06-2807 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002807 Owner:
Property Address: 51955 VIA ROBLADA VISTA LA QUINTA PARTNERS
APN: 772-270-010-15 -311232- 223 E. DE LA GUERRA
Application description: POOL - RESIDENTIAL SANTA BARBARA, CA 93140
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 20000 D
Contractor:
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, I
83695 AVENUE 45
�n �� ►_�" i � I� INDIO, CA 92201
(760) 342-3612
II�1' LiC. No.: 614611
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.
License Class: 453 License No.: 614611
/ate: f_ Contractor:
OWNER -BUILDER DECLARATION
I re" affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
f "owing
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 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.).
1 _ 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.).
(_ I 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.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/26/06
a u
AUG 012006
v5 V
OF LA QJJNTA
WORKER'S COMPENSATION DECLARATION
I 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, 1 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 sub' to the workers' c pensajon provisions of Section
3 0 of the Labor Code, I or ith comply with t e prns.
-Date: ApplicanC_/
WA NG: FAILURE TO SECURE KERS' COMPENS 61
ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC INAL PENALTIES A CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). INA ITION TO THE COST F 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 informati�is correct. I a ee to comply with all
city and county ordinances and state laws relating to building construct ,and hereby esentatwas
of this county t ter upon the above-mentioned property on purposes.
Date: Signature (Applicant or Agen -
Application Number . . . . . 06-00002807
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
207.00 Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. . .
. 19719
Expiration Date . .
122/07
,Qty Unit Charge
Per
Extension
BASE FEE
45.00
1.8.00 9.0000
----------------------------------------------------------------------------
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 Datc . .
1/22/07
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
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
1/22/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING
POOL
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check
Fee
8.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
1/22/07
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
Permit . . . . . . WALL/FENCE PERMIT
LQPERA11T
Application Number
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
Qty Unit Charge
. . . . 06-00002807
WALL/FENCE PERMIT
15.00 P1
Va
1/22/07
Per
an Check Fee . . .00
luation . . . . 281
Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 13LFX5' EQUIPMENT WALL Cia-Y
STANDARD ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Dermit Fee Total 326.00 .00 .00 326.00
Plan Check Total 160.55 .00 .00 160.55
Grand Total 486.55 .00 .00 486.55
LQPERMIT
Bin #
Permit.#
51- 155
Project Address: p
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 an -racking Sheet
Owner's Name: -
A. P. Number: �,
Address:
/- 7 o
Legal Description:
City, ST, Zip:
Contractor:
Address:
j/Z A
Telephone -
Telephone:
Project Description:
City, ST, Zip:
Telephone:
State Lic. # : G
City Lic. #: -
Arch., Engn, Designer:
Address:
City, ST, Zip:
I
Telephone:
State Lic. #:
Name of Contact Person: a
Construction Type: Cccupancy:
Project type (circle one)—/I; Add' a Alter Repair Demo
Sq. Ft -6
# Stories: nits:
Telephone # of Contact Person:�Q— —
S �
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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"d Review, ready for correctionsrissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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
.
-----�-------------------
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L.:wT�r..�IIIA�nM
LA CMTEM LOT 15=2 -INSPECTION FEE of
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WILL BE CHARGED IFI ht
RD ARE NOT ON
PLANS AND JOB CA
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR C NSTRUCTION
DAT ��` _ ��B
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