06-3536 (SOTB)44 P.O. BOX 1504. VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, `CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/03/06
Application Number: 06-00003536 Owner:
Property Address: - 86 VIA ROBLADA VISTA LA QU•INTA PARTNERS
APN: 772-270-010-25 311231- 51686 VIA ROBLADA ti
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA. 92253
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 2000 tiOoCQ
• Contractor:
Applicant: qArchitect or Engineer: MCINTYRE POOLS & S INw
83695 AVENUE 45
IFT)IO, CA 92201
(760.)342-3612
' 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) of Division 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 Class: C53 License No.:. 614611 - - for by Section 3700 of the Labor Code, for the performance of the work for. which this permit is
,jj s �_ /J issued.
1 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 HRH• INS Policy Number 020060333601
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 subjec the workers' comp e ati on provisions of Section
• License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the r Code, I atGiotthw't>mply with those pf isions. ..
. 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):: ta: c' / pplicant: '
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 WAR ING: FAILURE TO SECURE WORK S' COMPENSATION COVE AGE 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.). 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 andProfessionsCode: 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 contractors) 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,
(_ 1 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
- - of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or fallowing issuance of this permit.
Date: Owner: 2.. Any permit issued as a result of this applicatioA 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this application and state that the abovein ormation is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating wilding c truction, and here y authorize re resentatives ,
of this unt to enter upon the ove-mentioproperty f �mspection purpos i
Lender's Name:
Lender's Address: ate: '1��8f ture (Applica r Ag�) F/
i _.
LQPERMIT
v
• ."Application Number . . . . 06-00003536
Permit . . . . . BUILD_ING PERMIT
•. Additional desc .
Permit Fee 45.00 Plan Check Fee
29.25
_ Issue Date Valuation
2,000
Expiration Date 4/01/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
15..00 2.0000 HND BLDG 501-2,000
30.00,
Permit . . .. ELEC-MISCELLANEOUS
Additional desc .
Permit Fee 17-25 Plan Check Fee
4.31
_ ..Issue Date . . . . Valuation
0
Expiration Date 4/01/07
Qty Unit Charge 'Per•,
Extension
BASE FEE
15.00
-" 3.00 .7500 PER ELEC DEVICE/FIXTURE'1ST 20
,2.25
Special'Notes and Comments
BBQ PER APPROVED PLANS
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ENERGY REVIEW FEE
2.93
STRONG MOTION'(SMI) - RES
.50
Fee summary Charged Paid Credited
Due
' Permit Fee Total 62.25 .00' .00
62.25
Plan Check Total 33.56 .00 .00
33.56
Other Fee Total 3.43 .00 .00
3.43
Grand Total 99.24 .00 '.00
99.24
'A.&" 4-t., 5 r
Bin #
City of La Quinta
1
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit. Application and Tracking Sheet
Permit #
`J
35
Project Address: 0 4
Owner's Name: l
A. P. Number: # �
Legal Description:
Address:
City, ST, Zip: 41,
Contractor:
y�
Telephone:
Address:471G
Project Description:
City, ST, Zip:
Telephone: 2 ,
State Lic. # City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: /�
Construction Type: Occupancy:
Project type (circle one)• Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 5-0 ��.!S �/
Estimated Value of Project: fig .
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 Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Flood plain plan
Plans picked up
Plans resubmitted
Construction
Mechanical
-
Grading plan'
Subcontactor List
2°d Review, ready for correctionsfissue
Called Contact Person
Electrical
Plumbing
Pt vrot -if
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
Alliwf
6 U'r-