06-2096 (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:
-06---O'00020.9-6:-!
80718 VIA GLORIETA
772-270-010-19 -311231-
POOL --RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
COOK.
80-718 VIA GLORIETA
.LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS &'SPAS,
83695 AVENUE 45
INDIO, CA 9? -201
(760)342-3612
Lic. No..: 614611
VOICE. (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/19/06
%1NG .
U MW 2.2 2006
CITY OF LA QUINTA
FINANCE DEPT
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and. my License is in full force and effect. _ I have and will maintain a certificate of -consent to self -insure for workers' compensation, as provided
License Clas C53 License No.: 614611 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier HRH INS Policy Number . C20060333601
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become sub' o the worker 'compsation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or Jr - 3700 of the Label Code, I I fort , ifh comply wi hose ovisions.
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).: Date: pplicant• '
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 WA ING: FAILURE TO SECURE W KERS' COMPE ATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SU JECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the, work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement_ is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business. and'Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, -
( 1 I am exempt under Sec. , B-.&P.C. for this reason - 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCYpermit to cancellation. -
I hereby affirm under penalty ofperjury that there is a construction lending agency for the performance of the _ I certify that I have read this application and'state that the above information is correct. agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building co struct , and hereb uthoriz epresentatives
• of this co w o ent upon the above-mentioned prope spe n purposes.
Lender's Name:
.. _ Da te• gnature (Applicant or Agen
Lender's Address:
J
LQPERMIT
Application Number .
. . . . 06-00002096
Permit.
BLDG POOL PERMIT
Additional desc .
Permit Fee
207.,00 Plan Check Fee
134.55
Issue Date
Valuation .
. 20000
Expiration Date
11/15/06
Qty Unit Charge_
Per
Extension
BASE FEE
45.00
18.00 9.0000
THOU BLDG 2,001-25,000
162.00
Permit
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date ,.
11/15/06
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
11/15/06
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
33.00 Plan Check Fee
8.25
Issue Date . . .
Valuation
0
Expiration Date
11/15/06
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 ONLY. ALARMS/BARRIERS SHALL
LQPERMIT ..
-
Bin 1y :.
City. Of La QuIlIt'a .
Building 81 Sarety Divislon
PeRltlf` P.O. Box 1504, 78.495 Calle Tampico
�Z QGj La Quinta, CA 92-253.(760) 777-7012
Building Permit Application and Trac '
Project Address: �� o • lictik1n, Sheet
Owner's Name: •
A. P. Number:
_
Legal -Description: Address: • "
City, ST, Zip: '
Contractor:
Address: _ % . Telephone:
City, ST, Zip: .� Project Description:
Telephone:
State Lic. # : L
CityLic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: <iso££'�•;� �..'�,:,:,,�:,., s,
'y,Rf.:�7i•'�{�• •f,>�} ?� yr, `•,3,:;; f/:,Yry�:q:G
Construction Type: Lie. Occu.
LSqq.
ct type (circle one) eye
Name of Contact Person: Add'n Alter Repair. Demo
t.: # Stories: #Units;
Telephone # of Contact Person:
�� Estimated Value of Project:
APPLICANT: DO 'NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd
TRACKING*
clan secs PERMIT F'EPS
Plan Check submitted
?
Structural Cala. Item Amount '
' Reviewed, ready for corrections
Trusr'Calcs. Pian Cbeek Deposit
.Called Contact Person
Title 2:4 Calcs: Plan Check Balance
Plans picked'up
Flood plain plan Construction
Plans resubmitted
Grading.plan hiecha Tical
2" Review, ready for correctionsfissue
Subcontsctor List F-ltctrc:al
Called Contact Person
Grant Deed Plumir.ng
Plans picked up
I1.O.A. A S.11f.1.
peroral Plans. resubmitted
IN I[OUSE:. Gradiag
J! Review ' eady for correclions/issue�
PlanningA Develcper Impact Fee
Approval Called Contact Person
Pub. Wks. Appr
Date of permll-issue
School Fees
Total Permit tees