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06-0508 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t!t 4 4QurMrw Applicant: Architect or Engin'ee)r: LICENSED CONTRACTOR'S DECLARATION S 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: C53 License No.: 862797 ,.----Date: Cont ctor: 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 t?e or she is, Xempt 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).: ( _°j-+1, 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_,1, 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.). (_ I I am exempt under Sec. , B.&P.C, for this reason CONSTRUCTION LENDING AGENCY I hereby affirm unCer 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: w, Lender's Address: Y LQPERMIT ARTMENT 11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/01/06 Owner: DEMPSEY , MORK/PATTY 55051 RIVIERA LA QUINTA, CA 92253 Contractor: BAHAMA POOL COMPANY 15240 VIA MONTANA DESERT HOT SPRINGS, CA 92240 (760)329-9273 Lic. No.: 862797 ------------------ 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 EXEMPT Policy Number EXEMPT Dcenify 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 beco a subject to the workers' compensation provisions of Section 3700 of he Labor Code, I sh forthwith comply ith those provisions. WARNING: FAILURE TO SECURE WdRKER$' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000). 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 correct. I agree to comply with all city.and co y ordinances and state laws relating to buildin const ction, and hereby authorize representatives of this my to enter upon the above-mentioned propert or�in;ecb puy�ses. �6DWE Application Number: 06-00000508 ��j��6 Property Address: 55051 RIVIERA �y p APN: 775-153-018-F LA ®���� Application description: POOL - RESIDENTIAL f,P"ORIC���� Property Zoning: MEDIUM HIGH DENSITY RES FINS► Application valuation: 25000 Applicant: Architect or Engin'ee)r: LICENSED CONTRACTOR'S DECLARATION S 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: C53 License No.: 862797 ,.----Date: Cont ctor: 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 t?e or she is, Xempt 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).: ( _°j-+1, 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_,1, 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.). (_ I I am exempt under Sec. , B.&P.C, for this reason CONSTRUCTION LENDING AGENCY I hereby affirm unCer 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: w, Lender's Address: Y LQPERMIT ARTMENT 11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/01/06 Owner: DEMPSEY , MORK/PATTY 55051 RIVIERA LA QUINTA, CA 92253 Contractor: BAHAMA POOL COMPANY 15240 VIA MONTANA DESERT HOT SPRINGS, CA 92240 (760)329-9273 Lic. No.: 862797 ------------------ 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 EXEMPT Policy Number EXEMPT Dcenify 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 beco a subject to the workers' compensation provisions of Section 3700 of he Labor Code, I sh forthwith comply ith those provisions. WARNING: FAILURE TO SECURE WdRKER$' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000). 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 correct. I agree to comply with all city.and co y ordinances and state laws relating to buildin const ction, and hereby authorize representatives of this my to enter upon the above-mentioned propert or�in;ecb puy�ses. Application momber . . . . . 06-00000508 Permit . . . . . . BLDG POOL eEoMzr Additional deoo Permit Fee . . . . 252.00 eIao Check Fee . . 163.80 Issue Date . . . . Valuation . . . . 24740 Expiration Date . . 7/31/06 . Qty Unit Charge Per Extension BASE FEE. «s.00 23.00 ------------------------ 9.0000 raOo BLDG 2'001-25'000 --------------------------------------------------- 207.00 Permit . . . . . ' MECH POOL . Additional . deao Permit Fee . . . . 26.00 Plan Check Fee . . 6.50 Issue Date . . . . Valuation . . . . O Expiration Date . . 7/31/06 ' Qty Unit Charge Per � Extension BASE Foo ' 15'00 1.00 ------------------�-_------------------�--�--------------------------------- 11.0000 EA MECe FURNACE >100K 11.00 ' Permit . _ . . . . . ELoC POOL PERMIT -RES Additional deoc . . Permie Fee . . . .«5.VV Plan Check Fee . . 11.25 Issue Date . . . . Valuation . . . . O Expiration Date . . 7/31/06 _ ' Qty Unit Charge Per ' Extension aaaE FEE 15.00 ' 1.00 ------------------------_-------------------------_------------------------- 30.0000 EA oLoC Paz\Aro SWzMmzrw]'eOOL 30.00 ~/ Pezmit . . . . . . eLlnnazmG Additional deoo . . Permit Fee . . . . 27.00 Plan Cbeok.Fee . . 6.75 Issue Date . . . . Valuation . . . . O Expiration Date . . 7/31/06 Qty Unit Charge Per � Extension - BASE FEE 15.00 1.00 6.0000 oa gLo FIXTURE 6.00 1.00 3.0000 EA gLB WATER Im8z/xuLz/RoP 3.00 ' 1.00 -------------------------------------------------------------------'-------- 3.0000'EA gLo GAS PIPE I~4 OUTLETS 3.00 eezmdt . . . . . - WALL/FENCE eoaMIz LQPERMIT Application Number . . . . . 06-00000508 Permit WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 260 Expiration.Date 7/31/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL WITH HEATER. 12 L.F. 5' WALL, CITY STANDARD. GAS LINE STUB FOR FUTURE APPLIANCE. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. Fee summary Charged Paid ----------------- Credited Due ---------- ---------- Permit Fee Total 365.00 ---------- .00. ---------- .00 365..00 Plan Check Total 188.30 .00 .00 188.30 Grand Total 553.30 .00 .00 553.30 LQPERMIT Bin # cltybf U Quints - Building 81 Way Division P.O. Box 1504, 78-495 Calle Tampico Permit # J�0t La Quinta,- CA 9225-3 -,(760) 777-7012 -Building Permit Application -and Tracking. Sheet ,LojectAddress:''Sy6l Z ilj1 ner's Name DeF &e 4 o a - A. P. Number: ;Ow �ddress3 Legal Description: iPitY._STj-Zip- -44 Contractor A je�lephon�:. ;r7i e7c CD -Vcr:`i��fion: -vL,4 LA dllVe s- ,2 46 VIA N V / F17, �_Tzw V.0 &Aj;re 4A TZ) V 6 w SEM=, CTe 176 pA—on e. 2&0 E [State =C# T Arch.,-Engr., Designer: -z ZT4a Address: City, ST, Zip: Telephone: Con"struction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo �of(;6:7ntfact-Person:r mq� Sq. Ft.: # Stories: # Units: .Telephone-#To–f'CFnta—ctP,e7Eson: 7 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec!d TRACKING. PERMIT FEES Plan Sets Plali. Check submitted item Amount Structural Cales.Plan Reviewed, ready for• corrections Check Deposit'., Truss Ca1c;. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan -Plans resubmitted Mechanical Grading. plan 2"d R , eview" ready for corrections/issue Electrical Subcontactor List Called -Contact Person Plumbing Grant Deed Plani picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Inipaict Fee Planning Approval , Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees F_7 'total Permit Fees CITY OFLA GUINTA SUB -CONT. ACTOR LISA JOBADDRESS'PERMIT , �"UILDER NUMBER fb -,5- WNE I This form shall be- posted on the job with the Building Inspection .Card at all times in a conspicuous glace. Only' person ring 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 of building permit. For each applicable trade, .all information requested below must be completed by applicant, "On File" is not an acceptable response. Trade Classification. T / as rac o .: Cont t r ::::>::;.>.>':<;:r::<:>.:: :..::....::.:SiSt ate::Contractor.s. Lrcense .. .;.. . W..o�ke�s.C�m er�sation;Insu�ance:..:` :`..:.- City Business. License::.:: Company Name Classification License Number Exp. Date Carrier Name Policy Number. Exp. Date . License Number.' Exp. Date (e.g. A, B, C-8) (x]xxxxxxx) (xx/xx/xx) le.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx) EARTHWORK (C-12) :.: LJ� Ci — {o(T ! s� a �a3 CONCRETE (C-8) FRAMING 1C-5).::: $TRUCT: STEEL (G-51) 4Y _62 R3110 . MASONRY (C-29) PLUMBING (C-36) PLASTER (C-35) �, - t!oS a o2,r `t DRYWALL (C-9).:. HVAC. (C-20)'.::.<`..:`:. ELECTRICAL. (C-1 0) ; .• . J b (q // �1J✓?/ V �%�3yY U 7/22 RQOFING'iC=39) SHEET METAL(C43) ... ' FLOORING (0:15): GLAZING INSULA TION:(C-2) . t SEWAG15 DISP (C-42) , 33) PAINTING (C=7. CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C713) ` LANDSCAPING (C=27). Af` POOL IC -531 C_- '. PJ '' d. l aZ' �0 / d(r Q �$ �. 3 V wim