07-0299 (RPL)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO • - _ FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760),777-7153
BUILDING PERMIT
Date: 1/30/07
Application Number:. 07=00000299 "�� Owner -
Property Address: 56793 --VILLAGE- DR RUSTOM r
APN: 764-050-026- - - 56793 VILLAGE DRIVE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL _
Application valuation:' 35000
- Contractor: J
Applicant: - .'Architect or Engineer: ` MCRAE POOL & 'SPAS d
79105 DESERT STREAM DR '
• LA .QUINTA;- CA 92253
.1 (760) 772-2440 FEBo 1
Lic. No.: 823017 D 1 1
4 - AF 007
- -
��
------ ----- - ------ --- -- -- --------- ��
LICENSED CONTRACTOR'S DECLARATION s - -� WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty,of perjury that I -am licensed Linder provisions of Chapter 9 (commencing with, , ' , ,• �. : I hereby affirm under penalty ofperjury one of the following declarations: `
Secti6n.7000) of Division 3 of the Business and Professionals Code, and my-License'is in full force and effect._ 1 have and will maintain a f
certificate of to self -insure for workers' compensation, as provided
.License Class: C53 -C27 _ License No.:- 823017 - fo'r by Section 3700 of�the Labor. Code, for the performance of the work for which this permit is
. 4Q/S� �_'11/ issued. -
• ate: l `/0.' ctor: �/! v/.rf _ -- - _ 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-BUILDE 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 EX , PT Policy Number EXEMPT
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit, to,_JICLcertify 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 3700 of the abor Code, I s comp y with those provisions. ,
• that he or she is exempt therefrom -and the basisfor the alleged exemption. Any violation of Section 7031.5 by
any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: ate:
(_- I I, as owner of the. property, or my employees with wages as their sole compensation, will do the work, and
- the structure is not intended or offered for, sale (Sec. 7044, Business and Professions. Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL '
Contractors' State License Law does not apply to an owner of property who builds or improves thereon_, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESAND CIVIL FINES UP TO ONE HUNDRED THOUSAND `
and who does the work himself or herself through his or her own employees, provided that the DOLLARS*($ 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 -
.(_) I, as owner of the property, am exclusively contracting with licensed contractors toconstruct 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 contractors) 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.l. - 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 Ouinta, its officers, agents and 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 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 thereis 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
of this. my to enter upon the ove-mentioned propert
I _ Lender's Name:012 - C�
t ate: -_Ln (Applicant or Age r
Lender's Address: _
LQPERMIT
Application Number 07-00000299
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee .317.00 Plan Check Fee
206.05
Issue Date : Valuation
35000
Expiration Date 7/29/07
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
6.5,0
Issue Date Valuation
0 .
Expiration Date 7/29/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 •11.00.00 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 7/29/07 �-
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL
----------------------------------------------------------------------------
-30.00
Permit . . . PLUMB.ING
Additional desc `
Permit Fee . . . . 33.00 Plan Check Fee :
8.25
Issue Date Valuation
0
Expiration Date 7/29/07
Qty Unit Charge Per
Extension
BASE.FEE
15.00 .
2.00 6.0000 EA PLB FIXTURE
12.0'0
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00'
3.0000 EA PLB GAS PIPE 1-4'OUTLETS
3.00
=--. - - - .- ----- -- ---- - - -- ---- ----
Special Notes and Comments
--- --- ---
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
Application Number ... 07-00000299
-------------------------------------------------
Special Notes and Comments
PLACE AT PRE-PLASTER INSPECTION.
EQUIPMENT ENCLOSURE,NOT INCLUDED
Fee summary Charged
Paid
Credited
Due
----------------------
Permit Fee Total 421.00.
.00
------------------,--
.00
421.00
• -Plan Check Total_ 232.05
00.
.00
232:05
Grand Total 653.05
00
.00
653.05
LQPERMIT - -
1
- -.
4 11,-3'6"
CITY OF LA QUINT
BUILDING & SAFETY DEP .
APPROVED
FOR CONSTRUCTION
DAA 1 90 BY � G
Bin #
Permit #
1�
Project Address: S 6 .
Project type (circle one):.
A.P. Number:
1LI�' Sq. Ft.: I Stories: A Units:
Legal Description:
x
. Contractor. RAI EC
x
Address: -7 _
.1<
City, ST, Zip: t�
X
Tdephoae: "7 .
.
A
_
State Lia # :Zvi L
Reviewed, ready for corrections
Ar&, Engr., Designer:
Address:
Called Contact Person
City. ST, Zip: -
Telephone:
Plans Picked ■p
state Lic. #:
R
Name of Contact Person: '
X
Telephone # of contact Perso
•
N
Submittal
Plan Sets
Called Contact person.
Structural Cates.
Plans picked up
S.111.1.
Plans resubmitted
Truss Cala.
Review. ready for correctib issue
Developer Impact Fee
Called Contact Person'
Eaeigy Cates.
A.LP.P.
Date of permit Issue,
plain plan '
-
LFlood
Grading plan
Subcoutac tor List
Grant Deed
H.O.A. Approval
IN HOUSE:.
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building a Safety. Division
P.O. Box 1504, 78-495 Cape Tampico
La Quinta, CA 92253 - (760) 77"7-7012
Building Permit Application and Tracking Sheet
3 VIVA66 D Owner's Name: FA
vs orh
��' '11
City. ST. Zip: Qu,,
-07A na
3 %s -CMcphone: -S0 _789. 4V
S'TL EaM Al2 , ject Description: Aird oft w
0
City Lic. #:
Construction Type.
Occupancy:
Project type (circle one):.
New Add'n Alter Repair Dano
1LI�' Sq. Ft.: I Stories: A Units:
-760 7 Y- 6 3 y .3 Value of Project:.
APPLICANT: DO NOT WRITE BELOW THIS UNE
I'd Reed TRACKING
PERMIT FEES
Pian Cheek submitted
Item '
Ar4ount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Cheek Balance
Plans Picked ■p
Construction
Plans resubmitted
•
Mechanical
2" Review, ready for correctionsrissne
Electrical
Called Contact person.
Plumbing
Plans picked up
S.111.1.
Plans resubmitted
Grading
Review. ready for correctib issue
Developer Impact Fee
Called Contact Person'
A.LP.P.
Date of permit Issue,
Total Permit Fees
CITY OF LA QUINTA SUB-.CONTRAC T 0 R LIS
I
..JOB ADDRE!SS_j6 -793 DR PERMIT NUMBER OWNER. BUILDER Mc AE4a
This form shall *be potted on the job with the Building Inspection Card at.all times in a conspicuous place. Only persons appedring on this fist or their employees are authorized to work
on this iob. Anv chances to this list must be approved by, the Building Division prior to, corntne . ncement of'work. Failure to comply will result in a stoppage of work and/or the voidance.
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Business
....'..'Sta Contrac C
... : :
tdt'.S� U eris6.: r* C 4: City. e!.ss M6
Contractor,
Trade I Classification .w
e�,xpr.rffi31e' License Number Exp. Date
Company Name Classification License Number Exp. Date •Carrier Name Policy -Number Policy -Number
(e.g. A, 0, C-8) (xxxxxx) (ki/xx/xx) (e.g. State'Fund, CalComp) (Format Varies) lxx/xx/xx) (xxxx) (xxlxx/xx)
EARTHWORK . IP -12)•
FNAVAWa.aCAj)A.VjC?,j
A.-
CONCRETE (C -B)''-
)Qt2c,11uLFTA
Z4 ICLV)
FRAMING -jC_ti
QN$
STRUCT. .-AT EEL-
0
:MASONRY . id -29)
PLUMBING IC -36) -
4- JH7N P
: PLASTER S T E. R
LATH.P r:3
S(; bigQ`ok
6
DRYWALL (C-9).::
HVAC- IC -20
q
ELECTRICAL. (C"16)'--'..".
R o3s;S70
S-MjF CbmD
222-Q0-?_9q'?2
4/-/-'D�
971 -2
/ _3)_0
RO
_7
...SHEET METAL.
A:,
06RING� 191"1 5i':.
GLAZING (C-17):::
INSULATION'. (C-2)
SEWAGE D!sP(6-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-43)
LANDSCAPING (C'-27)
POOL �(C-531��-