12-0712 (RER)4'
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT -
Date: 6/26/12
CA:pP._Ilcation Number. _ 12-0 000 0712 . Owner:
Property Address: 51461 VIA SORRENTO MCCONNELL DARREN &STACEY t
APN: 777-330-002- - - 51461 VIA SORRENTO
Application description: • REMODEL °- RESIDENTIAL LA QUINTA, .CA .92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2860
• Contractor: k 1tglk-
Applicant: Architect or Engineer: - 1 MCINTYRE POOLS & SPAS, -IN,
83695 AVENUE 45 G+c>`... �s s
INDIO, CA 92201 '
(760)342-3612 s
'V Lic. No. 614611
• i
LICENS CONT A OR'S DECLARATION WORKER'S COMPENSATION DECLARATION • ,
I hereby affirm under penalty of perjury that I a r ensed rid r provisions of Chapter 9 (commencing with I,hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and If'
al Code, and my License is in full force and effect.. _ I have and will maintain a certificate bf consent to self -insure for workers' compensation, as provided
License Class: C53 - icense No.: 614611- for by Section 3700 oftheLabor Code, for the performance of the work for which this permit is
- - issued. - _ .. •.. -
Cf( Date:�r,Contracto ' - ' _ 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-thisrmit is issued. My workers' compensation
OWN R•BUILDER DECLARATION insurance carrier and policy number are _
1 hereby affirm under penalty of erjury that I m exempt from the Contractor's State License Law for.the ' - Carrier COMMERCE- WEST I Policy umber 0130843590
following reason (Sec. 7031.5, B siness and rofessions Code: Any city or county that, requires a permit to _ I certify that, in the performanceofthe rk for whi is permit is issued, I shall not employ any
construct, alter, improve, demolis or repair ny structure, prior to its issuance, also requires the applicant for the person in any manner so as to becom subject t th workers' compensation laws of California,
permit to file a signed statement th he or s e is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become s ject to th w rkers' compensation provisions of Section
License Law (Chapter 9 (commencing ith ection 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall fort ith co ly ith those provisions.
that he or she is exempt therefrom and t 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 ($50M.: a Date. l( App_ licant: I• _
(_) 1, 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 WARNING: FAILURE TO SECURE WO ERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon„ SUBJECT AN EMPLOYER TO CRIMIN L PENALT ES AND CIVIL FINES UP,TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that,the DOLLARS (S100,000). IN ADDITION 0 THE 'ST .OFCOMPENSATION, DAMAGES AS PROVIDED FOR IN -
improvements are not intended or offered for sale. If, however, the building or improvement is sold within _ SECTION 3706 OF THE LABOR COD INTER T, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT '
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
•
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
• property who builds or improves•thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)" whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ I I am exempt under Sec. , B.&P"C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold h mless the City
of La Quinta, its officers, agents and employees for any act or omission related to a work being
' - performed under or following issuance of this permit. -
Date: - Owner: - - - 2. Any permit issued as a result of this application becomes null an old if work ' no commenced
within 180 days from date of issuence_of such permit, or cess on of work or 1 0 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation. - '
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this application and state that the above informati is correc I a ee to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1. city and county ordinances and state laws relating to building constructio , and hereb au orize representathFes�
' - of this county to enter upon the above-mentioned property for inspection rposes. -
Lender's Name:-
- `.Dater ? 7-(ZrSignature (Applicant or Agent):_
Lender's Address:
LQPERMIT
Application Number .12-00000712
Permit . . ELECT - ADD/ALT/REM
Additional desc .. .
Permit Fee 18.00 Plan Check Fee
Issue Date: . . . . Valuation
0
Expiration Date 12/23/12
Qty Unit Charge- Per
Extension
BASE - FEE ..
15.00
4.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
3:00
Permit PLUMBING
Additional desc .
Permit Fee 18.00 Plan Check Fee
4.50
Issue Date . . Valuation . . .
0
g Expiration Date 12/23/12,
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
Special`Notes and Comments
MOVE EXISTING POOL EQUIPMENT TO NEW
LOCATION TO ACCOMODATE NEW ROOM
ADDITION. 2010 CODES.
Fee summary Charged Paid Credited
Due
Permit Fee Total 36.00 .00 .00
36.00
Plan-Check Total 9.00 .00 .00
9.00
Grand Total 45.00 .00 .00
45.00
LQPERMIT
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Bin #
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City of La Quinta.
Building & Safety Division
Permit # n 1
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (7¢0) 777-7012
Building PermitApplication and Tracking Sheetss;
Owner's Name:
kAdd.La
:Address:.Gtion:
_rrA
ty, ST, Zip:
�
Telephone:
- U
Project Description' .
C
City, ST, Zip:
Telephone:: C 7Gd .S - 2
State Lic. # : 6 "
City Lic.
Arch., Engr., Desigger:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occu an
P cy:
State Lit. #:
Project type (circle one): New Add'n Alter Repair
Demo
Name of Contact Person:7erru
of -W-19 Z
Sq. Ft.:
# Stories:.
# Units:
Telephone # of Contact -Person: 760
2SC9 .-"8 6'
Estimated Valae.o�Project: "
11 X60
APPLICANT:
DO NOT WRITE BELOW THIS UNE .
#
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 Cales.
Called Contact Person _
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan ,
Plans resubmitted
Mechanical
Grading.plan :.
.2" Review, ready for correctiods/issue '
Electrical
Subcontactor'List
Called'Contact Person
Plumbing
GranfDeed
Plans: picked up
S.M.I.
H O.A. Approval
Plans resubmitted
Grading..
IN HOUSE:
''" Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Caped Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees