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04-4573 (RPL)79785 Amalfi Dr 04-4573 IIIIIII VIII III VIII IIII 53 ✓ IE -- a BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760)1777.;7.012 C of-.t 9 78=49'5°=CALLS TAMPICO FAX (760) 777-7011 LA=Q=UIN , A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 A 3 Ngh BUILDING PERMIT Appli-c.ationNumber . . . . . 04.-00004573 Date 5/25/04 Prope-rt'y-Add=ress . . . . . . 79785 AMALFI DR. APN: 6097590-036- - - Application description . -POOL - RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation 14.000 Owner. Contractor. PONDEROSA HOMES II, LLC CALIFORNIA POOLS & SPAS 400 S. FARRELL DRIVE, 8103. P.O. BOX 1280 .PALM:SPRINGS,. CA 92264 COACHELLA CA* 92236 LA QU.IN'I'A CA 922.53 (76.0)_ 398-922.2 WCC: STATE FUND: WC: 04.600061168. .0,1/01/05 CSLB..:. 656128 10./31/04 CCC:' C8 C2 7 C2 9 C53 -- — —— - — — — ———————— — - — — ————- — — — — — — -- --——— — — — — —— --- ----- ------.------ 's': Permit MECH POOL Additional desc Permit Fee 24.00 Plan. Check Fee 6.00 Issue Date ..Valuation' 0 Qty. iJnit Charge Per Extension BASE .FEE .15. 00 1.00 9.0000 EA .MECH FURNACE <=100K 9.00 Permit BLDG POOL.PERMIT Additional desc Permit Fee. 153.00. Plan Check Fee 99.45 Issue Date .`Valuation 14000 Qty Unit Charge Per Extension BASE FEE 45-.00 12.00 9: 0000 THOU - BLDG 2,001--25;000 108:00 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00. Plan Check Fee 11.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 TA* P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICOFAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 Application Number: e'3 !K— Applicant: Applicant's Mailing Address: . . BUILDING & SAFETY DEPARTMENT Architect or Architect or Lic. No.: Date: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 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 foroe and effect j License Class ' $3 License No. (DJ Date'V. Contractor ` OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury fiat 1 am exempt from the Contractors' State License Law for the following reason (Sea 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 Piofessions Co0e) or.that he or she is exempt therefrom and the basis for ft 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 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 (Sea 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-)uilder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). U 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sea 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 contractors) licensed pursuant to the Contractors' State License Law.). U 1 am exempt under Sec. . B.14 PA. for this reason Date Owner. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:. —1 have and will maintain a certificate of consent to self -insure for workers' compensaton, as provided for by Section 3700'of the Labor Code, for the perfornanoe of the work for which this permit is Issued. 1 have and will maintain workers' compensaton Insurance, as required by'Section 3700 of the Labor Code, for the performance of the work for which this permit is My rs compensation.insurance carrier and poliy n mber are: Cartier _4-f,Q P 4—r.c, , .rte Policy Number D 5 (oaaQ /—///, A _ I. 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 became subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shat j forthwith comply with those provisions. Date w 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 (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 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 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,foilowing 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 pernA or cessation of work for 180 dayswill subject permit to cancel 'on. 1 certify that 1 have read this application and state that the above inf on 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 county e I upon above -me ' for In _ spactlon purposes. Date Signature (Applicant or Agent): Application Number . . . . 04-00004573 Page 2 Date 5/25/04 Qty Unit Charge Per Extension 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 -------------------------------7-------------------------------------------- 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 Special Notes and Comments POOL ONLY. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited Due --------------------------- Permit Fee Total ---------- 255.00 -------------------- .00 .00 255.00 Plan Check Total 124.95 .00 .00 124.95 Grand Total 379.95 .00 .00 379.95