13-0207 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000207
Property Address: 52455 VIA SAVONA
APN: 772-410-999-5 -298943-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 68800
Applicant:6 .
----------------- - LICENSED cCo-I-O
1 hereby affirm under penalty of perjury that I a license
Section 7000) of Division 3 of the Business a d Prof
License Class: C53 /
Date. tom' r %> Contract
Architect or Engineer:
Ow
TJ
VOICE (760) 777-7012
✓ E� FAX (760) 777-7011
r �
BUILDING & SAFETY DEPARTMENT �� INSPECTIONS (760) 777-7153
BUILDING PERMIT
11 TORS DECLARATION
er provisions of Chapter 9 (commencing with
Is Code, and my License is in full force and effect.
license No.: 614611
OWNER -BUILDER DECLARATION
I hereby affirm under penalty oIllperjury t�t I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business%%a�nd Professions Code: Any city or county that requires a permit to
construct, alter, improve, demoli h, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement tKQIA 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, 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: Uy
LQPERAII17'
Date: 3/01/13
Owner:
FISHOFF
52455 VIA SAVONA
LA QUINTA, CA 92253
Contractor:ffMARO
MCINTYRE POOLS & SPAS,
83695 AVENUE 45
INDIO, CA 92201 CITYQt<IAqWNTA
(760)342-3612 FINANCE DEPT.
Lic. No.: 614611
WORKER'S COMPENSATION DECLARATION
1 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 insurer} 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 e:
Carrier WESCO INS CO Poliy Number CA1843029
I certify that, in the performance of
person in any manner so as to b
and agree that, if I should beton
3700 of the Labor Code, I shall
Date:,'Zy-Applicant
�n lnis permit is issued, r snail not employ any
the workers' compensation laws of California,
workers' compensation provisions of Section
with those provisions.
WARNING: FAILURE TO SEC RE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADD 10 O 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 Id harmless the City
of La Ouinta, its officers, agents and employees for any act or omission related the work being
performed under or following issuance of this permit. %
2. Any permit issued as a result of this application becomes null d void if' wor is not commenced
within 180 days from date of issuance of such permit, or ce ation of wor for 180 days will subject
permit to cancellation. (
I certify that I have read this application and state that the above inform ion iVcorr ct. I agree to comply with all
city and county ordinances and state laws relating to building construe n, d reby authorize representatives
of this county to enter upon the above-mentioned property for inspec { n po es.
Date: ._ /4l ignature (Applicant or Agem):
Application Number . . . . . 13-00000207
Permit . . . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
8/28/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE
>100K
11.00
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
500.00
Plan Check
Fee
325.00
Issue Date . . . .
Valuation
. . .
. 68800
Expiration Date . .
8/28/13
Qty Unit Charge
Per
Extension
BASE FEE
414.50
19.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
85.50
Permit . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00
Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
8/28/13
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 . . . .
27.00
Plan Check
Fee
6.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
8/28/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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, FIREPIT AND
BBQ AT REAR YARD
LQPERA1IT
Application Number . . . . . 13-00000207
----------------------------------------------------------------------------
Special Notes and Comments
(2 INCH GAS PIPING TO POOL HEATER/1 INCH
ELSEWHERE] THIS PERMIT DOES NOT INCLUDE
EQUIPMENT SCREENING WALL. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
February 27, 2013 8:16:44 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
3.00
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 598.00 .00
.00,
598.00
Plan Check Total 349.50 .00
.00
349.50
Other Fee Total 3.00 .00
.00
3.00
Grand Total 950.50 .00
.00
950.50
LQPERM1i
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Bin #
City of aQ uinta. .
Building 8t Safetypivision 222o13
Z013
Permit # P.O. Box 1504, 78-495 Calle Tampico
U Quinti, CA 92253 - -(7¢0) 777-7012 �MMUry ��Cq 4UI
Building Permit Application and Tracking Sheetry U11 Tq
Project Address: _ o p N%
Owner's Name: o
A- P. Number: Address:. ,
Legal Description:' o City, ST, Zip: L. o
Contractor: Telephone:
S
Address: 4?j S Project Description:.
City, ST, Zip:. 2
Telephone:
S
State Lie. # : 6l City Lie.
< <
Arch., Engr., Designer:
r '
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
SWe Lib.#: . Project type (circle one): New Add'n Alter Repair Demo
r-
Name of Contact Person: S Ft:
r q• # stories: #Units:
Telephone # of Contact-Person: '
Qttd Value.orojet: ro Nr
APPLICANT: DO NOT WRITE BELOW THIS LINE .
# Submittal W. Req'd • RWd 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
Gradingplan Zed Review, ready for correctionsrssue Electrical
Subcontactor-List Called'Contact Person Plumbing
Grant•Deed Plans. picked up S.M.L.
H.O.A. Approval Plans resubmitted
Grading.
IN HOUSE: Review, ready for correctionslissue )Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub. Wks. APpr Date of permit issue
School Fees
Total Permit Fees
I.. In tonit I<1'1 Grt-(. (Se( 0Q.J"aalt) kqmdev
r ,�- VST
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