lic. #:Z
y� 4/0
'5 2 F C� v
IV
-( b`' >
GY�-C S�
'L V—City,
ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: �G��
Construction Type: Occupancy:
P Y:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Estimated Value of Project: o
Telephone # of Contact Person: �g�-!�/!�� S�—Q�
APPLICANT: DO NOT WRITE BELOW THIS LINE
>/
Submittal
Req'd
Recd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
II
Item
Plan Check Deposit
Amount
Structural Calcs.
Reviewed, ready for corrections
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Constructio■
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n' 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
Developer Irapact Fee
IN HOUSE:-
'"' Review, ready for corrections/issue
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
ZIqo
' Z$bo