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04-6146 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777=7011 INSPECTION REQUESTS (760) 777-7153 Application Number 0.4-0000.6.146 DDate 9:/0-2-/04 Property Address 49,500 ALI CT APN:. 649-630-070- - - Application description POOL - RESIDENTIAL SEP Q 7 004 Property Zoning . . . . . . . LOW DENSITY RESIDENT AL CITY Application valuation 16000 FI�Ab E EUI�TA T. Owner Contractor -- - - - -- - - - - - - - - - - - - - - - - -- -------------7---------- PM RENAISSANCE, LLC CALIFORNIA POOLS & SPAS 9968 HIBERT STREET, STE. 102 P.O. BOX 1280 SAN DIEGO CA 92131 COACHELLA CA 92236 (760) 398-9222 WCC: STATE FUND WC: 04600061168 01/0.1/05 CSLB: 656128 10/31/04 CCC: C8 -C27 -C29-053 ------------ --------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee 171.00 Plan Check Fee 111.15 Issue Date . . . . Valuation . . . . 16000 Qty Unit. -Charge Per Extension BASE 'FEE 45.00 14..00 9.0000 THOU BLDG 2,001-25,000 126.00 --------------.=-------I------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc Permit.Fee24.00 Plan Check Fee 6.00 Issue Date . . . Valuation . . . . 0 Qty Unit -Charge Per- Extension BASE FEE 15.00 1.00 9.0000.EA MECH FURNACE .<=100K 9.00 ----------------------------------------------=----------------------------- Permit . . . . . . ELEC-POOL PERMIT -RES Additional desc . Permit Fee' . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per 1.00 - 30.0000 EA Extension BASE FEE 15.00 ELEC PRIVATE SWIMMING POOL .30.00 08 IE Extension BASE FEE 15.00 ELEC PRIVATE SWIMMING POOL .30.00 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: t3UILUING PERMIT DECLARATIONS C SED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under - rovisi ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Lic se's' fW force and effect. License Class ice a No. J Date / Contractor OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from 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. , BA P.C. for this reason Date : Owner WORKERS' COMPENSATION DECLARATION 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 hav and will main i workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance. of the work for which this permit is i4we y coo 'ens' compensation insurance carrier oli u b a�ej Cartier 5�K lz� Policy Number _ 1 certify that, in the performance of the work for which this rmit i issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree that, i I s uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those pro si ns. Date / " ( Applicant WARNING: FAILURE TO SECURE WORK S. 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 Lenders Address ENT IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT and Safety foraCKNOWLEDGEo the y 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 agr- s to, d shall, defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the workrbeing perfoned 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. j I certify that I have read this application and state that the above i ation is co I agreep comply with all city and county ordinances and state laws relating to building construction an hereby authorize representatives of this cou to ter upo th abov me Ironed property for inspection purposes. Date Signature (Applicant or Agent)/ , Page 2 Application Number ... . . . 04-00006146 Date 9/02/04 ---------------------------------------------------------------------------- Permit . . . ... PLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 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. ALARMS/BARRIERS SHALL BE IN + PLACE AT"PRE-PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged ------=----------- Paid Credited Due -------------------- Permit Fee Total 273.00 ---------- .00 .00 ---------- 273.00 Plan Check Total 136.65 .00 .00 136.65 Grand Total 409.65 .00 .00 409.65 Bin. # Otj/ Of * La Quints Bulldog 8r Safety Division Permit # P.O..Box 1504,•78-495 Calle Tamplco 1.a.Quinta, CA 92253 -:(760) 777-7012 Building Permit -Application and. Tracking Sheet Project Address: SO dCAI)12 Owner's Name:.'1/�G. A, P. Number. Address: 5QX J Q 66 1?. Legal Description: City, ST, Zip: Contractor. 566n A4,WV.kk Telephone: Q SO Address: Project Description: City, ST, Zip. I/J Telephone:DELL, State LIe. #: City Lia C- Arch., Bngr., Designer- esignerAddress: Address: City,, ST, Zip: Telephone: Construction Type:. Occupancy: State Lie. #: Project type (circle one): New Add'n. Alter Repair Demo Name of Contact Person: Sq. FL: # Stories: # Unit$: Telephonc # of Contact Person: Estimated Value of Project. APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd RtedTRACICYIVG PER?drrFEES- Plan Sets Plan Check submitted Item Amount Structural Calca. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance _ Tithe 24 Calcs. Pians picked up Construction Flood plain plan Pians resubmitted Mecharilcal Grading plan 2`! Review, ready for corrections(kssue Electrical - - — Subcontaetor List Called Contact Person Plumbing 3 °' o 00 Grant Deed Plans picked up S.M.I.Z • w _ n ^ n h C G 1� h Cr H.O.A. Approval Plans resubmittedGrading Q Q a Q U CC® Ik HOUSE;- ''• Review; ready for eorrecdonsAssae Developer 1i oo = _ Planning Approval. Called Contact Person Ad.P.P. LL W F Y Z w w J Pub. Wks. Appr Date of permit issue 2z LL School Fees 0 o l - =O W U O�w J U) m Total Perm v O� ULn H CMLYe11 XW CD -J OUFa- ato Z v7 ao a 0