06-00000734 (RPL)P.O. BOX 1504 E VOICE (760) 777-7012
78-495 CALLE TAMPICO• t - FAX (760)777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT - ' ' INSPECTIONS (760) 777=7153
BUILDING.`PERMI T'
* .. ;, Date: 2/21/06.
- Application Number 06 00 -�—%,� Owner ,;.
nnn 7�
Property Address: 81148 VICTORIA 'LN UPSON
APN: 764-2. - - 0234- ° 81-208 VICTORIA LANE E. .
• Application description: "POOL - RESIDENTIAL LA QUINTA, CA .92253
Property Zoning: ' t MEDIUM HIGH DENSITY' RES .O
Application valuation: ,+ X35000 '
Contractor. D a�006
Applicant: : • Architect or Engineer: ^ :HIRE STANDARDS POOL •CONSTR O ��
P.O. BOX 4713
%% PALM° DESEPT CA 92261
(760)341-3377
.Lic. No: - .818538 F�
-- -= -- - - -- ---- ' - -- - -- - - - ------'----`-----=-------- ---:-- - -------=-------"-=
LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION
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 License No.: 8.18538 for by Section 3700 of the Labor Code,, for the performance of the:work for which this permit i.s
/�•• �� fZ . issued...
�Date:>-7•►Oiu Contractor. „y p t I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor'-
r ' _ _ Code, for the performance of the work for which this permit is issued. My workers' compensation '
• - OWNER -BUILDER DECLARATION � r' . ° � - � � insurance carrier and policy number are: ' .-
•- > - ,I hereby affirm under penalty ofperjury that I am exempt from the Contractor's State License Law for the - .Carrier STATE FUND Policy Number 00295202006
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.re air an structure, prior to its issuance, also requires the applicant for the in any manner so as to become subject to the workers' compensation laws of California,
• P p Y P q PP _ 'personY I P ,
.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 P700 of the Labor CC94e, I shall Wrth```'''���(((ith comply with those provisions.
' that heor she is exempt therefrom'and the basis for the alleged exemption. Any violation of Section 7031.5 by / •A + • // a-\ I
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: " gate:. pIAcant.
• 1 -1- 1, as owner of the property, or, my employees with wages as their sole compensation, will do the work, and '• -
the structure is not intended orofferedfor sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property whobuilds 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"t) 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 thisapplication 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, -
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•an0 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 this application becomes null and void if work isnot 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 I 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. 3097, Civ. C.). city and county ordinances and state laws relating to building construction,.and hereby au_ thorize representatives...
• _ e of !PS COty to nter upon the above-mentioned prope fQr �'as ion pos
es.
es. ,..
Lender's Name: -
-0ate: gnature (.Applicant Age
)I '9q' rrrrrr,,,,������jjjjII� 3
S�F�r� 1
Lender's Address: - - '• - - .
- LQPERMIT• •. t , . • . -- _ :.- .. ... -• I ; y .i. } -+ - - - a' •
Application Number 06-00000734
Permit BLDG.POOL'PERMIT
Additional'desc`:
Permit Fee' 317.00 Plan Check
Fee
206.05
-Issue Date Valuation
:-.
35000,
- Expiration Date 8/20/0.6'
Qty .Unit, Charge Per...
Extension
..,.BASE FEE
252.00
10.00 6.5000 THOU. -BLDG _25,001-50,,000
---------------
65:00
..'_ Permit MECH POOL
Additional desc .
- Permit'Fee 26.00 Plan Check
Fee
: 6:50
Issue Date - Valuation
0
Expiration Date 8/20/06.
Qty Unit Charge ' Per-
Extension ;
BASE FEE
15.00 r -
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 8/20/06
-e
Qty Unit Charge 'Per
Extension
BASE FEE
15.00
1:00 30.0000 EA-. ELEC PRIVATE SWIMMING
-- - -
POOL
30.00
Permit" PLUMBING .
f Additional desc .
Permit Fee .. 33.00 Plan- Check.
Fee
8."25
Issue Date. Valuation.
. . .
. 0
Expiration Date r 8/20/06
.,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
---
Speci"al Notes and -Comments
POOL.&SPA ONLY. ALARMS/BARRIERS SHALL'
LQPERMIT.
Bin #
City of. La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
73�
Project Address: S1-a0S W C`bri Lane,
Owner's Name: IWC) Sp V
A. P. Number:
Address: $i -DCE
Legal Description:
City, ST, Zip: nAa �A QQS3
Contractor: NkreSkX & r,& ?CX51 COPVS-Jrj�C_ -okl, 1110..
Telephone:
Address:
Project Description:'
City, ST, Zip:%k i 0 JA, 9cia
Telephone��(� 3t{ 3
State Lic. # : �rJy ���
City Lic. #: (p (p a•
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:- ti J
State Lic. #:Project
Name of Contact Person: �Cev ��-1
Construction T e: rp
YP 16p1 Occupancy:
type (circle one) New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
# Units:
Telephone•# of Contact Person: (I () 3 41-,33-1—+
Estimated Value of Project: t351000
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING.
PERMIT 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
2" Review, ready for correctionsfissue
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 corrections/issue
Developer 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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