10-0315 (RPL)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 1NSPECTIONS (760) 777-7153
BUILDING PERMIT
Date:. 4/14/10
Application Number. 10-00000315 -- Owner:
Property Address: 80215• VIA MIRASOL SEDONA HOMES; INC.
APN: 777-090-027-1.- - 73091 COUNTRY CLUB DR. # A481'
Application description: 'POOL - RESIDENTIAL PALM DESERT, CA 92260
Property Zoning: LOW DENSITY RESIDENTIAL O
Application valuation: 25000
Contractor: 4
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, C.
83695 AVENUE '45
INDIO, CA 92201 C` 1
(760)342"3612 A
t9
IPC Lic. No.: 614611
• = " LICENSED CONTRACTOR'S DECLARATION. - 'WORKER'S COMPENSATION DECLARATION -
1 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)-ofDivision.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 Cl as : C53 - L-ns o.:- 614611 - ' ' for by Section 3700 of the.Labor,Code, for the performance of the work for which this permit is
Kissued.
ate: z -� ILntractor. - Y\ I have and will maintain workers' compensation insurance, as required b Section 3700 of the Labor r -
q Y
!, ` _ 6odo"for tl a pvlfolllli, ou of ll4v r. olklVl ..IJuL. lila pui-li la Issued. blq-"ulkela' ciumpensatluu
OWNER-BUILDER DECLARATION-insurance'earrierand policy number are:
I hereby affirm under penalty of perjury that) am exempt from the Contractor's State License Law for the - , Carrier GOLDEN INS Policy Number 2010010139097Z
following reason reason (S.ec. 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 00 of the Labor Cod 1 II for•j�e4ith c�rnply w' those provisions.., -
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ,I•, ,
any applicant fora'permit subjects the applicanato a civil penalty of not more than five hundred dollars ($500).:. e: 7)
1,
U A 'ant:
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 - WARNI7G-.7FAIWdAE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to anowner 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 workhimself 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
• ( 11, 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 whocontractsfor 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,
C_ 1 I am exempt under Sec. BAP.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 fromdate of issuance of such permit, or cessation ofworkfor 180 days will subject -
CONSTRUCTION LENDING AGENCY permit to cancellation.
Thereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read thisapplication and state that the above information is correct. I agree to comply with all
work for which thispermit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building constru tion, and hereby authorize representatives
• - _ - - of this count to enter upon the above-mentioned property fo ins -
Lender's Name: - -
Cat, ign re (A
Spplicant or Agent)` .
Lender's Address: 1Ar.
LQPERMIIT .
Application Number..
. . 10-00000315 ,
Qty Unit Charge Per
Permit . . .
BLDG POOL PERMIT
15.00
1.00- 30.0000".EA ELEC.PRIVATE SWIMMING; POOL
Additional desc .
Permit -PLUMBING
Additional desc-
esc-Permit
Permit Fee . . . .
-252.00
Plan ,Check Fee
163.80
Issue Date . . . .
-
Valuation . . .
25000 -
Expiration Date
10/11/10
15.00
2.00 6:0000 EA PLB FIXTURE
Qty Unit Charge
Per
3.00
Extension
3.00
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
10/11/10
Expiration Date 10,/11/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00- 30.0000".EA ELEC.PRIVATE SWIMMING; POOL
30.00
Permit -PLUMBING
Additional desc-
esc-Permit
PermitFee .. 33.00 Plan Check Fee
-8.25
Issue Date . . . Valuation
0
Expiration Date _ `, 10/11/10 .
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, GAS .STUB -OUT FOR FIREPIT TO BE
. LQPERMIT
Application -Number . . . . . 10-00000315
----------------------------------------------------------------------------
Special Notes and Comments
DONE BY OTHERS. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE & FIREPIT NOT
INCLUDED. 2007 CODES.
-------------------_-----_--------------------------------------------------_-
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee `summary Charged Paid
Credited
Due
-- - - - - - -------
Permit Fee Total 356.00 .00
.00
356.00
Plan Check Total 189.80 .00
.00
189.80
Other.Fee.Total 1:00 .. AO
.00
1.00
Grand Total 546.80 .00
.00
546.80
' LQPERMIT
Bin #
City of La Quinta
Building U 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: tJ — a S
Owner's Name:,
A. P. Number: g ��^ 174//L 5')
Address:
Legal Description: 44te I,q ---
City, ST, Zip: k6HAZe�q—
Contractor:
Telephoner
Address:6cls . Ule S•
Project Description:
City, ST, Zip:
Illy)C`;n.
L � i
Telephone: 1-3611
'
State Lic. # : G / 6'1 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:l/
Name of Contact Person: I {1� e `
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: a 5 �j - Fj
Estimated Value of Project: S�
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsfissue
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
a
D
M -S
—�6-T-E: 7LL—W�FL -CALL OU S IN I H III S
AS M uRED FROM F.INSH OR
GREAT