06-2552 (RPL)1
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P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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Application Number: 06-00002552
Property Address: 56465 VILLAGE DR
APN: 764-040-012- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Applicant: Architect or Engineer:
1A
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Class: C53 -C27 osa No.: 823017
Date: Contractor L�
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 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 ISec. 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 ISec.
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—) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
MR & MRS. CHITTICK
56465 VILLAGE DR.
LA QUINTA, CA 92253
Contractor:
MCRAE POOL & SPAS
79105 DESERT STREAM DR
LA QUINTA, CA 92253
(760)772-2440
Lic. No.: 823017
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/28/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 EXEMPT Policy Number EXEMPT
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
3700 of the Labor Code 1SurtpwiE7reemg4y-wiip.ihcse provisions.
Date: ��Applicants Lit
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 0100,0001. 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 to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspec ion purposes.
Date: 04 Signature (Applicant or Agent): /
' Application Number . . . . . 06-00002552
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . 252.00 Plan Check Fee 163.80
Issue Date Valuation . . . . 25000
Expiration Date 12/25/06
Qty Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG 2,001-25,000 207.00
----------------------------------------------------------- =----------------
�� Permit . . . MECH POOL
Additional dcsc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 12/25/06
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 12/25/06
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 12/25/06
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 ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . . . 06-00002552
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURES NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 356.00 .00 .00 356.00
Plan Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 .00 545.80
1t
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LQPERMIT
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 g Sheet
Permit #
N. 25�
Project Address: V t 2 56 -q&s-
Owner's Name:
A. P. Number:
Address: � D% i' I 667 De 56- 7
Legal Description:
City, ST, Zip:V � 92
Contractor: CDnnt
Telephone:,
Project Description: C
Address: S �' 2,
City, ST, Zip: LA wwA
Telephone: (7 _ ,G3
State Lic. # : .Z City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#
Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plao Check Deposit
Truss Calcs.
Called Contact Person
Plac Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading, plan
god 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
G�
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CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS 1,I'IIAGIF X12_ _ PERMIT NUMBER OWNER_<14 i - TH Gl; BUILDER
This form shall be posted on the iob with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are 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
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade /Classification
Contractor
::::.:;;.::.::::State:.Contractor s. License ..
Workers Com eirsation;lrisura,nce: `..:' ` . ":'.
City. Bus riess License:: ::
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12)
A
A
�j p
s
_
CONCRETE (C-8)''
_
.v
I-1-0
/ l
FRAMING (C-6}
'/
STRUCT. `STEEL (C-51)
—717
—O
MASONRY (C-29)
PLUMBING (C-36)'
p S a!G/n(
LATH, PLASTER (C-351
(j `
•.
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0 t7
— — 7
6 Z
.i�
DRYWALL (C-9) . ..:
HVAC (C-20)
ELECTRICAL.(C-10
VJJ�
c L
SHEET METAL (C' 43)
FLOORING�IC-:151;
GLAZING (C.17):: ` :>
INSULATION'. (C-2)
SEWAGE DISP. (C-42)
PAINTING (C=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (C=27)
POOL IC -53)n
3
(57.0 APPROVED PAD)
FIRE PLACE
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— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
COLUMN5 WITH FOT5 . . . . . . A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
Construction contractor agrees that in accordance with generally accepted construction
Important Notice — Underaround SerVice Alert CITY PLANS LAND JOB CARD ARE NOT ON 851 16 321
practice5, construction contractor Mll be required to a.55ume, 5ole and complete responsibility for OF LA QUINTA THE SITE FOR A SCHEDULED
OR Section 421614217 of the Covernment Code requires job site conditions during the course of construction of the project, including safety of all persons Y" I LL A 0% 'X` ["to D% R I V E BUIL & SAF DEPT.
a Dig Alert Identification Number be issued be re a and property; that this requirement 5haill be made. to apply continuously and not be limited to APPROVED INSPECTION. =7
Permit to Excavate' will be valid. For your Dig Alert normal v4orking hours, and construction contractor further agrees to defend, indemnify and hold
Identification Number call Underground Service AIM design professional harmless from an and all liability, real or alleged, in connection with the FOR CONSTRUC-no,4 NO EXCEPTIONS!
911gence of deli NORTH
-800-227-2600 two working days pting liability arising from the, sole ne
TOLL FREE at I performance of Nork on this project, exce
before you dig. professional. 5GALE: 1 (5'-0
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