07-1631 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
07-00001631
56205 VILLAGE DR
764-030-017- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
28000
Architect or Engineer:
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 License No.: 823017
Date:^ Contractor:
WE
"I f
OWNER -BU DER 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.(comniencing 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 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 _ 1 I, 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
I—) 1 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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERA11T
Owner:
MAKS RESIDENCE
56-205 VILLAGE DR.
LA QUINTA, CA 92253
Contractor:
MCRAE POOL &
79105 DESERT
LA QUINTA, CP.
(760)772-2440
Lic. No.: 823
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/04/07
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
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
3,-.7Ly00 of the Labor Code, I shall forthwith comply with those provisions.
Date: 14L/LIL.L/J�L
Applica
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 ($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.
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 t enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent
Application Number . . . . . 07-00001631
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 271.50 Plan Check Fee 176.48
Issue Date Valuation . . . . 28000
Expiration Date 12/01/07
Qty Unit Charge Per Extension
BASE FEE 252.00
3.00 6.5000 THOU BLDG 25,001-50,000 19.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc . .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . 0
Expiration Date 12/01/07
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 . . 12/01/07
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 12/01/07
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
-------------------------------------------------------I--------------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS SHALL. BE IN
LQPERAIIT
Application Number . . . . . 07-00001631
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 375.50 .00 .00 375.50
Plan Check Total 202.48 .00 .00 202.48
Grand Total 577.98 .00 .00 577.98
LQPMIIT
Do,
r1j,
V
C
2-0-T V,-'LJ,46Er A2 CITY OF LA QUINTA.SU134%ONTRACTOR LIST
JOB AUDRESSg PERMIT NUMBER OWNER BUILDER
This form shall be posted on the job withthe Inspection Card at all times in q conspicuous place. Only persons appe0ring on this fist or their -employees are authorized o work
/or
*his 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/orthe v idlance.
on.t
of building permit. For each applicable trade, all information requested below must be completed, by applicant. *On File* is not an acceptable response.
Cit itiiusi, ei.
Contractor State ntractiW.s.
Tra�e 6�s'so Iication
Lice
; . . .. '.
Company Name.
Classification
(e.g. A, B, C-81
License Number
(xxxxxx)
Exp. Date Carrier Name
Cc
(ik/xx/xx.) (e.g. State Fund, CalComp)
Policy Number
(Format Varies)
-
qSxp-rDaT6
lxx/xx/xx)
License Number.
(xxxx)
Exp 1. Data
lxx/xxlxx)
EARTHWORK (P-12)
gs�hflr P-7,41)
0 0 1 E -7
1411-1-33
2, 124102
CONCRETE (P-
12. VO? Stlt r�- Rinih
ro 44�I"i`O7
LF
FRAMING.0;
Pais I"q Ism I,,q
ay=on
S�O'NRY (C-29)
PLUMBING (C-.361
P—\/,S
LATH; P,.LA$TER.(0r,)
L42,17
ELE TRICAL 1 4.
S 'MtE CbMQ
M
I HE METAL
GLAZING (C-17)'
INSULATION , C-21
PAINTING (C -*33)
CERAMIC T105 (C-54)
CABINETS 10-61
FENCING (P-13)
LANDSCAPING 10-27.)
4-10 71 00
q1 POOL- (C-53)
e2arasee�ars�s�r !dam. as6�-s��z�®„�
p CHECKED
L1
' o.Q & Q J: ®®
DAT E
Io/®-7
SCALE
` t6 1
JOB NO.
SHEET
SHEETS
Bin #
City of .La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Buildin Permit Application
g and Tracking Sheet
Permit #
On
Project Address:_VQfA66 D2
Owner's Name: AR I MEN S
Address: S6 20,19- Vi'llh 6c DQ
A. P. Number:
Legal Description:
City, ST, Zip: sLA CA Fa2.Q.
Contractor: /7) C aqS
Telephone:
Project Description:
Address: -
City, ST, Zip: L/4 V '
Telephone: 7722 1 0
State Lic. # :City Lic. #:
Arch., Engr., Designer:
2
.=
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: C
Construction Type: Occupancy:
Project type (circle one): New Add`n Alter Repair Demo
Sq. Ft.:
#Stories.
#Units:
Telephone # of Contact Person: 3
Estimated Value of Project: 21, 6
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Chec z Deposit
Truss Calcs.
Called Contact Person
Plan Chect Balance
Energy Cales.
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:-
''' Review, ready for corrections/issue
Develops Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r