11-0682 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number,'--41�Q00.00682=.-_
Property Address: 51494 VIA SORRENTO
APN: 777-340-024- - - -
Application description: POOL - RESIDENTIAL
..Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 24000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ANDY_& SANDY EISENBOCK
51494 VIA SORRENTO
LA QUINTA, CA 92253
Contractor:
TORRES CONSTRUCTION, A.O.
82375 MARKET ST, #15
INDIO, CA 92201
(760)834-5870
Lic. No.: 550498
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS .(760) 777-7153
Date: 6/23/11
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under 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 Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation -as provided
Licens Class: A B License No.: 550498
for by Section 3760 of the Labor Code, for the performance of the work for which this permit is
Date: ontractor:
issued. '
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
l
—91
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier CASTLEPOINT Policy Number WSATMEC30063202
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter,'improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California, '
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State,
and agree that, if I should become subject to the workers'. compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Codec I shall fhwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
m
any applicant for a permit subjects the applicant to a civil penalty of not ore than five hundred dollars (5500).:
ate- Iicant: �J i
(_ 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
WARNI G: FAILURE TO SECURE WORKERS --COMPENSATION 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 CRIMINAL PENALTIES 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, 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 CODE, INTEREST, 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 1, 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,
1 _ ) 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 harmless the City
.of La Quinta, its officers, agents and employees for any act or omission related to the work being
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
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 ands a laws relating to building constru ion, and hereby authorize representatives
of this ounty to enter upon above-mentioned property for inspegoon purposes.
w
ate r nature (Applicant or Agent):
,401
f•
Application Number . . . . ." 11-00000682
Permit . . BLDG POOL PERMIT`
Additional desc .
Permit Fee _ 243.00 - Plan Check 'Fee
157.95
Issue Date Valuation
24000 .
Expiration ,'Date 12/19/11
Qty Unit Charge Per
Extension
BASE FEE
45.00
22.00 9.0000 THOU BLDG 2,001=25,00.0
198.00 _
Permit MECH POOL
Additional desc .
Permit Fee 26:00• Plan Check -Fee
6.50
Issue Date Valuation.
0
Expiration Date.. '. 12/19/11
" Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 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 12/19/11
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 12/19/11
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. . . . . . 11-00000682.
-- - -------------------------------.-------------
Special Notes and -Comments
--------------
--------------
PLACE AT PRE-PLASTER.INSPECTION.
EQUIPMENT.ENCLOSURE NOT INCLUDED. 2010
CODES. -
Other Fees BLDG STDS-ADMIN (SB1473)
1.00
Fee summary Charged Paid
Credited
-Due
Permit Fee Total 347..00 :00
.00,
347.00
Plan Check Total 183.95 .00
.00
183.95
Other Fee'To,tal .1.00. ..00
.00
1.00
Grand Total 531.95 .00
.00
531.95
' - LQPERMIT -
-
Bin #
City of La Quinta
Building 8r, Safety Division
P.O. Box 1504, 78-495 Calle Tampico:
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
It
Project Address: .. Yj �. K)C G o
Owner's Name: A.
A. P. Number:
Address: f .. 9 Y/ A Aa flV -f a
Legal Description:.
Contractor: ` o•
City, ST, Zip:
®.. .c }`'` " ,„Y
Telephone: y
Address; h• D��Z� G” !•
Project Description:
City, ST, zip:. Ai� B CA— 92-2-03
Telephone:7X-0 -03 V-.vrr2 d ;'�:'
State Lic. # : So. % City Lic. #c
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: 4 ;.• _ ` ..:
State Lic.w�
s >":
Name of Contact Person: 1111Sq.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Plan Sets
Req'd
Rec'd
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cates.
Reviewed, ready for corrections
Ptah Check Deposit
Truss Cale&
Called Contact Person
Pian Check Balance
Tide41 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for eorrectionsrssue
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 eorrectionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr.
Date of permit issue
School Fees
Total Permit Fees