06-3094 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 77777011
INSPECTIONS (760) 777-7153
Date: 8/24'/06
Application Number:06-00003(T94 Owner:
Property Address: \ 51805 -VIA- ROBLADA . FUENTES
AP.N: 772-270-010-4 -311231- 51805 VIA ROBLADA
Application description: POOL - RESIDENTIAL D 6 QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000 D /G1
AUG 2 8 2006
ntractor: p
Applicant: Architect or Engineer: CITYOF�Ql11NTA M INTYRE POOLS & SPAS, INC. AUG 28 200x'
FINANCEDEpt 8 695.AVENUE 45 0
DTO, CA 92201 C17YOFQUINT
(760)342-3612. FINANCE DEPT A
Lic. No.: 614611
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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.
Lice seCla C53 �- LicenseNo.:- 614611
Date:fntractor:' GrG
t
OWNER -BUILDER DECLARATION
I ereby 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).: '
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10
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
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: ,1
Lender's Address: T./
rA
LQPER1111T
WORKER'S COMPENSATION DECLARATION
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.
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 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 ubject to the w rkers' c mpensation provisions of Section
3700 of the Labor Code I shaIIJ hwith compl ith t e provisions.
k
ate:plican .
W NING. FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 personat 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 have, read this application and state that the above informatio is correct. agree to mply with alt
city and county ordinances and state laws relating to building constructio and hereby [horiz epresentatives
of this county �ienter upon he above•mentioned.property for i c ' purposes. �
te: L d� gnature (Applicant or Agent —
Application Number,
06_-00003094"
• Permit
BLDG POOL PERMIT
Additional desc
Permit Fee
207.00.:- Plan Check-Fee
134.55 '
Issue Date
Valuation ..
20000
Expiration Date
•2/20/0
_..
Qty Unit'Charge
Per
Extension
.,
BASE FEE
45.00
18.00 9.0000
THOU, BLDG.2,0.01-25,000
162.00
Permit
MECH POOL
Additional'desc ".
Permit.Fee -,f:
26.00 Plan.Check Fee
6.50
Issue Date
Valuat"ion
0
_. Expiration Date
2/20/0^
. Qty Unit' Charge
Per
Extension,.
BASE FEE `
1.5.001 '
1.00 11.00'00
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 .
2/20/07
;
Qty Unit Charge
Per
Extens'ior
BASE FEE '`
15.00
1.00 30.0000
EA., ELEC PRIVATE 'SWIMMING POOL -
30.00,.
Permit
PLUMBING
Additional-desc
Permit.Fee
33•.00 Plan-Check Fee
8.25
Issue Date
Valuation
0
Expiration Date
2/20,/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 .'3.000.0
EA PLB GAS PIPE 1-4 OUTLETS
3.00
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'Special-Notes and Comments------
POOL,SPA. ALARMS/BARRIERS.SHALL BE.
LQPERMIT '. .. ,, ; .. .:.
'. :. .'' _ • -
-
Application Number. ..•. 06-00003094-
- - - - -- - --- ----
---.-
Special- Notes.and ,Comments
- - - --
- -- - - - -- - - --
-------- - - ----
IN PLACE AT PRE -PLASTER
INSPECTION.EQUIPMENT-ENCLOSURE-NOT_
,. INCLUDED
-Fee .summary,. Charged.
Paid
Credited
Due
Permit Fee -Total 311.00
---
.0000.
----- - - - -.- -
-
311:00
Plan -Check Total-. 160.55 -'
.00,
00•:
160.55.
Grand Total
00
00
4.71.55
• LQPERMIT , -. . _ ' :.: . ' .• .; - - _ --. ,. - .' .. , .' -. .. - ...
_
_ -
- -
Bin it
City Of La Quhltj.
Permit #Building
Safety Division
°1
P.O. Box 150478.495 Calle Tampico ,
La Quints, CA 92'253.(760) 777-7012
Project
Building Permit Application and Tracking Sheet
Address:
A. P. Number:
Owner's Name:
Legal Description:
Address: G
Contractor:
City, ST, Zip:
10
Address:
Telephone:
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City, ST, Zi �—
P•
Project Description:
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Telephone:
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State Lic. #
... •+S.•1
'L
City Lic. #:
Arch., Erl Designer:
Address!
City, 8T, Zip:
Telephone:
'p��ry ztpF��'S,5yy: L4lY:'• a„yy, x,,.
State Lic. #:
s,r,.Yy
Construction Type: Occupancy:
'
Name Contact
j e circle one). env Add'n
of Person:
Alter Repair Demo
Telephone # of Contact Person:
'
Sq. FI�2�
'.
# Stories:
#Units;
Estimated Value of Project:
APPLICANT: DO NOT WRITE
#
Submittal
BELOW THIS LINE
Req'd
Recd
Plan Sets
TRACI:INC
PERMIT PEFS
Flan Check submitted
I
Structural Calcs.
Rtviewed, ready for corrections
Item
Amount .
Truss'Calcs.
Plan Check Deposit
Called Contact Person
Title 24 Calcs:
Plan Check Balance
Plans pieked'up
Flood piaia plan
Construction
Plans resubmitted
.Grading plan
h4chanical
Subcontactor Li sl
RevK"'. ready for corrections�ssue
Fleclrical
Called Contact Person
---------
Gran( Deed
Plumbing
Plans picked up
II.O.A. A pp'roval
S.hu.
Plans.resubmitted
IN IIOUSE:-
Grading
PlanningA
Approval
Review eady for corrections/issue
Developer Impact Fee
Called Contact Person
Pub.11'ks. Appr
A.I.P.P.
Date of Permit-issue
School Fees
Total fermi( Fees