06-1353 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
r --
%06-00001353
53443 -VIA MALLORCA
772-420-'999-46 -298943
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Applicant:. Architect or
T4'yl 4 a4& Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT ,
-----A-
- - - - - - - - - - - - - - - --- - - - - - - - - 7 - - - - - - --- - - - - - - - - - -
--------------------------=---=--------- - - -
LICENSED CONTRACTOR'S DECLARATION
' I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with,
Section 7000) f Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License C ss C53 License No.: 614611'
ate: Contractor
' OWNER -BUILDER DECLARATION
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
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
4 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 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 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:
NRI CCP I
81100 AVENUE 53
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & SPAS, INC.
83695 AVENUE 45
INDIO, CA 92201 „ 4
(760)342-3612
LiC. No.: 614611
• - 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..
. 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 HRH INS Policy Number, 020060333601
I certify that, in the performance of the work for which this permitis issued,I shall not employ any
person in any manner so as to become subject to.the workers' "compensation laws of California,
Magree that, if I should become subject to the workers' compensation provisions of Section
0 of the Labor C .all forthwith comply with those ns. "
ate: Applicant. �� ,,., - C
WARNING: FAILURE TO SECURE WORKERS' 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. -
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.
.1 certify that 1 have read this application and state that the above information is correct. I agree to comply with all
city and ounty rdinances and state laws 'relating to building construction, and hereby authorize representatives
of this u t o enter upon the above-mentioned pro rty r inn/ypect'.ion purpt�sVes..,V,,l._
D Signature (Applicant or Agent): �`-"-^—�'� ► —�
VOICE (760) 777-7012
FAX (760) 777-7011` ,
INSPECTIONS (760) 777-7153
Date: 4./03/06
Application Number . . . . .06-00001353
Permit BLDG POOL PERMIT.
Additional desc .
Permit Fee 252.00 Plan Check Fee
163.80
Issue Date . . .Valuation
25000
Expiration Date 9/30/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
23.00 9.0000 THOU BLDG 2,001-25,000
207.00
Permit MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check Fee''.
6.50
Issue -Date Valuation
0
Expiration Date 9/30/06
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.. 9/30/06
Qty' Unit Charge Per
Extension-.
BASE FEE
15.00
1.00 30.0000 EA ELEC PRIVATE.SWIMMING POOL s.
30.00
Permit PLUMBING
Additional desc_.
Permit Fee 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation'
0
-Expiration Date 9/30/06
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 & TWO WATERFEATURES.
LQPERMIT . _
-
well q
Permit #
D 6— /J�gs�
Project Address:
A. P. Number:
X Contractor.
x Address: n
X
City, ST. Zip: N C�b /fir
f* Telephone:.
A State Lic. N
Arch.. Engr.. Designer:
Address:
City, ST. Zip:
Telephone:
State Lic. !1
1C Name of Contact Person:
X Telephone # of Contact Person:
a=�
q Submittal Req'd
Plan Sets
Structural Coles.
Truss Coles.
Energy Calt:s.
Flood plain plan
Grading plan
Subcoatactor List
Grant Deed
H.O.A. Approval
!M HOUSE:.
Planning Approval
Pub. W'ks, Appr
School Fees
City of La QuInta
Building s Safety Dhtslon
P -O. Box 1504, 78.495 Calle Tampico
La Quinta, CA 92253 • (760) 777.7012
Building Permit Application and Tracking Sheet
O o%%rer's Name: �l0l�l�rG�
Is
i)
Address: J 3 • q I
A
Ciry. ST. Zip: .",—
ILI
ATelephone: :_ s
Project Description:
R 2•'2.,x; n
Citv Lic. #:
Total Permit Fees
Construction Type:
Wt'F',e. r.. `:�'•• :'
�:
Occupancy;
.:. •..
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: �pv
Stories:
M Units:
—_...
stimated Value of project:
S
A�rLt�ANT: 00 NOT WRITE BELOW THIS LINE
Reed
TRACKJMG
Plan Check submittedPERMIT
�.3
FEES
Reviewed. ready for corrections
Q
Item
Amount
Coiled Contact Person
Plan Check Deposit
Plans ticked up
Plan Check Balance
Plans resubmitted
Construction
_" Review, ready for correctionspssue
Mechanical
Called Contact Person
Electrical
Plans picked up
Plumbing
Plans resubmitted
S.�t.l.
3" Review. ready for eorrectionsAssue
Grading
Called Contact Person
Developer Impact Fee
Date of permit issue
A•I.P.P.
Total Permit Fees