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05-5416 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: J Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 05-00005416_ 7 J 80255 VIA'MIRASOL 772-430-006- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 20000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT t ' LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - - Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Licen Class• C53 License No.: 614611 at Contractor. (6)�� JJ .OWNER -BUILDER DECLARATION 1 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 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).: - _ I_) 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.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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.I. Lender's Name: Lender's Address: LQPERMIT Owner: JOHNSON 80-255 VIA MIRASOL LA QUINTA, CA 92253 Contractor: MCINTYRE POOLS & SPAS, 83695 AVENUE'45 INDIO, CA 92201 (760)342-3612 Lic. No.: 614611 VOICE (760) 777-7012` FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/12/05 CrrY OF LA T. A �IPId1NCE DEP L - ----------------------------------------------- -WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: - -- - - - - -- 1 -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. 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 STATE FUND Policy Number ' 1769111 ' _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor C ddf I all forthwith comply with those provisions. D e Applicant: WARNI : I UR FAE 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. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and c"aordinances and state laws relating to bui ' -' construction, and hereby authorize representatives of th' o enter upon the above-mentioned pr r inspection [urpose, . D Signature (Applicant or Agent). Application Number 05-00005416 Permit .. . . . BLDG POOL PERMIT Additional desc . Permit Fee 207.00 Plan Check Fee.. 134.55 Issue Date Valuation 20000 Expiration Date .. : 6/10/06 Qty- Unit Charge Per Extension BASE FEE. 45.00 18.0.0' 9.00.00 7-7 ------------------------------------------------------------------------- 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 -6/10/06 Qty Unit. Charge. Per Extension. BASE FEE 15..00 1. 00 -.11.0000 EA MECH FURNACE >100K. 11.0,0." Permit •.. . . . . . POOL PERMIT -RES .ELEC AddAiojaal disc - Permit Fee 45.00 Plan Check Fee .11.25 Issue Date Valuation 0. Expiration.Date 6/10/06 Q'ty:-Unit.Charge Per Extension.. BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 3"0'00 . . Permit PLUMBING .' Additional desc.. Permit ..Fee . . 33.00 Plan Check. Fee 8.25 Issue Date' Valuation 0. Expiration Date. 6/10/06 ; 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. ALARMS/BARRIERS SHALL BE IN LQPERMTT Application Number 05-00005416 -- ------------------------------------------ Special Notes and Comments PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged- Paid Credited Due City of La Quinta Building a Safety Divtslon Permit 11 P.O. Box 1 SO4r 78-49S Calle Tampico QS ��� U Quinta, CA 922S3 - (760) 777.7012 Project Address: Building Permit Appiication and Tracking Sheet 1f �' � Owner's Name: (, �� A. P. Number. Address: S�-1(A 1 gSib Legal Description: � \!! XCity. •Ac. ST. Zip: <.A\ Contractor. XAddress: � ^ v F Tele phone: X Cil)-, ST, Zip: nn Project Description: �lV vl2-� A Telephone: State Lie. q MMMMWM�City Lie. M: Arch., Engr.. Designer. Address: City, ST. Zip: State Lic. il: s r-;ti'f' •�`� ; construction Type: Occupancy: 1( Name of Contact Person: _ _ Project type (circle one): New ------------- Add'n Alter Repair Demo X Telephone sr of Contact Person: � Sq• Ft.; (' Stories' Enits: "= stimated Value of project: ArrLi%-ANT: DO NOT WRITE BELOW THI p Submittal S LINE Req'd Reed TRACKING Plan Sets PER\IIT FEES Plan Check submitted- Structural ubmittedStructural Coles. 1i•III, 05 Item Reviewed, ready for corrections Amouat Truss CaICs Plan Cheek Deposit Called Contact Person Energy Gales, Plans Oleked up Plan Check Balance Flood plain plan Construction Plans resubmitted Grading plan Mechanical 2" Review, ready for eorrecdonsAisue Sutxoataetor List Electrical Called Contact Person Great Deed Plumbing Plans picked up H.O,A. Approve! SAM. Plans resubmitted IN HOUSE:. Grading '"' Review, ready for torreetionsAssue Planning Approval Developer Impact Fee TP=ub.'%'kL Appr Called Contaet Person Date of permit i�F ssue �'►•I•P P School Fees Total Permit Fees