06-4193 (SOTB)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: 12/05/06
Application, Number:
2/05/06Application,Number: 06-00004193 Owner:
Property Address: 51710 VIA SORRENTO SHOPMATE
APN: 772-250-997-153 -31349 - 51710 VIA SORRENTO
Application description: STRUCTURES OTHER THAN BUILDINGS UINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 800
y pp actor:
JJii' 4
Applicant: Architect or Engineer: I1N 2, " ES RT PARADISE POOL & Si
80 5 WILDCAT DRIVE SUIJU
104
cirfOFLAQUINiA PAL DRSERT, CA 92211
FINN 9 SPT. ) 360-7400A '
CIYV OF
Lic. No.: 419309 FINANCE�FP
--------------------------------------------------------------------------------------------------
' - 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
License Class: C53 C27 icense No.:• 419309 / for by Section 3700 of the Labor Code; for the performance of the work for which this permit is
issued.
tractor:7'" I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
L3 '�� G Code, for the performance of the work for which this permit is issued. My workers' compensation � 7 OWNER -BUILDER DECLARATION �y�' 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 ENDURANCE WORK Policy Number WVS001347901
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 Y7�� 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 G✓ and agree that, if I should become subject t 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 Code, I shall forth ' mply with t prove ions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by / �Z3 • O7
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate:`, 2� icant: -
1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and11
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORK ERS"COMP,ENSATION COVERAGE IS UNLAWFUL, AND SHALL
t Contractors'. State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES_BND 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 15100,0001. 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 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 Licerise 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 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.
Date: Owner: 2. Any permit issued as a result of thisapplication 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 -
CONSTRUCTION LENDING AGENCY permit to cancellation.
- I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that 1 have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 30,97, Civ, C.).. - city and county ordinances state laws relating to building construction, a hereby authorize representatives
of s county to. enter n the above-mentioned .property f in ti p poses
Lender's Name: •� �� Z3 -z>-7 '-
Date- Signature (Applicant or Agent):
Lender's Address: - `-
LQPERAIIT -
-
Application Number . . 06-00004193'
Permit BUILDING PERMIT
Additional desc
Permit Fee _. 15.00
Plan Check Fee.
9.75
Issue Date
Valuation
416
Expiration Date 6/03/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
Permit . . PLUMBING
Additional desc .
Permit Fee . . . . 18'.00
Plan Check Fee
4.50
Issue Date
Valuation
0
Expiration Date.: 6/03/07
Qty Unit Charge Per'
`Extension
BASE FEE
15.00
1..00 3.0000 EA PLB GAS PIPE
.1-4 OUTLETS
3.00
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00
Plan Check Fee
.00
Issue Date
Valuation
384
Expiration Date 6/03/07
Qty Unit Charge Per
Extension "
' BASE FEE
15.00
-----------------------------------------
Special Notes and Comments
- - --
24 L.F. 4' BLOCK WALL, ORCO SYSTEM AND
FIREPIT
----------------------------------------------------------------------------
Other Fees . . . . ENERGY
REVIEW FEE
.98
Fee summary Charged 1 Paid
Credited
Due
Permit Fee Total 48.00
.00 .00
48.00
Plan Check Total 14.25 ..00
-.00.
14.25
' Other Fee Total 98
.00 .00
.98
Grand Total 63.23
.00 .00
63.23
LQPERAIIT'
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949 733 4320
. 09/25/02 WED 09:19 FAX 949 733 4320 CSA/IAS Irvine
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ISP;
CSA INTERNATIONAL
a-
Certificate: 1355624 Master Contract: 217348
Project: 1355624 Date Issued:. 2002-09-24
Issued to: Grand Effects �.
10 Argento Dr.
MISSION VIEJO, CA 92692
USA
Attention: Mr. Kevin Doud
The products listed below are eligible -to bear the CSA Mark shown
with adjacent indicator VS' r
iC
F ® Issued by:
Trinidad
us Authorized bp: Len Bardsle .
Operations Manager
,'PRODUCTS k F
2731-82. LIGHTING (GAS) Outdoor Decorative Type .
Minimum Maximum
Model Number • .Input Rating Input Rating
For Use With Natural Gas
illuminating Appliance for Outdoor Installation
Trade name: GRAND EFFECTS '
100. i 60,000 80,000
APPLICABLE REQUIREMENTS "' t
I.A.S. Requirement 8-96 Gas -Fired Decorative Illuminating Appliances For Outdoor Installation , "«
MARKINGS' '
All markings and printed instructions are in compliance with the above-mentioned requirements. '
The'US' indicator adjacent to -the CSA Mark signifies that the product has been evaluated to the applicable ANS WL Standards, for use in the U.S;. This 'US' indicator
includes products eligible to bear the'NRTL' indicator. NRTL, i.e. National Recognized Testing Laboratory, is a designation granted by the U.S. Occupational Safety
and Health Admioistration (OSHA) to laboratories which have beets re cognized to perform certification to U.S. Standards.
DOD 5b7WD 2n02Hkt/-An
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City of La Quinta
Building u Safety Division
'Permit #
P.O..Box 1504, 78*5 Calle Tampico
La Quinta, CA 92253 - (76%777-7012
Building Permit Application and Tracking Sheet
Project Address: 57-7/0
vlL�E
Owner's Name:y-�-
A. P. Number.
�.
Address: t
Legal Description:
City, ST, Zip: '
lily Qo, �
Contractor: �P��rt -f�ool�:Telephone:
-
Address:
Project Description:
.City, ST, Zip:
Telephone: 6 0 7 7 Cf a 0
LState
.
Lie. # y/ 1 30 �
�� � ` � •
Arch., Engr., Designer:
$00
Address:
City,. -ST, Zip:
Telephone:
I'm
Constructioa Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
.
Name of Contact Person: j %i 4 �.✓�v 3q:
�• Yv.
Sq: FL:
#Stories: '
#Units:
Telephone # of Contact Person: 3 Q ,
b Q
Fated value of Project: D U
APPLICANT:
DO NOT WRITE BELOW THIS UNE.
;.
#
Submittal
Req'd
Recd
TRACKING .. PERMIT FEES
Kn
Plan Sets
Plan Cheek submitted ��
O Item
Amount
Structural Cates.
Reviewed, ready for corrections 11:r0l PlauCk ekDeposit
_
Truss Calcs
Called Contact Person • �D Plan Check Balance
Energy .Cates.
Plans picked up
Constructiou
Flood plain plan
Plans resubmitted��.
Mechanicalt (3
F.
Grading,plan'
20' Review, ready for correctiow issue Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked 4p
H.O.A. Approval
Plans resubmitted.
''Review, ready for eorrectio
a 'n
A-
��sd ' Fee..
;
IN HOUSE:-
IN
Planning Approval
.
Called Contact Persoa
P
Pub. Wks. Appr
Date or permit issue.
CTlQN •
School Fees
:..
DATE: Y .
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T o
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