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04-6443 (RPL)BUILDING & SAFETY DEPARTMENT P0.:Box 1504 - 4 (760) 777-7012 78-495 CALLE TAMPICO• FAX (760) 7.77-7011 LA 'QUINT'k CALIFORNIA92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number X04-00006443 n 27/04 Property Address .-5-24-G-0—VE N7rA­JBR Q� APN: "' 773=255-006,- 6 .. - 000 - Application description' . �P.00LRESSIDENTI SEP 28 Property Zoning . . COVE RESIDENTIAL 2004Application.,valuation 23000 COFLAgU11dTA FOWgPNCIE Owner Contr_a.c-t.or DEFaT -------------------. ----- ------------------------ STROUD GUDELIA S FREELAND., TRIDON G. 52400 AVENIDA OBREGON ;` 4;8;869 PAtRADI,S-E- AVENU LA.QUINTAz CA 92253 MORONGO.VALLEY CA 92256 (76;0.).,,363-7400 WCC "' EXEMPT WC EXEMPT 09/30/05 CSLBin 837648 05/31/06 CCC: C53 Permit MECH POOL , Additional desc Permit. Fee 24.00 Plan Check Fee 6.00 Issue Date . . . Valuation . . . . 0 Qty Unit- Charge. Per Extension ` BASE FEE 15.00 1.00 9.'0'`000:. EA MECH FURNACE <=100.K 9.00 --------------------------------------- Permit - - - - - - - . - - BIDE, -- ------------------------------ POOL ;PERMIT Additional desc J Permit Fee 234-.00 Plan Check Fee 152.10 Issue Date !' Valuation'. . . . . 23000 Qty '`' Unit Charge° Per- . Extension BASE, FEE 45.00 21.00 9.000.0* THOU - BLDG-,�2 /, 01=25, 000 189.00 Permit . . . ELEC POOL :PERMIT, -RES. Additional desc Permit Fee 4.5;100 P.lan•.Check Fee 11.25 Issue Date . . . Valuation 0 Qty Unit ¢•Per Extension .Charge- BASE FEE 15.00 1:00 30.0000 EA ELEG''•PRIVATE SWI-MMfiNG`POOL 30.00 P.O. Box 1504 78-495 CALLS TaMPICO fl VOICE (760) 777 FAX (7621.) 777-701101= La QuINTa, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: t9 —& V 3 I Date: Applicant: Applicant's Mailing Address:i, Architect or Engineer: Architect or Engineer's Ad r Lic. No.: BUILDING PERMIT DECLARATIONS 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. cT License Class License No. 7� �3% C0 L1 9 Date _ 7— ! Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. . B.& P.C. for this reason Date Owner. WORKERS' 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 Policy Number 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, I shall forthwith comply with those provisions. Applicant 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. 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 IMPORTANT Application is hereby made to the Director of Buildingand Safety o ACKNOWLEDGEMENT 1. Each permit subject to the conditions and restrictions set forth on this application. 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, indemnity 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to buftding construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date�� . 7— Signature (Applicant or Agent): f , \ F Page 2 Application Number 04-00.0&6.443- Date 9/27/04 Permit PLUMBING Additional desc Permit Fee 33. 00 Plan' .Check Fee 8.2.5 Issue Date . . . Valuation' 0 Qty Unit Charge. Per Extension BASE. FEE 15.00 2..00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0.000 EA PLB WATER INST/A, REP 3.00 1.00 3.00.00 EA PLB GAS'`Pi:PE 1=4.OUTLETS 3.00 ' Special Notes, -aftdL Comments: POOL '& .SPA. ALARMS BARRIERS -'SHALL BE IN-PLACE PRIOR TO PREPLASTER INS'PECTI,ON. EQUIPMENT ENCL•OSURE,NOT INCLUDED IN PERMIT. Fee summary Charged. Paid Credited Due Permit Fee Total 336'.00 .00 .00• 336.00 Plan Check Total 177._6.0. .00 .00 177.60 Grand Total 513'.60.,:._. .00 .00 513.60 IOB ADDRES -n this job. Any changes to this list must be approved by the f4...:1A. .. c-- - -1-1:--LI- - -J--1. - _ r IIT NUMBER OWNER la J01, BUILDER_I lr on Card at all times in a conspicuous Rlace. Only persons appearing on this list or their employeesare authorized to work Building Division prior to commencement of work. Fai t com I, will reVlt in ' stoppage of'7work and/or the voidance • ion. requested De ow Must 136 Complete. _ y,applicant. ;"On: File" is not an -accetable res onse, Trade / Classification. Contractor:, State. Contractor's License yl�iforkeU a ation Insurance. -`' City Business License Company Name Classification. License Number Exp. Date Carrier Name Policy Number . Exp: Date License Number Exp. Date le.g. A. B, C-81 (xxxxxx) Ixxlxx/xxl (e.g. State Fund, CalComp) (Forman Varies) (xx/xx/xx) (xxxx) (xxlxxlxx) EARTHWORK IC-12!3� 2 CONCRETE (C-$).3 C»C O' E i.IL G X5 % US T 64 o 0 10 ( 1 I. l (� r2f3f.3� ' c' STRU.CT STEEL (C-54, MASONRY I6-29) ..; - :. PLUMBING (C-3�6) o14C , 1 rl8-BL16(o-260 ' !i3 o,4 44*? I o3�o2�hS LATH,XPLASTER (C-36) : — =s DRYWALL 1C=8) IU} HVAC�!0-201. N ELECTRICAL. (C-1 0)) g,:_ -5. a143�1 12 . �3c; os 12 _; 110 -BLl0b-W-05 1�,3�04 . CA4u731 ROOFMa IC -391 N /a _ SHEETI�METAL (C-43) FLOORING (C-15).Anj •, GLAZING IC -17) N jq' INSULATION i.0„21f�- SEWAGE DISP. (C-42) 'NIA ” — PAINTING 10-331 N A CERAMIC TILE (C-54) N�A CABINETS IC -6) IvIA FENCING IC -13) IBJ A 4 LANDSCAPING (C-271 �/jC� 44 POOL IC -&31 G1D ..` 'Z5 `10-i 5 .ern pT LEC _ .. RESIDENCE Guadilia Placencia 52400 Avenida Obregon L.Q. CITY OF LA C UINTA A RE -INSPECTION FEE OF $30 BUILDING & SAFETY DEPT. APPROVEDWILL BE CHARGED IF THE 38'9 A Rn\/I r) PLANS AND JOB CARD ARE NOT ON FOR ,O#FROCTION —7 PLANS THE SITE FOR A SCHEDULED DATE _ INSPECTION. NO EXCEPTIONS! TRIDON POOL AND SPA CONSTRUCTION 48869 PARADISE AVE. MORONGO VLY. CA. 92256 1 Lie. # 837648 POOL 14 X 27 PERIMETER 72 J AREA 300 Sq. SPA 6X7 PERIMETER 22 AREA 35 Sq. r s PUMP, 1.5 HP FILTER 320 Sq. HEATER 400 BTU GROUP 1 PEBBLE TEC DECK 560 Sq. WITH CANTILEVER EDGE GROUP 3 WATER LINE TILE 4 JETS IN SPA 1 FULL SIZE LIGHT IN POOL 1 SPA BRITS LIGHT IN SPA SALT SYSTEM DESIGNATED VAC LINE IN POOL. GAS LINE NOT INCLUDED IN PRICE.