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08-1179 (RPL)It P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number " �—Property-Address: APN: Application description: Property Zoning: Application valuation: Applicant: 0006-01-1 08-00001179; -80185 RIVIERA 762 -130 -001- POOL 62 -130 -001 -POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 40000 Tay/ 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: NIA Owner: LUNDEEN RESIDENCE 80-185 RIVIERA LA QUINTA, CA 92253 Contractor: VACATION POOLS INC 83900 AVE 45 STE C INDIO, CA 92201 (760)775-0468 Lic. No.: 856835 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/10/08 RL 14:;313 CITY OF LA QUINTA FINANCE DEPT. ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm_ under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consant to self -insure for workers' compensation, 's provided License Class: 3 License No.: 856835 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: V Contractor:, _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier DELOS INS CO Policy Number 01DKRM22003430 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, I 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 manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become 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 370 of the Labor Code, I shat fort ith 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 civil penalty of not more than five hundred dollars ($500).: f Datelicant. 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 WARNING: FAILURE TO SECURE -WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR 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 improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, 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 projects with a contractor(s) 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 permit issued as a result of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 ISec. 3097, Civ. C.). Lender's Name: _ Lender's Address: I.QPERDIIT 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 thatI 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 building construction, and hereby authorize representatives of this couWylo nter upon the above-mentioned property for'nsurpos S.Mjoa2 Date:' Signature (Applicant or Agent): ''•�_/L/•ir(///� Application Number . . . . . 08-00001179 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee. 349.50 Plan Check Fee 227.18 Issue Date . . . . Valuation 40000 Expiration Date 1/06/09 Qty, Unit Charge Per Extension BASE FEE 252.00 15.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 97.50 Permit . . . MECH POOL Additional desc . Permit Fee. . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/06/09 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/.06/09 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 1/06/09 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, ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number . . . . . 08-00001179 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due --------------------------------------------------------- .Permit Fee Total 453.50 .00 ..00 453.50 Plan Check Total 253.18 .00 .00 253.18 Grand Total 706.68 .00 .00 706.68 LQPERMIT Bin # City of La Q uinta ' Building 8i' 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: Owner's Name: A P. Number: Address: T)l k d�)Dt/1/a, Legal Description:99 O 3 City, ST, Zip: L--� !tip a (A q —jam Contractor:VA 14T1 ON `�'� . • , ..:,,!!:,z.!,;: Address: Project Description: City, ST, Zip: Telephone(A0775 Dqb6, State Lic. # :$3,� IC53 ity Lic. #-- Arch., Engr., Designer: Address: 7 City, ST, Zip: An r Tele hone: .: :.:::.;;<<:>.:> p % 3 (p '<w;::;:;:;aw',-,!s,!:;. ` �rh<:��:: .<.,.:.::. •.•a;f:r•: •:. iYi} i:'.%:f,{if ii<;':4 tib$ r'.%f�//•.f:: `i:4i�2:i: State Lie. #: <=`:>>< :<<=>:>>;<:>: `:>s�f. �.:...l:!:::.::....:.;..:•..• .:...::.:::.. .• Construction Type: panty: Project type (circl420e one): New Add'n Alter Repair Demo r Name of Contact Person: Sq. Ft : # Ston #Units: Telephone # of Contact Person: Z Estimated Value of Project . APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACHING PERMIT FEES Plan Sets Plan Check submitted ID Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date or permit issue School Fees Total Permit Fees