09-0373 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
09-00000373
52647 VIA SAVONA
772-410-999-13 -298943-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
35000
Tityl 4 4 Q" -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BERNARD
52647 VIA SAVONA
LA QUINTA, CA 92253
J'EC;1TV1DP!�A
Contractor:
Architect or Engineer: DUNN' S DESERT LANDSCAPE SRVC
® 2��8 74866 LENNON PL, SUITE A
PALM DESERT, CA 92260
1(760)773-9923
M CLINTA Lic. No.: 635896
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 fessionals Code, and my License is in full force and effect.
License Class: C37 C53 License No.: 635896
ate: ontractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perj y that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, B ness and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demoli , or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed stateme that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (com ening with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt ther from 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 ($5001.:
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.).
(_ ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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 _ 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 ISec. 3097, Civ. C.I.
Lender's Name:
Lender's Address: L -y ti
LQPERi11IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/27/09
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 DELOS INS CO Policy Number 02DKPM12000717
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 me subject to the workers' compe ation provisions of Section
4700 of the Labor Co I all IoVh�comply with those vis
, ions.
WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRYAINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD ION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABQR 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this�ature
r upon the above -menti
date(Applicant or
Application Number . . . . . 09-00000373
Permit
BLDG POOL PERMIT
Additional desc . .
Permit Fee
317.00 Plan Check Fee
206.05
Issue Date . . . .
Valuation
35000
Expiration Date
10/24/09
Qty Unit Charge
Per
Extension
BASE FEE
252.00
10.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
65.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
10/24/09
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
10/24/09
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
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
10/24/09
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 . . . . . 09-00000373
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSEPCTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS
ADMIN (SB1473)
2.00
Fee summary
-----------------
Charged
Paid
Credited
Due
-
Permit Fee Total
--------------------
421.00
.00
--------------------
.00
421.00
Plan Check Total.
232.05
.00
.00
232.05
Other Fee Total
2.00
.00
.00
2.00
Grand Total
655.05
.00
.00
655.05
LQPERMIT
a
B�,
City of La Quintal
Building er Safety Division
Permit #
P.O. Box 1504, 7&495 Calle Tamplco
La Quints, CA 92253 - (760) 777-7012
3��
D q "
Building Permit Application and Tracking Sheet
Project Address S a. - G y 7
MMMMMMM-ft�
✓ l R Owncr•s Name:
A. P. Numbcr:
Addnms: , y O
Lgal Description:
city. ST, Zip: LA
Contractor.
Ci Js Telcpbone:
Address: — R6& Ltac-r—"A"
l Project Description:
City. ST. Zip: V.411AS
Telephone: a) -'J ' 3 0
State Lie. 9:
City Lie. Ih
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Conswction Type: Occupancy-
Statc Liu. 4.
Ptvject type (circle one): New Add's Alw Repair Demo
Namc of Contact Pcrson:
Sq. Ft. d Stories: a Units:
Telephone A of Contact Parson:
Estimated Value of Project:
dq
APPLICANT: 00 NOT WRITE BELOW THIS ME
0
somittat
Rrq'd
Reed
TRACMG PERIYIII• FEES
Plan Sea
Pin Cheek nbmiltcd Item Amuset
Structural Cates.
Revlewed, ready for corrections Plan Cheek Deposit
Truss Coles.
fitted Cower Person Plan Cheek Bahner
Energy Cates.
Plana picked up Constraetinn
Flood plain plan
Plans Mubmil" Meetfanieal
Grading play
2" Review, ready for rorrectionsrism Electrical
Subeuataetor Llat
Catled Contsa Perron Pimabiug
Groat Deed
flans picked up SALL
ILO.A. Appravol
flans resabinitted Grading
IN HOUSE:-
'"' Review, rady for evrrationsrusae Developer Impact Fee
Planning Approval
Cdica Cuatset rersou
Pub. Wks. Appr
Date ofperwit issue
School Fie$
TOW Persil Fees
TMITQ -[WA 1,47-M nt11R IdINIRD V1 TIOLLLL09L 90:80 800Z/EZ/60