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06-0026 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA'QUINTA, CALIFORNIA. 92253 Application Number: 06>0000_0-02'6 Property Address: APN: 5-6-605 VILLAGE DR D 764-050-015- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW .DENSITY RESIDENTIAL Application valuation: ' 20000 I Applicant: Architect or Engin BUILDING & SAFETY DEPARTMENT BUILDING. PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/05/06 ' LICENSED CONTRACTOR'S DECLARATION Owner: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with BUTENSHON Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. 56-605 VILLAGE DRIVE License Class: C53—C27 License No.: 823017 LA QUINTA, CA 92253 JAN0 6 1006 issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor' CITY OF LA QUINTA Contractor: FINANCE DEPT. MCRAE POOL & SPAS I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the , 79105 DESERT STREAM DR following reason (Sec. 7031-.5, Business and Professions Code: Any city or. county that requires a permit to LA QUINTA, CA 92253 construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the (760.) 772-2440 _ permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State, Lic. "No.:"82301'7 ' 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 License No.: 823017 _ for by Section 3700. of the Labor Code, for the performance of the work for which this permit is -0 6 Coractor: _ 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. -OWNER- UILDER DECLARATION 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 EXEMPT Policy Number EXEMPT following reason (Sec. 7031-.5, Business and Professions Code: Any city or. county that requires a permit to _ Icertify 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 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, 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 that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 3700 of the Lab Code II forthwith comp) w' za+risions. any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 atle e: 1 `.7'V b Applic (_ 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 or offered for 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 who builds 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 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 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, 1 1 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 mission related to the work being o 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 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 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 authorize representatives Lender's Name: - - of county to enter upon the above-mentioned property for inspection purpose /ate: L . Signature (Applicant or Agent Lender's Address: LQPERMrT - , Application Number 06-00000026 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . 207.00 Plan Check Fee 134.55 Issue Date Valuation 200.00 Expiration Date 7/04/06 Qty Unit Charge .Per Extension_ BASE FEE 45.0.0 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'.. .7/04/06 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 7/04/06 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 7/04/06 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.. ..- .. CITY OF LA QUINTA SUB -CONTRACTOR LIST . Ip - I I�C�� D(Z PERMIT NUMBER (� (�. - 462,(, OWNER1ketrf go-M;gSRON BUILDER 1 k JOB ADDRESS This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees ar authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to, comply will result in a stoppage of work and/or the voidance __A __... _ .,. &_, — __t_#-4 ti:, nmm1;r-nr,t "(fin File" is not an acceptable response. of buildingpermit. For eac app Ica a trade, a information F, F,r,.. ,,..... _ .. - - ► _ -. .. City. Business License': Trade I Classification Contractor State;.Contractors.lacense • . :..:...;;:. Woikei Com ensation;Insurapce`:° Policy Number Exp. Date (Format Varies) lxx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) Company Name Classification License Number Exp. Date Carrier Name State Fund, CalComp) (e.g. A, B, C-8) (xxxxxx) (xx/xx/zx) (e.g. C)y �� F /I // EARTHWORK ICA 21 /l CONCRETE (C-8) • ARC 14LI /I i�. i/ it !� !! d 3 e 1 _ `S _ ./. 7 FRAMING :(C-5) STRUCT.: STEEL• (C-51) MASONRY.IC-29) PLUMBING (C-36) 14&qQ hl 1 N EM h46 �' -� (�� �Z"�� Tit PLASTER (C-35) Fp —5 -.3 -31-0 DRYWALL (C-9) . <. t HVAC. IC -20) ELECTRICAL, (C=101' g03.S"� _ comp 2 2 6 7 /04, 7 L.7- RQQFING iC_381' :.. :SHEET METAL.(..(' j) .FLOORING GLAZING (C-17) INSULATION: (C-2) SEWAGE DISP (0-42) PAINTING (6=33) CERAMIC TILE.(C-54) CABINETS (C-6) FENCING (C7,13) LANDSCAPING (C=27). '. ' 2 0OL (C=5$) �' I 4W Bin #, . . City of La Quinta Building u Safety Division P.O. Box. 1504, 78-495 Calle Tampico La Quinta, CA 92253 -.(760) 777-7012 Building Permit Application and Tracking Sheet Permit # I� (•� Project Address: 5(, Owner's Name: ITH �h/S A. P. Number: Address: 3_6 - (9 C)S. VO (4 G ,Q /2 Legal Description: Contractor: Is S City, ST, Zip:.44 t✓/ Telephone:M —1339 ,•� Address: �� _ OS' ozrS7)_) C.A?I, _ Project Description: J City, ST, Zip: 3 Telephone:. City Lic. #: State Lic. # : Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: P -C Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:L - 6 31, Estimated Value of Project: • � 000. APPLICANT: DO NOT WRITE BELOW THIS LINE N 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 corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" 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