10-1305 (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:
10-00001305 M
53475 VIA ALLORCA
772-420-999-47 -298943-
POOL l- RESIDENTIAL
LOW DENSITY RESIDENTIAL
30000
T4'1�v 4 4 Q*&
Architect or'Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GREEK
53-475 VIA
LA QUINTA,
MALLORCA
CA 92253
Contractor:
*4MCINTYRE POOLS `& SPAS,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/10
ncr-
L..._., G rn 6 2010 Fj
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.l.
(_ 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.).
(_ 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
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 a dcounty ordinance and state laws relating to building construction, and hereby authorize representatives
of is county to enter u n the. above-mentioned property for inspection purposes.
Date: 1 Ok O ignature lApplicant or Agent):
1
83695 AVENUE 45
INDIO, CA 92201 F? 92201
(760)342=3612
PI"
Lic. No.: 614611
- - - - - - - - - - - - - - - -
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
l.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 certificate of consent to self -insure for workers' compensation, as provided
'License Class: C53 License No.: 614611 -
_
'for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Dai Ite: onuactm:/ `� �,�. Y1 '1- t
Y, 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 GOLDEN INS Policy Number 2010010139097Z
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 subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the or Code,,l shall forthwith comply with those provisions.
that he or sheds exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -
1- �6 `I �"
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ..
ate:. I0 pplicant: �-l� ''f". `mom'{ F C
c-
(_ 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
_
;WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE'IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,.
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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.l.
(_ 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.).
(_ 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
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 a dcounty ordinance and state laws relating to building construction, and hereby authorize representatives
of is county to enter u n the. above-mentioned property for inspection purposes.
Date: 1 Ok O ignature lApplicant or Agent):
1
12
Application Number . . . . . 10-00001305
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 284.50 Plan Check
Fee
184.93
Issue Date . . Valuation.
. . . .
30000
Expiration Date 5/29/11
Qty Unit Charge Per
Extension
BASE FEE
252.00
5.00 6.5000 THOU BLDG 25,001-50,000
32.50
Permit . . . MECH POOL
Additional desc -.
Permit.Fee 26.00 Plan Check
Fee
6.50
Issue Date . . Valuation
. . .
. 0
Expiration Date ..' 5/29/1,1
Qty Unit .Charge Per
Extension -
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.•0,0
Permit ELEC POOL PERMIT -RES -
Additional desc
}
Permit Fee . . 45.,00 Plan Check
Fee
11.25
Issue Date• . . . . Valuation
0
Expiration Date 5/29/11 .
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 5/29/11
Qty Unit Charge Per
Extension
BASE PEE
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, WATERFEATURE & FIREPIT. GAS
LQPERMIT
Bin #
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
p
Project Address: 5-2z. t&c, Ma
Owner's Name:
A. P. Number:
Address: -3 —7 5 (/)aMy
Legal Description:
Contractor:e
City, ST, Zip: kc i7 •
Tele hone:" w`
P
Address: RZQS '&U1. 45
Project Description: (�
City, ST, Zip: Thcko e Ro
Telephone: '�:•'� ,:� R.4 •�_... �r� �'`�
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State Lie. # : CS(
City Lie. #;45
Arch., Engr., Designer:.
Address:
City, ST, Zip:
Telephone:
...n m
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Ft.: # Stories: # Units:'
Name of Contact Person:Sq.
Telephone # of Contact Person: S — L/6
Estimated value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plaus.picked up
Construction.
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god 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
IN HOUSE:-
''a Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
R
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APPROVED /
FOR CONSTRUCTION 0
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