08-1608 (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: .
08-000016081
53095 VIA CHIANTE
772-550-011- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
Tityl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 and Professionals Code, and my License is in full force and effect.
License Class:
`BB License No.: 801142
_Date:L3=� Contractor:
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
F.
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
Ay applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 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.l.
1 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:
HIDEAWAY JFC 197
78365 HIGHWAY 111
LA QUINTA, CA 92253
VOICE (760)777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/22/08
Contractor:
COAST & DESERT DEVELOPMNT C ,
78365 HIGHWAY111 STE
LA QUINTA, CA 92253
(760)567-202.6 -
Lic. No.: 801142 p
----------------------- �U
-------WORKER'S COMPENI hereby affirm under penalty of perjury one of the following dI have and will maintain a certificate of consent to omp sation, as provided
for by Section 3700 of the Labor Code, for the r f ich this permit is
issued.
I have and will maintain workers' compensation ins700 of the Labor
Code, for the performance of the work for whichy workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 3 5925-2008
I certify that, in the performance of the work for whichthis 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 Cod , I shall forthwith comply with those provisions.
Date. i Applicant:
WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001 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 buildi construction, and here b arize representatives
of thi'my to enter upon the above-mentioned propert r inspection purpo
Date:` � ` - -Signature (Applicant or Agent):
l -
Application Number . . . 08-00001608
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee 189.00 Plan Check Fee
122.85 ,
Issue Date Valuation . . . .
18000.
- Expiration Date.3/21/09
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 26.00 Plan Check Fee
6.50
sDate :' Valuation" . . .
r 0
Expiration tion Date 3/21/09
Qty Unit Charge, Per
Extension
' BASE FEE l
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 3/21/09 r "
Qty Unit',Charge. Per. =�
Extension
BASE FEE
15.00
1.00 30.0000'EA ELEC PRIVATE SWIMMING POOL
30.00 fi
------------ - -------------- -- - - - - - - - - - - - - - - - + -..- - - - - -1• -' - - - - -. -.- -
'
- - - fl- - - - - - t .
- Permi t PLUMBING
Additional desc
Permit Fee 33.00, Plan Check,Fee
8.25
Issue Date . . . . Valuation
0'
Expiration Date 3/21/09
Qty Unit -Charge Per
Extension. .
BASE FEE
15.00
2.00 6.0000 EA PLB-FIXTURE
12.00
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
--------
Special Notes and Comments
----------
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
LQPERMIT -
- .
f{
Application Number 08-00001608
--------- --------------------------- _ - -
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT -ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
Permit Fee total 293.00 .00 .00 293.00
Plan Check Total 148.85 .00 .00 148.85
Grand Total 441.85 00 .00 441.85
LQPERMIT
Bin #
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
Permit #
Project Address: 'S 3 U�
Owner's Name: e
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: c
Telephone:
Address: ,Ir
t -t
City, ST, Zip: 'r
Project Description:
Telephone: D 2!✓�
State Lic. # - 2 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Ob anc Occu
P Y:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: JCL�11 d AJ
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project• l
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up '
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2id Review, ready for correctionstiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r
rvw
at
m
1+1
US
IN BATH
11 IX I*4 •�•�i
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