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05-4778 (RPL)• 4.4 P.O. BOX 1504 " 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: c05-00004,7-78Owner: Property Address: -80668 VIA TRANQUILA HERRERA APN: 772-2707010-39 -311231- 80-668 VIA TRANQUILA Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 20000 d � Contractor: Applicant: Architect or Engineer, MCINTYRE POOLS & SPAS, INC. `� NOVN 0 2 1005 83695 AVENUE 45 INDIO, CA 92201 CITY pp (760) 342-3612 �l(� FlNgjy�QUINTA Lic. No.: 614611 -------------------------------------------------- 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 Professionals Code, and my License is in full force and effect. License Cl s: C53 Licens/e�No.:///6��14611 �Date:� ContractoS OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom 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 ($500).: (_ 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 (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.). (_ ) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/25/05 ---------------------------------------- ------ 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 STATE FUND Policy Number 1769111 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 become subject to the workers' compensation provisions of Section / f9 3700 of the Labor Q`\�p I shall forthwith co ply with those provisions. ate: li`G Applicant:: \ �f t! .r WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR 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 tabuc nsruction,and herebyof this c my onenter upon the above-mentioned pspecton purposesDate' C/Signature (Applicant or Agentlcr Application Number . . . . . 05-00004778 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date . . 4/23/06 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 162.00 Permit MECH POOL Additional desc . . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/23/06 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 . . 4/23/06 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 . . 4/23/06 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 ONLY. ALARMS/BARRIERS SHALL LQPERMIT Application Number . . . . . 05-00004778 ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid ----------------- Credited Due -------------------- Permit Fee Total 311.00 .00 -------------------- .00 311.00 Plan Check Total 160.55 .00 .00 160.55 Grand Total 471.55 .00 .00 471.55 LQPERMIT Permit # 6.�- q7y Project Address:.* go A. P. Number: Contractor: X Address: _ C City. ST, Zip: Telephone: x 1. State Lic. # Arch.. Engr.. Designer: Address: City. ST, Zip: Telephone: State Lic. ti: Name of Contact Person: x t Telephone # of Contact Person: N Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE:. Planning Approval Pub. Wks. Appr School Fees City of La Quints Building S Safety Divi'si`on P.O. Box 1504, 78.495 Calle Tampico La Quinta, CA 92253 . (760) 777.7012 Building Permit Application and Tracking Sheet 7e-,fR 00/4-ATAjdd 's Name: X _ 1c s: X V / T. Zip: K/ Plan Check submitted Reviewed, ready for con Called Contact Person Plans picked up Plans resubmitted 2"° Review, ready for cor Called Contact Person Plans picked up Plans resubmitted '~ Review, ready for torr Called Contact Person Date of permit Issue ,CKING PERMIT FEES Item Amount •ections Plan Check Deposit Plan Check Balance Construction Mechanical rections/issue Electrical Plumbing S.M.1. Grading ections/is ue Developer Impact Fee A.I.P.P. 17=01,1permit Fees .. x ,r -l" and mma DATE: 10 /0 7 /05 SCALE` DRAWN BY: l% T