08-1114 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
08-00001114
80140 VIA TESORO
772-250-018-6 -31349 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
23000
TdAt 4 Xry Q"
Architect or Engineer:
P111-
•-------------- - - - - -
LICENSED CONTRA TOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un r provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an rofession Code, and my License is in full force and effect.
License Class:, C53 icense No.: 614611
�te: •7, �_ -actor. - r �
OWNER•BUILDER DECLARATION
I hereby affirm under penalty of per, at 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 (5500).:
(_) 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.).
1, 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
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: 6/27/08
Owner:
SMOLICH
80140 VIA TESORO
LA QUINTA, CA 9,2,E
Contractor:
MCINTYRE POOL & SPAXILI41 1009 1i
83695 AVENUE 5 Y(J
INDIO, CA 92 1 CITyOF 1
(760);42-361 FINgMCEpEpITTA
Lic. No.: 614611
--------------- - --
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: r'
_ 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 DELOS INS CO Policy Number OIDKPM12001870
I certify that, in the performance of the work for hich this permit is issued, I shall not employ any
person in any m4WOERS'
me subj o the workers' compensation laws of California,
and agree that, isubject o he workers' compensation provisions of Section
3700 of the Labrthwit mply with those provisions.
te: O plicant:r
WARNING: FAILURE TO SECURMPENSATION 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.
APPMANT AQKNQWLEDQ,EMENT
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 � formatio correct. I agree to comply with all
city and county ordinances and state laws relating to building c structio d hereby authorize representatives
of hi unty to enter upon the above-mentioned property for ' specti rposes.
i
ate: - ignature (Applicant or Agent)'
Application Number . . . . . 08-00001114
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
234.00 Plan Check Fee
152.10
Issue Date . . . .
Valuation . . .
. 22872
Expiration Date . .
12/24/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
2.1.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
189.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
12/24/08
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 . .
12/24/08
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 . .
12/24/08
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
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
Application Number . . . . . 08-00001114
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 128
Expiration Date . . 12/24/08
Qty Unit Charge Per Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 8 L.F. 4' EQUIPMENT WALLS,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
.IN PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 353.00 .00 .00 353.00
Plan Check Total 178.10 .00 .00 178.10
Grand Total 531.10 .00 .00 531.10
LQPERMIT
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IA QUINTA., CA
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DATE:
04/ 18/ 08
SCALE:
DRAWN BY: 1
JOB: 5MDUCH
SHEET
OF
SHEETS
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Bin #
Cit/ of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - (740) 777-7012
Building Permit Application and Tracking Sheet
Permit # \.
V(
Project Address; _
v
Owner's Name:t Mn'
Ino t
A. P. Number:
Legal Description:
Address:90- V
ro
City, ST, Zip:
Contractor: Ar
Telephone:
Project Description:. Q S
Address: A
V, `I
City, ST, Zip:
Telephone:
��^^
State Lic. # : - 5 3 ' C�7
.6
city Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Te ry-V
Construction Type: Occti an
P c3':
Project type (circle one): New Add'n ' Alter Repair Demo
Sq. FL:
# Stores:
# Units:
Telephone # of Contact • Person:
6 Z
Estimated Value of Project:. � a0 I � .
APPLICANT:
DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd ,
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
'Iten
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
2ad Review, ready for corrections/issue
Electrical
Subcontactor. List
Called 'Contact Person
Plumbing
GranfDeed
Plans, picked up
S.MI.
H.O.A. Approval
Plans resubmitted
Griming
IN HOUSE:-
Review, ready for corrections/issue
Dev:loper Impact Fee
Planning Approval '
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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