12-0859 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 120_00008.59_
Property Address: 52849 R AVE.
APN: 767-670-017-21 -33076 -
Application description: POOL - RESIDENTIAL
Property Zoning: RL AG/EQ OVERLAY
Application valuation: 82000
Tiht 4 4'Qu&&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SUGARMAN, M&B FAMILY TRUST
9440 SANTA MONICA 40
BEVERLY HILLS, CA 10
Contractor: 1
Applicant: Architect or Engineer: DESERT OUTDOORS INC
79405 HIGHWAY 111, MB 42
LA QUINTA, CA 92253
. (760)399-9600
PIP(
LiC. No.: 964474
1.
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 o e NE9
nse is in full force and effect.
License Class: C27-05 74
/te: • ontractor:
OW R -BUILDER DECLARATION
I hereby affirm under penalty of perjury at I am ex pt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business a ions 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 _) 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 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/01/12
.
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.
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 NORGUARD INS Policy Number DEWC229889
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 sho ome eject to the workers' compensation provisions of Section
/ rn3�700 of the Labor Co I sh I f rt i comply with Those provisions.
Date: • �v Applica
WARNING: FAILURE TO SEC E WORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C INAL NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITI 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 Ouinta, 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 ove infor 'on is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi constr do , and hereby authorize representatives
of j s county to/ enter upon the above-mentioned rty r insp do purposes.
D/ate• • - 1 nature (Appli n r A
Application Number .
. . . . 12-00000859
Permit . .'.
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
558.50 Plan Check Fee
363.03
Issue Date
Valuation . .
82000
Expiration Date
1/28/13
Qty Unit Charge.
Per
Extension
BASE FEE
414.50
32.00 4.5000
------------------------------------------------------------------------------
THOU BLDG -50,001-100,000
144.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check Fee
6.50
Issue Date
Valuation . .
. 0
Expiration Date
1/28/i3
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
1/28/13
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
1/28/13
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, 2 WATER FEATURES.
LQPE641T
LQPERMIT
Application Number 12-00000859
--------------------------------------------------------------------------
Special Notes and Comments
ALARMS/BARRIERS SHALL BE IN PLACE AT` -
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED. 2010 CODES.
------------------_------------------------ - -
.--
Other Fees . . . BLDG STDs ADMIN (SB1473)
4.00
Fee summary. Charged Paid
Credited
Due
Permit Fee Total 662.50 .00
.00
662.50
Plan Check Total 389.03 .00
.00
389.03
Other Fee Total 4.00 .00
.00
4.00
Grand Total 1055.53 .00
.00
1055.53
Bin #
Cit}/ Of QUiilta
Building 8r 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: 152S49 % ,A VC.
e: --PIS �\�'Z.-% 1 CD t --
A. P. Number
7Addrew:p 1 `t.J A
Legal Description
City, ST, Zip: LA Q&13
Contractor: Desert Outdoors
Telephone: IaRQ• 37z:� Y , .:N;
Address: 78-065 Main St. Ste. 205
Project Description:
city, ST, zip: La Quinta, Ca. 92253,,E
Telephone: 760-399-9600
:{r`'
City Lie #;
State Lic. #: • e-53 964474
Arch, Engr., Designer: Flying Buttress
Address: - 77725'Enfield Ln. Ste. 130
city., sT, zip: Palm Desert, CA. 92211
Telephone: 760-772-4411
State Lie. #: 33446< �
',.< '- �
Name of Contact Person: J
Construction Type: • Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo •
Sq. Ft.:#Stories: #Units:
Telephone # of Contact Person:-1Ucu!21<--ZS0
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Rec'd
TRACKING
PERMITFEFS-
Plan Sets
r.
Plan Cheek � �
It. Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs•
Called Contaet Pcrs4 U L -3 1 � Z 01 Z
Plan Check Balance •
Title 24 Cates.
Pians picked up
Construction
Flood plain plan
Plans resubmitted '
Mechanical
Grading plan
V Review, ready for correctionsfissue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7e° Review; ready for correctionsAssue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees