06-3474 (RPL)ic� .0i
' P.O. BOX'1504 VOICE760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011 '
SLA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153_''
BUILDING PERMIT
Date: 9/27/06
Application Number:E 06-0000_3474 Owner:
Property Address: 78755 VILLETA DR PAUTASAFRAN
APN: 1, . 604-153-012-1601-23269 - f 78755 VILLETA DRIVE D n 0
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 LrZj
Property Zoning: :LOW DENSITY RESIDENTIAL
Application valuation: 40060
SEP: 2 7 2006
Contractor:
Applicant:. Architect or Engineer: INTERNATIONAL GUNITE r INC C�NOF �4 QUINTA
75153 MERLE DRIVE; SUITE B FIN gNCE DEPT
PALM DESERT, CA 92211
I (760)034-1350
:875
i
LiC. No..: 875547
---——------------—-- _ _ _'_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ — _ — _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
„ 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:
., t .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.: 875547 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,
i
issued.
�. ate: ntractor: , I have and will maintain w rkers' c mpensation insurance, as required by Section 3700 of the Labor ,
Code, for the performa a of th work for which this permit is issued. My workers' compensation
- OWNER-BUILDER DECLARATION - insurance carrier and po icy num er are: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law fortheCarrier J WARLIN 'INS. olicy Number 229003373006
following reason (Sec. 7031.5,. Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the perfor ance of a 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 p son in any manner s as to be me 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 - a agree that, if I sho ecome ubject to the workers' compensation provisions of Section
License Law(Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or3 of the Labor Cod shall fo with comply with ;hose provisions. ..
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 civil penalty of not more than five hundred dollars ($500).: ate: - icant:
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 WARNING: FAILURE TO SECURE WO KER -C ENSATION 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 CRIMIN L P ALTIESAND 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 0 HE 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, TEREST, AND ATTORNEY'S FEES.
one year of completion, the ow er-buil r will have the burden of proving that he or she did not build or - F - -
improve for the purpose of sale.. APPLICANT ACKNOWLEDGEMENT
1 _) 1, as owner of the property, am excl sively mracting 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: a 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, nd who contracts for the protects with a contractor(s) licensed - 1. Each person upon whose behalf this appli atian is made, ach person at whose request and for -
pursuant to the Contractors' Sta imnse aw.). - - whose benefit work is performed under o pursuant to an permit issued as a result of this application,
I—) I am xemp under Sec. C. fo this reason the'owner, and the applicant,'each agrees to, and shall de nd, indemnify and hold harmless the City
i _
of La Quinta, its officers, agents and empl yees for any a or omission related to the work being
_ Jn� /j� performed under or following issuance of t is permit.
Date: l' �1 l� Owner: - 2. Any permit issued as a result of this applic ion becomes n 1 and void if work is not commenced _
I within 180 days from date of issuance of uch permit, or s"tion of work for 180 days will'subject ,
C STRUCTION LENDING AGENCY permit to cancellation. '
I hereby affirm under penalty of perjury that her is a construction lending agency for the performance of the I certify.th t I ha a read this application and state that t ve informs ion is correct. �I agree to comply with all '
work for which this permit is issued (Sec. 3 7 Civ: CJ. - - city an unty di
and state laws relating to bui onstructio , and hereb ' authorize representatives
" of s coo, ty to nter upon the above-mentioned props nspection urposes -
Lender's Name:7 r
' Date: _1 N 'gnature, (Applicant or Agent):
Lender's Address: pf
LQPERMIT
Application Number .
. . . . 06-00003474
- Permit .'
BLDG POOL PERMIT
Additional desc.;
Permit Fee . . . .
349.50 Plan Check Fee
227.18
Issue Date . . . .
Valuation
40000
Expiration Date'.
3/26/07
Qty Unit Charge
Per
Extension
BASE FEE
252,.00
15.00 6.5000
THOU BLDG 25,001'-50,000
97.50
Permit
MECH POOL
Additional desc..
Permit Fee . .
26.00 Plan Check Fee
6.50
" Issue Dated
Valuation . . .
. 0
Expiration Date
3/2,6/07•
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 ..
3/26/07
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
3/26/07
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
Special Notes and Comments
-POOL/SPA. ALARMS/BARRIERS'SHALL
BE IN -
t
LQPERMIT
Application -Number 06-00003474
--.------------------------ --
Special Notes and Comments•
-
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 453.50
.00
.-00
453.50
Plan Check Total 253.18
;.00
.00
253.18
Grand Total 706.68
.00
.0.0'
706.68
LQPERA11T -
'
Bin #
City of La Quin ta
Building. &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: —��s t (� 7- tp 0—
O"ner's Name: 11 A.)
Address:
City, ST, Zip:
W) rA
A. P. Number:
Legal Description:
Contractor:( ou 100 6 0
v
'Telephone:'
Address: ��3� �— `�
City, ST, Zip:
h
Telephone:
one
P O
`l 1
3 3
Project Description:���
State Lic. #
city Lic. #;
Arch., Engr., Designer:
'�
construction os
truct
ton Type: OccuP anc Y•
Address:
City., ST, Zip:
Telephone:
e.
State Ltc: #
Pr oJec
t e.
type (circle e on n After Re air
p Demo
Name of Contact Person:. (J
Sq. Ft.: #Stories: #Units:
Estimated Value of Project:40.,
Telephone # of Contact Person:
3
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd .
Rec'd.
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
q ZZ
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title.24 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:L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
$eemudo Dunes, A A p p t
,California 92203 MRS:,PAU Lf1 SAFRA-N
• d,. -
PHONE t (760) 27279516 78-7.55 VILLETA DR.
•10RGE A. CONTRERAS, FAX -(760),772-'9732 s +,
DESIGN coMierasolmos@aol.com y LA QUINTA , CA..
SCALE :.
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