10-0702 (RPL)r
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000702
Property Address: 81864 VIA SAN CLEMENTE
APN: 764-010-008-70 -31910 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Annlication valuation: 26590
Applicant:
1 hereby affirm under penalty of perjury that I
Section 7000) of Division 3 of the Business t
License Class: C53
Date: 15, -( 0 ontractor:
Architect or Engineer:
O v
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-------------------------
CTOR'S DECLARATION
�r provisions of Chapter 9 (commencing with
Code, and my License is in full force and effect.
ense No.: 614611
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pert ry that I m exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Busi essand rofessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, orv,& 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.).
(_) 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
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
Owner:
FINHOLT
81-864 VIA SAN CLEMENTE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/29/10
Contractor:
MCINTYRE POOLS & SPAS,FrVAUG'042010,
83695 AVENUE 45
INDIO, CA 92201 (760)342-3612
Lic. No.: 614611
LA (WINTA
-----------------------------------------------
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 wor for which this ermit is issued. My workers' compensation
insurance carrier and policy number e:
Carrier GOLDEN INS Pol' yNumbar 10 01013 90 97Z
I certify that, in the performance of t work for i this permit is issued, I shall not employ any
person in any manner so as to be me subjec t the workers' compensation laws of California,
and agree that, if I should becom subjec t workers' compensation provisions of Section
3700 of the Labor Code,' I shall orthwi o ply with those provisions.
ate: =TSEaCUR
nt: N
WARNING: FAILUWORKE 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR INAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITI 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, indemnity 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 a d old if work is not commenced
within 180 days from date of issuance of such permit, or c sa on of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th above in f r a ' n is correct. I agree to comply with all
city and county ordinances and state laws relating to b Ing con r ct' n, and hereby authorize representatives
of this my to enter upon a above-mentioned pro y for i c n purposes.
ate: ature (Applicant or nt)
Application Number . . . . . 10-00000702
Permit
BLDG POOL PERMIT
Additional
desc . .
Permit Fee
. . . . 265.00 Plan Check
Fee
172.25
Issue Date
. . . . Valuation
26590
Expiration
Date . . 1/25/11
Qty
Unit Charge Per
Extension
BASE FEE
252.00
2.00
------------------------------
6.5000 THOU BLDG 25,001-50,000
----------------------------------------------
13.00
Permit
MECH POOL
Additional
desc . .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date
. . . . Valuation
. . .
. 0
Expiration
Date . . 1/25/11
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 . . 1/25/11
Qty
Unit Charge Per
Extension
BASE FEE
15.00
1.00
-------------------7--------------------------------------------------------
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 1/25/11
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
LQPERMIT
Application Number . . . . . 10-00000702
----------------------------------------------------------------------------
Special Notes and
Comments*
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS
ADMIN (SB1473)
2.00
Fee summary
-----------------
Charged
--------------------
Paid'
Credited
--------------------
Due
Permit Fee Total
369.00
.00
.00
369.00
Plan Check Total
198.25
.00
.00
198.25
Other Fee Total
2.00
.00
.00
2.00
Grand Total
569.25
.00
.00
569.25
LQPERMIT
Bin #
City Of La QU%Cita
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
0
Project Address: $
G
U 1 e
Owner's Name:
A. P. Number:
Address: 8 _ un /
Legal Description:
City, ST, Zip: u n (j
Contractor:11,
Address: d .. G
S
'46-
>
Telephone: :, M.
Project Description: D
City, ST, Zip:
U0 I
Telephone:
6
+L - U
2 < �r. L;.
State Lic. # : G S
4 6
City Lie. #,
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
- X, . ,':
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
O - �Cj 2
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person:
f f
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
k
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted;
Item
Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanlcal
Grading plan
2`° Review, ready for correctionvIssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for correctionvIssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permil Fees
y