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10-1214 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO -LA QUINTA, CALIFORNIA 92253 T 'a ihf 0 4 " Application Number: �10-00001214 Property Address: 5507.5 MONROE ST APN: 767-580-013--000000- Application description: POOL - RESIDENTIAL Property Zqning: LOW DENSITY RESIDENTIAL Application valuation: 63000 Applicant: �� Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: License No.: Date: Contractor: 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 an 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 1 I am exempt under Sec. , B.&P.C. for this reason Date: 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.). It Lender's Name: Lender's Address: VOICE (760) 777-7012 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 Date: 11/08/10 Owner: TALLY RANCH, INC. 55-075 MONROE STREET LA QUINTA, CA 92253 --------------------------------- Contractor: D A Owner ! NOV 17 2010 cmr qF ^�.n FiJA%'CE ------------------ 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 Policy Number 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 r rs' compensation provisions of Section subject co I with hose provisions. 3700 of th5,Labor Code,^hall forthwith ate: 1 pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UN- AWF , AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 c ect. I ree to comply with all city and county ordinances and state laws relating to building construction, and ereby ouch ize representatives of s county to enter upon the ve-mentioned prope o 'nsp to purp Date: Sig upon; (Applicant or Ag LQPERNIIT Application Number . . . . . 10-00001214 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 473.00 Plan Check Fee 307.45 Issue Date . . . ." Valuation 63000 Expiration Date 5/07/11 Qty Unit Charge Per Extension BASE FEE 414.50 13.00 4.5000 THOU BLDG 50,001-100,000 58.50 Permit . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date", 5/07/11 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 5/07/11 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 5/.07/11" 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 ---------------- 7----------------------------------------------------------- Special Notes and Comments POOL/SPA ONLY. ALARMS/BARRIERS SHALL BE LQPERMIT Application Number 10-00001214 Special Notes and Comments IN PLACE AT PRE -PLASTER INSPECTION. PERMIT DOES NOT INCLUDE TRELLIS, WALLS OR EQUIPMENT ENCLOSURE. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 3.00 Fee summary Charged Paid Credited Due Permit Fee Total 577.00 .00 .00 -577.00 Plan Check Total 333.45 .00 .00 333.45 Other Fee Total 3.00 .00 .00 3.00 Grand Total 913.45 .00 .00 913.45 g LQPERMIT Bin # Project Address: 5 —� A. P. Number. Ckyof -La Qdinta Btkcgng 8z Safety Division P.O. Box 1504, 78-495 Ca& Tampko La Quanta, CA 92253 - (760) 777-7012 Building Permit APPifcation and Tracking Sheet o $1`nce� Owmer's Naaw. �\ Address: City. ST, Zip: 2 I J r .,. al . • 1 11 �� ,> iJ>� ny f1C<.v....:i�>G.'`::.�: 00!�..�3�,. f;'\i^t'4t •>iN.�LFnCY� �l�. �i iu'>:Si^.�::::.�S:.i.•ii•(::�t. :k::'.a:`:\�j t 1 wl lil.. 1.. � .11 1 1 • 11 1 �I r1111- 1 111 1j M Plan Seb Structural Gala. T run ales. Title 24 Cales. Flood plain plan Grading plan Subcontactor Urt Grant Deed MO.A. Approval IN HOUSE:- Planning Approval Pub. Wks. Appr School Fees a Plan Check bi Revlevred, ready Called Contact Pbms picked Cap Plans resubmitt 2" Review, reap Called Contact Plans picked al Plans resubmit Review, real 1 Called Contact Date of permit ACKIIY Plan Seb Structural Gala. T run ales. Title 24 Cales. Flood plain plan Grading plan Subcontactor Urt Grant Deed MO.A. Approval IN HOUSE:- Planning Approval Pub. Wks. Appr School Fees a Plan Check bi Revlevred, ready Called Contact Pbms picked Cap Plans resubmitt 2" Review, reap Called Contact Plans picked al Plans resubmit Review, real 1 Called Contact Date of permit G PBRMIT FEES pitted item Aukoant for corrections Plan Check Deposit 'eon Plan Check Balance Construction Mechanical ly for correcuo"Anue Electrical Person Plumbing S.M.I. ed Gradlog y for correctionsiftne Developer Impact Fee Person A.LP.P. issue Total Permit Fees NORTH i OWL_ FIRE PIT El •1: O11I• ■ i �:.✓c—�lM�-:-ue!a.I�I:.!:i:��/I�►u. . if�'�yr -��!1.4� q�_��.�11i� r}••��i•c.r:�_ IY�..:. II�� �—��J„I�� ����,', '�� r:.n., III'i�l`� J -►Ililb' `.i\-\1� -1i T':. it�t� Lii.L!', �� • 4 19I0 • [IN - TF II r w REVISIONS Ems-• E� Q11N/10 Lrl GM REVISED PER CLIENTS w COMMENTS as Q 1!Mlo L-1 GM REVISED PER CLIENTS O COMMENTS H E- V w z x A SHEET # L_ 1 z a DATE: 09-1:7-10 w � Q w x LPOOLLAYOUT i n CITY Or LA QUINTA SUB —CONTRACTOR LIST JOB ADDRESS 55rO_5 (� r� gr'OF_ 3if-,eT PERMIT NUMBER OWNER 7Ev\�s4 Jew BUILDER This form shall be posted on the job 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 or Duiiaing permit. ror eacn appncaple traae, all inrormation requestea beiow must be completea by applicant. -L)n rue" is not an acceptable response -: Trade / Classification Contractor State Contractor's license rJtcrs Compensation Insurance City Business. iicehs.o Codipany Name - Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) e 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) CONCRETE IC-8) FRAMING IC-81 STRUCT. STEEL 107514,� C Skc((. s 2 51Y)l () i"Ao bl { `a;% o0 )i1'-1 Go 7/311 t1 MASONRY�.(C29) �.�.. LAKA- �4S C-Re, ie\`k652 513x(li .5e_c :, N-0- L-.Oz L((520 % 7. to 11 10\o'24.a -7f-3ii it PLUMBINGIC-3s) 6Y �=c. oa Loen`o'n C-3L 15�111I I r 1\ G-a"C�s'<iJt1 -1 6064ZLI.glo J\t�\\ 16-0001 5-31 lI NZ) C_ C-\0 1P06L(C-53) Oki 1 C-53 1 i�\9652 15bili1 I sec_13r,A N�i^ I LCook 2b on I \°ji3fii I lo L2-01111 JI