06-3707 (RPL)P.O. BOX 1504
78-,495 CALLE TAMPICO
LA �QUINTA, CALIFORNIA 92253
T4ht 4 XP Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HARRISON
53315 VIA MALLORCA
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/18/06
v .
Application Number:
06-00003707
P_coperty-Address:
53315 VIA`MALLORCA
AP.N:
772-420-999-42 -298943-
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY 'RESIDENTIAL
Application valuation:
25000 '
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HARRISON
53315 VIA MALLORCA
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/18/06
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
'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 bove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi construction, and hereby authorize representatives
of this county to eyter upon the above-mentioned propert ection purposes. _
Date:
or
v .
- LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury oneofthe following declarations:
Section 7000) of Division 3 ofthe Business nd Professionals Code, and my License is in full force and effect. ,
-
_ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C8 C27 C29 License No.: 656128
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.. '
Date: l - Contractor: -
- _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
L 1 -
- Code, for the performance of the work for which this permit is issued. My workers' compensation
WNER-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 -SEABRIGHT Policy Number BB1060510
_ 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 mannerso s tobecome 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 ecome 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 Labor Code, forthwith comply with those provisions.
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:. , ! W I Applicant:
(_ 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 WORKER ' 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 PE LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
Viand who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,0001. 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
(_ 1 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 contractor(s) 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,.
(_) 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
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
'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 bove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi construction, and hereby authorize representatives
of this county to eyter upon the above-mentioned propert ection purposes. _
Date:
or
Application Number 06-00003707
Permit' ... . BLDG POOL PERMIT
-' Additional desc
Permit Fee 252.00 Plan Check
Fee
163.80
Issue Date . . . Valuation
. .
25000
i Expiration Date..- ." 4/16/07
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 4/16/07
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
Issue Date Valuation
0
i Expiration Date 4/16/07
Qty. Unit"Charge Per."
Extension
BASE FEE
15.00 "
1.00. 30..0000 EA ELEC PRIVATE SWIMMING POOL.
30.00
Permit PLUMBING.
..
Additional desc _
r
Permit Fee _33.00., _ Plan Check
Fee ..
8.25
Issue Date Valuation,
0
.Expiration Date 4/16/07
_
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 ''
_
Total Permit Fees
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Bin #
.: _ .City of. La Quinta
Building U Safety Division
Per it # P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA -92253
- (760) 777-7012
Building Permit Application and Tracking Sheet
.
Project Address: 5',z,;, -Owner
1 's Name:
A. P. Number:
.
.. Address:
Legal Description:
City, ST, Zip: LLL
Contractor`: '
Y\; 1 Telephone:
" —Address:
co Project Description:
City, ST, Zip
Z23:.
Telephone: SC ZZ
State Lic. City Lic #:
Arch., Engr., Designer:
Address: -
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
P cy:
State Lic. #:
oject type (circle one): Add'n Alter Repair. Demo "
Name of Contact Person:
Sq. Ft.: # Stories• # Units:
Telephone # of.Contact Person: �S� C ��
Estimated Value ofProject Z4T a0 v
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACK]1VG PERMU FEES
Plan Sets Plan Check submitted }
Item Amount
Structural Calcs. Reviewed; ready for. corrections Plan Cfieck Deposit
Truss Calcs. Galled "Contact Person . Plan Cheek Balance
Energy Calcs. Plans picked up Construction
Flood plain plan Plans resubmitted Mechanical
Grading plan` Review, ready for correctionstissue Electrical
Subcontactor List Called Contact.Person Plumbing
Grant Deed Plans picked up S.M.I.
H.O:A. Approval Plans resubmitted Grading
IN HOUSE:- Review, ready for correction Developer Impact Fee
Planning Approval Cal r ' Q Q A.I.P.P.
aE
u `
Pub. Wks. Appr Dat of r • ENG & SA
School Fees A r, LJ I
Total Permit Fees
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