04-7473 (RPL)60267 Angora Ct
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t BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-70.12
Chat
OF9 78-495 CALLE TAMP.ICO FAX (760) 777=7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 .
BUILDING: PERMIT
Application Number 04-00007473 Date 11/24/04
Pr.opert.y,Addre.ss:... . . . . 1,60267 ANGORA CT
APN:76.4-270-999-122 -30023,3,-
Application.descr.iption.:. POOL --RESIDENTIAL
Property Zoning . . . . . . MEDIUM HIGH DENSITY RESl,
Application valuation.. 18000 ,
Owner Contractor`
------------------ - - - - -- - -- .--- - -- - -- - -----
-SHEA LA QUINTA CALIFORNIA POOLS & SPAS
C/O JEFF MCQUEEN P.O. BOX 1280
.-8800 - N GAINEY CENTER. 350. COP;CHELLA CA 92236
SCOTTSDALE. AZ 85258 (760) 398-922,2...
WCC:' STATE FUND...
WC,. 04600061168 01/01/05
CSLB.: 65.612$ . - 1.0/31/06
CCC: C8== -C29-053
Permit MECH POOL
Additional desc
Permit. Fee 24.00 Plan' Check Fee 6.00
Issue Date Valuation 0:
Qty Unit Charge Per Extension
BASE. FEE 15.00
1.00 9.0000 EA MECH FURNA CE.,<=100K 9'.00
Permit BLDG POOL PERMIT
Additional desc
Permit.Fee 189.00 Plan Check.Fe-e• 122.85
Issue.Date Valuation 18000
Qty Unit Charge Per Extension
BASE FEE 45,00
16.00. 9.0000 THOU BLDG 2,001-25,000 144.00.
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
1.00. '30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
Permit . . . PLUMBING
Additional desc
P.O. Box 1504
VOICE (760) 7.77-7012
79-495 CALLE TAMPiCO cu rAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
.BUILDING St: SAFETY DEPARTMENT
Application Number._ 4r/= . '2'el7 3 Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer
Architect or Engine s dr
I-ic. No.:
BUILDING PERMIT DECLARATIONS
I hereby aftimm under LICENSED CONTRACTOR'S DECLARATWN
penalty of pelf Oxy that i am licensed under provisions oft 0 (Commencing with Section 7000) of DMsion 3 of the Business and Prb(essWW*
Code, and my Lacers h to full tome and effect. /Z S
License Class License No.
Date Contractor 4�V
I hereby affirm under penalty of perjuxy that 1 am OWNER -BUILDER DECLARATION
emcermpt from the Contradors' State Lkense Law for the bAowkq reason (Sec. 7031.6. Business and Professbns Code: Any
city or county that requires a permit to constatd, alter, improve. demolish, Or repair any stnxtue, 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 C.ontreobrs' State License Lav (Chapter 9 (oommmermcing *0 Seddon 7000) of Division 3 of the Business
and Piofessiom Cole) 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 pemdt subjects
the applicant to a civil penalty of not mom than rive hundred dollars
U Las owner of tib property, or my employees with wages as their sole compensation, wli do the wok. and to structure Is not intended or offered for sate (Sec. 7044.
Business and Professions Code: Tib Coimtradors' Stab L.ker" Lave does not apply b an owner of property who builds or immprovat thereon, and who does the work
himself or herself or ttxarglm his or her own employees. provided that the kgmN mama ami not intended or offered for safe. If, however. the buidng or improvenmbnt k
sold whirl one year of Completion, the owner4Adsr will hm. the burden of proving that he or she did not build or improve for the purpose of sale.).
eiy
U I, as owner of the property, am WcWsivcontracting with licensed contractors to oonsbmrd time project (Sea 7044, Business and Professions Code: The Contractors! .
State License Law does not apply to an owner of properly who builds or Immprom thereon, and who
the Contractors' State License Law.). contracts for the projects with a oormtracta(s) ieensed puwant to
U I im exempt under See. _ 8.1E PSC. for this mason
Date Owner_
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:,
_ I have and.wii maintain a certificate of consent b setfarmsure for suckers' oompensetlon, as provided for by Section 3700 of the tabor Code. for to performance
of the work for Mich this permit Is issued..
1 have and wli maintain wakens' compensation Insurance, as requlmd by'Secdon 3700 of the Labor Code, for tit parfor mmama of the work ler whkh this permit Is
`<_=,efitY ' oamwensatlon.V%urame carrier and pd aro:
Carrier r . , �1 Policy Number - D=M � //le
_ I.certify that, in the pertommance of the wok for wNch this Permit Is hued, I shad not employ any Person In any manner so as to become subject to the workers'
cOff rfn amply w laws O C89 and agree that. V.1 should become subject b trs' he workeCompensation prwA* s of Section 3700 of the Labor Code. I shat
forim
Date Applies •,
WARNING: FAILURE TO SECURE WORKERS' COt4PENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (=100,000). UJ ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a eonstrucilon lending agency for the pedomance of the work for which this permit Is Issued (Sea 3097. Civ. C.).
Lenders Name
Lenders Address
IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT and Safetyfor aCKNOWL bOd to t NT
1. Each Person upon whose behalf this application is made. each Dem wbfue to the or wtmes and it work lisp set forth on this application.
Issued as a rosutt of this a Peen at whose request and for whose benefit wok le performed under or pursuant b any pe
ppicatiom, the owner, and the apptkant, e s lo, and shall. defend, Indemnify and hold hartNess the City of La Oulota. its
officers. agents and employees for any ad or omission related to the performed under or following issuance of eft pem L
2 Any permit issued as a result of this appicatlaw becomes nwi and not commeroed within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit b camalls loo.
ti t I av read this application and state that the above Wommation Is I b
by authorize ropresentafives of this county ter a tioneedd property
f and county odtnanoes and state laws relating to building
Y Purposes.
Date - / Signature (Appikant oe Agenq: --
Im
Page 2
Application Number .
. . . . 04-00007473
Date 11/24/04
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
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Permit . . . . . .
WALL/FENCE PERMIT
Additional desc
Permit Fee . . . .
15.00 Plan Check Fee
.00
Issue Date . . . .
Valuation
240
Qty Unit Charge
Per
Extension
BASE FEE
15.00
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Special Notes and Comments
------------------
POOL & SPA. 15 FL 4'
BLOCK WALL CITY
STND. ALARMS BARRIERS
SHALL BE IN PLACE
PRIOR TO PREPLASTER INSPECTION.
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
--------------------
306.00 .00 .00
----------
306.00
Plan Check Total
148.35 .00 .00
148.35
Grand Total
454.35 .00 .00
454.35
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