09-0061 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000061
Property Address: 81850 VIA SAN CLEMENTE
APN: 764-010-008-71 -31910 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application Valuation: 21000
Applicant:
T4ht 4 a (P Q"
Architect or Engineer:
-------------------
LICENS D CONTR OR'S DECLARATION
I hereby affirm under penalty of perjury that I a licensed u provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a Professio I Code, and my License is in full force and effect.
License Class: C53 License No.: 614611
ate: ntractor: �
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjuth t I am exempt from the Contractor's State License Law for the
following reason ISec. 7031.5, Busine 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 /
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
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: 1/27/09
Owner:
LA QUINTA 57 ESTATES INC
78401 HWY 111 STE�j'G'-�, -
LA QUINTA, CA 9d2f�53
Contractor.
MCINTYRE POOLS SPAS„ INCA.
83695 AVENUE ,45,_
INDIO, CA 92201
(760) 342-3612`
Lic. No.: 614611
------------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 ermit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier DELOS INS CO Policy Number DKRM120001870
I certify that, in the performance of the ork for w this -permit is issued, I shall not employ any
person in any manner so as to bec me subjec the workers' compensation laws of California,
and agree that, if I should becom subject to a workers' compensation provisions of Section
3700 of the Labor Code, I shall rthwit ply with those provisions.
ate: �• ZG (/ icant:
WARNING: FAILURE TO SECURE WO K S' 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.
certify that I have read this application and state that the above in rmation is c r ect. I agree to comply with all
city and county ordinances and state laws relating to building con ruction, an reby authorize representatives
;of this unty to enter upon the above-mentioned property for in ection pu es.
te:Si ture (Applicant or Agent):
Application Number . ... . . 09-00000061
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 216.00 Plan Check Fee 140.40
Issue Date . . . . Valuation . . . . 21000
Expiration Date 7/26/09
Qty Unit Charge Per Extension
BASE FEE 45.00
19.00 9.0000 THOU BLDG 2,001-25,000 171.nn
---------------------------------------------- -----------------------------
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date .
MECH POOL
26.00
7/26/09
Plan Check Fee . . 6.50
Valuation . . . . 0
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 . . 7/26/09
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 .
Issue Date . . . . Valuation . . .
Expiration Date . . - 7/26/09
8.25
0
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
& ELECTRIC STUB -OUTS FOR
LQPERMIT
Application Number . . . . '. 09-00000061
----------------------------------------------------------------------------
Special Notes and Comments
FUTURE APPROVED APPLIANCES.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charqed Paid rrPrli tpH n„P
Permit Fee Total 320.00 .00 .00 320.00
Plan Check Total 166.40 .00 .00 166.40
Other Fee Total 1.00 .00 .00 1.00
Grand Total 487.40 .00 .00 487.40
c
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City of La Quinta..
Building U SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico
BuildingPermit�A CA 9(ication and�7i-7o12
pp Tracking Sheet
Permit #
00t-
Project Address:' _
Owner's Name:
A. P. Number:
Address:. _
Legal Description:
City, ST, Zip: O
Contractor:41—VZ TIA 0
Address: g 5"
Zip:rk 2 ZQ
LTelephorn,e: .Q G . 3,6
Telephone:
Project Description:. C)
#
City Lic. #:.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lit. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n 'Alter Repair Demo
Name of Contact Person: —'
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: Q .—�6 2
Estimated Value-of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd ,
RWd
TRACIMG .
PERAM FEES'
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check T eposit .
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction '
Flood plain plan,
Plans resubmitted
Mechanical
Grading. plan
tad Review, ready for correctionsdssue
Electrical .
Subcontactor-List
Called Contact Person
Plumbing
Grant'Deed
Plans. picked up
H.O.A. Approval
Plans resubmitted
Grading.
IN HOUSE:
'"d 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 Eves