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10-0391 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ' Application Number: T.0_0'0'00'0391 Property Address: <5 2,976 AVEN� ID`A OBREGON APN: 773-315-012-12 Application description: description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 20000 .BUILDING & SAFETY DEPARTMENT BUILDING;, PERMIT Owner: CRUZ ROBERTO 52980 AVENIDA OBREGON LA QUINTA, CA 92253 Coritractor: Applicant: Architect or Engineer:: m A,& R -COMPLETE POOL •SERVI 38405 RANCHO LOS COYOTES INDIO,.CA 92201 (760)272-7349. Lic.'NO.: 841981 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ` l'J Date: 5/04/10 MAY 0 6 2010 ------------------------------- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION . Ihereby affirm underpenalty of perjury that 1 am licensed and provisions of.Chapter 9 (commencing with,. I hereby affirm underpenalty of perjury one of the following declarations: ' 'Section.7000) of Division 3 of a Busine s'andProf -siona .Code,"and,myLicense:is in full force and effect. " _ "1 have and will maintain -a certificate of consent°to self -insure for workers' compensation, as provided license Class: C53 icense iZ:. 841981 - - - foFby Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate Contrac .. - - _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor ' .4:.. ; . -- Code,�for the. performance of the work for which this permivis issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: 1 hereby affirm under penalty of perjury that I arh exempt,from-the Contractor's State License Law for the Carrier E} 'MPT' '-.: _ Policy, Number EXEMPT following reason (Sec. 7031.5, Business and Professions Code:, Any city or county that requires a permit to �"'I certify that, in the performance of the work for which this permit is issued, l shall not employ any construct, alter, improve, demolish, or repair any structure, -prior to its issuance,,also requires the applicant for the person in any rimanner-sous to become subject to the workers' compensation laws of California, permit to file a signed statement thatheor she is licensed -pursuant to the provisions of the Contractor's State and agree that, if I, shouldbecome subject to the workers' compensation provisions of Section License Law (Chapter 9.(commencing with Section 7000) of Division,3 of the Business and Professions Code) or 3700 of. theL or Co s aII'forthwith comply with those 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 a civilpenalty of not more than five hundred dollars ($500).:- e: W '�-V A t: " (_) I, as owner of.the property,or my employees: with wages as,their sole compensation, will do the work, and the structure isnotintendedor offered for sale (Sec..7044, Business and Professions Code: The' -. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors'. State "License Law does not apply to an,owner ofproperty Who builds or improves thereon, SUBJECT>AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND and who does tfie.work himself or herself.through'his or her'own employees, provided that the ` - DOLLARS'($.100,000)• IN -ADDITION TO THE COST. OF'COMPENSATION, DAMAGES.ASPROVIDED FOR IN . improvements are -not intended or offeied for sale.If, however, the building or improvement.is sold within SECTION 3706 OF, THEIABOR CODE, INTEREST, AND ATTORNEY'S FEES. " one year of completion,',the'owner-builder will have the burden of proving that'he or she did not build or ' impr'ovelfor the purpose of sale.). APPLICANT ACKNOWLEDGEMENT' (_) 1, as owner.of the property, am exclusively contracting 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:- The 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, and,who'contracts for the projecti. with a contractors) licensed 1 . Each person upon whose behalf this application is made, each person "at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any peimit issued as a result of this application, I—) I am exempt under Sec. BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employeesforany act or omission related to the work being ' performed under or following issuance of this permit. Date: Owner: 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 ' CONSTRUCTION LENDING AGENCY permit to cancellation. - - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relatin o buildin onstruction, d hereby authorize representatives ter uponthe above -mentions property r inspection p poses. Lender's Name:Sign �Dafe.re (Applicant or Age Lender's Address: LQPERMIT Application Number . . . . . 10-00000391 Permit . . . ELEC POOL PERMIT -RES Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/31/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . BLDG POOL PERMIT .Additional desc . . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date 10/31/10 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2;001-25,000 162.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/31/10 Qty Unit Charge Per Extension BASE FEE 15.00 _ 1.00 6.0000 EA PLB FIXTURE 6.00 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 ONLY. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -------------------- Due --------------------------- Permit Fee Total ---------- 279.00 .00 .00 279.00 Plan Check Total 152.55 .00 .00 152.55 Other Fee Total 1.00 .00 .00 1.00 LQPERMIT Application Number . . . . . 10-00000391 Grand Total 432.55 .00 .00 432.55 LQPERMIT P/L WOOD FENCE-,, r-PIL WOOD FENCE ccvP C C) -n o> DO 0-0Z®, G) —n Opo z -31611 -60 --------------------`--13- F - C ROBERT&. LETTY CRUZ 52980 AVENIDA.O,BREGON HOUSE Di C C) -n o> DO 0-0Z®, G) —n Opo z co cn C Bin # , Qty of La Quinta Building Bt,Safet Division P.O. Box 1504, 78495"Calk Tampico La Quinta, CA`92253-.(760j 777-7012 Building Permit ApplidtionandTratking Sheet Permit # Project Address: 011q?o VeAjld.P, D61tC60AJ Owner's Na*. k6bera Ce A. P. Number: Address: 5� 9 �(O j4y' b,+-,eO J Legal Description: ip W_YIfiC. O IS City, ST, Zip: ( n,lp ga•.,.���.�;1.x.3 k<• ?Contractor: r:. i<r•Sa.A4�r;;.. Telephone: p- _7 106­44q-044- Project Description: Address: Address:t5v)c 3 City, ST, Zip: L . 04.l,i Yui 14 9aa 4 %POb I 0 itl �y I ' I D Telephone: T00-4-72,73 : ` }cr" n ::r. • <>. ':s..c::: y :. ssr 1 i'�/1Q! _ (tit V1Af AJ A- State Lic. # : W1 Owl city lie. #;. a '41 S Arch., Engr., Designer. Address: City., ST, Zip: Telephone:ys.�.yx`4r State Lic. # .r , 4,: v.. Win.<::..:::•rv;v�..i.Gur/ .. +.;9Y•r^ ;a 'Construction Type: NZ i,v Occupancy: ro ect a circle'one New . Add'n Alter Repair Demo Name of Contact Person: R O R LD e Z Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 1 0 _. of = 15!P Esiirimated Value of Project: 901 000 APPLICANT: DO, NOT,WRITE.BELOW THIS LINE N Submittal Re4'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural Cales. 'Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21" Review, ready fon 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:- ''a Review, ready for correctionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P,P, Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CITY OF LA QUINTA SUB -CONTRACTOR LIST J09 ADDRESS V l V DlU PERMIT NUMBER OWNER�CZ 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 worl 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 voidanc( of building permit. For each applicable trade, all information requested below.must be com leted by. applicant. "On file" is not an acceptable response: Trade / Classification ., ::- ConVactor� - .`::: =-:: ..:..... .:.. . ,....;,.:�...:.:....:.. frac or s Lket►se.. ��.> .::.:. ��::�:.;;. .....,.::..:::..:.::.:. Stat�:Con :.: .-:.:.�_< �:.WPtker�'.. -. Company Name Classification License Number Exp. Date. Carrier Name Policy Number. Exp. Date license Number Exp, Date (e.g. A, B, C-8) (xxxxxx) lxx/xxlxx) (e.g. State Fund, CalComp) lFormat Varies) lxx/xx/xx) (xxxx) lxxlicx/xx) \ EARTHWORK (C-121 .... 0 � � t�o�- L�'-� S�+Iq �-� is A///4 J/4//_5 - CONCRETE (C-8) -- I'U..I; .. CULAJ141E &VP 74ri7N3 IZ-3I-11 Smrz 655 3-7a /.-Z(o /I wa5�2(p.. 'FRAMING.:(C-51 STRUCT STEEL 1-151) , NO, I I•e qC ua1. 1-C, IP X743 I2-3141 STMZ- T.fsc tamJCA DSS:H3-7. ;LI - -rr /a�5a ro -3i-i o MASONRY (C•291 64— 'PLUMBING (C 3611,C17 :.... 4e CO rvt I �jt. �oo I s - 5, . y I -30 7).b -.31 -i LATH 'PLASTER {C.35) vkW&L4 &yU,nj(4'G - -DO cp -193 I12 -31 -II Si►9-�,. Tn]SLn.vr+-nJc,F- ` , d55L4.37e): DRYWALL IC -9) . HVAC ie=20i 6 ELECTRICAL (C=10) _ Z -J` �/ I ` - i 7-p -�o �%- NG- SHEET:METAL. (1=431... •: ELO :RING �C`�:T51.:....`:.:> - - : '�, a GLAZING IC h JNSULAT1001C-2) . - .: A. SEWAGE DISP (C-42)' PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C=27) ? 0�L/.PO0'L_(C-53) I UA-lzr, 1 &Iurvt+u7— 7)b(.P 3-19. 1-ala"II