12-0480 (RPL)P.O.'BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C_—_1-2-0000_00#
48
Property Address: 53791VIASTRADA
APN: 772-540-042- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 48990
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BALLARD
53791 VIA STRADA
LA QUINTA, CA 92
Contractor:
MCINTYRE POOLS•&
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
53
De
MAY 0 3 201.2
A , INC.
CITY Or, LA QUINA
FINANCE DEPT.
Date: 5/02/12
Lic. No.. 6.14611
r,
v
_.
LICENSED C ECLARATION -
`''
.
WORKER'S COMPENSATION DECLARATION"
-
.. I hereby: affirm under penalty of perjury that I am lice dions of Chapter 9 (commencing with
/dre
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Prof siond my License is in full force and effect.. +
1 have and will maintain a certificate of consent to self -insure for workers` compensation, as provided
License Class: C53 - .: 614611 -
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
' •�
/Date: ��-(.�� ntractor. .,
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 ' ad'. My workers' compensation
- NER-BUILDER DECLARATION '
- insurance carrier and policy number are: -
I hereby affirm under penalty of p rjury that I a exempt from the Contractor's State License Law for the
Carrier COMMERCE WEST I .:Policy Numbe 00330 43 90
following reason (Sec. 7031.5, B siness and P ofessions Code: Any city or county that requires a permit to
shall not employ any
_ I certify that, in the performance of work for hich t�o.imrc--
rs issued, t1:
construct, alter, improve; demolis , or repair y structure, prior to its issuance, also requires the applicant for the
- person in any manner so as to become subj t to the pehsation laws of California,
permit file a signed statement t the or a is licensed pursuant to the provisions.of the Contractor's State
and agree that, if I should become subject the workmpensation provisions of Section
License Law (Chapter 9 (commenci wi Section 7000) of Division 3 of the Business and Professions Code) or -
- �'. 3700' of the Labor Code,1 shall forthwith omply wi e provisions.
that heor she is exempt therefrom an a 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).:
te: 3' I .plicant:
(_) 1, as owner of the property, or my employees withwages 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
MP NSATION COVERAGE IS UNLAWFUL, AND SHALL
WARNING: FAILURE TO SECURECINTEREJ
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRI 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 ADDITOF 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 C 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.).
(_ 1 I, 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:
LQPERMIT
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 harmless the City
of La Quinta, its officers,. agents and employees for any act or omission rel d to he work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes n� and void' work' not commenced
within 180 days from date of issuance of such permit, o essation work- r 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above in mation i corre . I agree to comply with all
city and county ordinances and state laws relating to building con ction, d hff�•• by authorize representatives
of this county
�to'enter
iupon t above-mentioned property for i action rposKS.
ate: nature (Applicant or A ent):
Application Number .
. . . . 12-00000480
Permit . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
408.00 Plan Check Fee :_
265.20
Issue Date . . . .
Valuation
48990
Expiration Date
10/29/12
" Qty Unit Charge
Per
Extension
BASE FEE
252.00
24.00 6.5000
THOU BLDG 25,001-50,000
156.00
Permit
MECH POOL
Additional desc
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date
Valuation
0
Expiration Date
10/29/12
Qty Unit Charge
Per.
Extension
BASE FEE
15..0'0
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
.10/29/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
EAELEC PRIVATE SWIMMING POOL
30.00'
Permit . . .
PLUMBING
Additional desc .
Permit Fee . .
33.00 Plan'Check'Fee
8.25
Issue Date
Valuation
0
Expiration Date
10/29/12
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
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Special Notes and Comments
POOL/SPA, FIRE PIT, GAS & ELECTRIC
LQPERMIT -
, P�
NPO' E.-MIZE
020 Z'
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THE ,ITIJ%EA W, AY
53-791 Vll�k STRADA
LA QUINTA5 CA
Bin #
City of La Quinta.,
Building u Safety -Division '
P.O. Box 1504, 78-495 Calle Tampico
U Quints, CA 92253 - (7¢0) 777-7012 '
Building Permit Application and Tracking Sheet
Permit #
��-
Project Address:'
791 o
_
Owner's Name:13 o
A. P. Number:
Address:
IPY,
Legal Description:
— -
ST, Zip:
Contractor:Ar Y1
re 19ry,)
Telephone:
Project Description:. 191n. C21�) o r
Address:
3 - 6O . V, 4s-,
S •
City, ST, Zip:. =,&O-
Co..
224
l .. �.,
Telephone:
2 , `J6
State Lie. # : C .S3 _ 614611
Arch., Engr., Designer:
City Lie. #:.
Address:
City, ST, Zip:
Telephone:
State Lit. #:
Name of Contact Person:
4
O r r k .
Construction Type: Occupancy:- up cy:
Project type (circle one): New Add'n 'Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact.Person: X76
S 6 Z
Estimated Value.of Project: ° d
APPLICANT: DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd ,
Rec'd
TRACKING .
PERMTT 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 .
Grading plan .
.21' Review, ready for correctionslssue
Electrical
Subcontactor•List
Called"Contact Person
Plumbing
Grant Deed
.j
Plans• picked up
S.M I.
H O.A. Approval
Plans resubmitted
Grading.
IN HOUSE:
'"' Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees