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06-4334 (RPL)t.. �. I IIIIIII VIII III VIII IIII 4 31 P.O. BOX 1504 IE 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 06-00004334 60920 AZUL CT 764-270-999-82 -300234- POOL - RESIDENTIAL MEDIUM HIGH DENSITY RES 18000 Architect or Engineer: J 111,e1 ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT 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: C12 C53 ense No.: 7466 Date: % 0� Contra tor: 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 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).: (_ 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 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 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason 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 (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: PAUL BUSTRUM 60-920 AZUL CT. LA QUINTA, CA 922 (760)702-3298 Contractor: NEUBURGER EQPMNT P.O. BOX 623 LA QUINTA, CA 922 (760)275-5740 Lic. No.: 746662 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/20/06 ----------------------------------------------- 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 STATE FUND Policy Number 1576693-2006 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 become subject to the workers' compensation provisions of Section X370000 of the Labor Cod hall f5ghw44.Gqmply with those pr s ns. Date: �L/ %Id��Pppli anY 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 15100,0001. 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 county ordinances and state laws relating to building construction, and �authorizereprof this county to enterrupon the above-mentioned property for inspectionpurp Date: 2 S°gnature (Applicant or Agent): Application Number . . . . . 06-00004334 Permit . . BLDG POOL PERMIT \ Additional desc.. Permit Fee . . . . 189.00 Plan Check Fee 122:85 Issue Date . . . . Valuation . . . . 18000 Expiration Date 6/1.8/07 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date.. 6/18/07 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 6/18/07 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 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 6/18/07 - J 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 LQPERMIT Application Number 06-00004334 _ - ------------------------------------------------------7--------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 293.00 .00 -------------------- .00 293.00 Plan Check Total 148.85 .00 .00 148.85 Grand Total 441.85 .00 .00 441.85 LQPERMIT Bin # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, cA 92253 - (760) 777-7012 Building Permit. Application and Tracking Sheet Pe it # ���/� ' "1 Project Address: 60 - 7QO Owner's Name: � .(, � g 7!� Address: lO - '72 v Az, C f A. P. Number: Legal Description. Contractor: e&- r /test ort.5 City, ST, Zip: -elk)yr ?!22-S3 Telephone; 744 Address: /1,,o. 6 2- 3 Project Description: City; ST, Zip: kin 4222S-3 Telephone: 6 d Do " 7 g State Lic. # : % 2 ?City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: D2CIP Construction Type: •��� SS Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:. # Stories:#Units: Telephone # of Contact Person: ((71-4 573 � Estimated Value of Project.�g' 00 a APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd :. Rec'd TRACMG . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates.Reviewed, ready fe 1t rections Plan Check Deposit. Truss Calcs. Called ContactPersou J Plan Cheek Balance Energy Cities. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading,plan 2' Review, ready for corrcetions/issue Electrical Subcoutactor 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. correctionstissue Developer Impact Fee Planning Approval Called Contact Person p I,p,p, Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees dQ � � 1 I I �kVM3AIa0 (3) I Noiiona1SNOO FJOJ I a3nOHd b5 S I -11 b1N I novTy 10 / I I ,,8 �/ C 031VOol3a 'd"1 £Z -d 38 01 VM Aldoad (3) V11sva (3) IIa3LX.L , 1N3NIdln03 VdS V l00 � '3'l 98-d I g5CLE-V / Lei,OIX,Z£ I I iSN011d33X3 ON � !'—_ ® low I NOU33dI 133a1S 01 3Nn NIVNG .£ 031nORDS b 803 hiS NO lON 38d OW 80f ONV S Id 03AOdddV 3H1310308VHO 38 IIM I 0£$ 30 33J NOIlO3dSNI- d b S Als I 133a1S 01 3Nn NIV8G .£ / "M9 S dls ',d9 S nis I / 96ZE-ZOL (09L) ,d!) S nes I 'dD `V-LNino v-1 ',vs s -dyS 'lo inzv OZ6-09 / 30N30IS3a Ntnd 4N9931 wnjisne -inbd IINn 0/V 9NlLSIX Fes__ I I a3A00 OLIVd I I I----- –=---- ---------------- --J M I N a3Ane AG 83AO ouvd 03SOdoa sHL9n 3A33 -IS Vll3a8Nln Sd31S L ,. It 83Ane Ae NOL10313S 0NId00 .SL JNId00 V Sllldd &) HLIM'n rw3e ON08 03SIVN .8L+-, S83MOlj IVnNNV HLIM V38V a31NVld 03SIV8 .ZL+.