06-0342 (RPL) IIIIIIIIVIIIIIIVIIIIIII 55
IE i4
P.O. BOX 1504 VOICE(760) 777-7012
78-495 CALLE TAMPICO FAX(760)777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760)777-7153
BUILDING PERMIT
Date: 1/23/06
Application Number: 06-00000342 Owner:
Property Address: 80843 CALLE AZUL MILLER
APN: 762-240-003-49 -300962- -8 ALLE AZUL
Application description: POOL - RESIDENTIAL D LA A, CA 92253
1 Property Zoning: MEDIUM DENSITY RES A
Application valuation: 20000 FEB q ye 006
1 Contra toy
Applicant: Architect or Engineer: �, 0�, LILY OOL CONSTRUCTION
BOX 283
/ ) LA QUINTA, CA 92247
(760)564-3655
!!! Lic. No. : 658996
-------- -- ------ ----- ---- --- - ---------------- -- ----- -- - - --- ----------=- ----- - - ----------------- -
LICENS D GO TORS DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I an
li red under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 70q0)of 9ivision 3 of the Business ro sionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License s: 3 License No.: 658996 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
D Contract I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor
n_ Code,for the performance of the work for which this rmit is issued. My workers'compensation
WNER-BUIL R DECLARATION insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am xempt from the Contractor's State License Law for the Carrier STATE FUND o icy Nu 1344032-2005
following reason(Sec.7031.5,Business and Prof sions Code: Any city or county that requires a permit to _ I certify that,in the performance o theles 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 toa 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 be abject 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 _ 700 of the Labor Code,I. 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).: Date: O Applicant✓
1_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 WARNIN : FAILURE TO SECURE WORKERS'C PENSATION 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 PENALTI S 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 CO 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
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.
Date: Owner: 2. Any permit issued as a result of this application as null and vo' if work is not commenced
within 180 days from date of issuance of suc per I,or cess n of work for 180 days will subject
CONSTRUCTION LENDING AGENCY - permit to cancellation. J '
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the ve rmation is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and ounty ordinances and state laws relating to b 'di ruction,and hereby authorize representatives
of thi c un to enter upon the above-mentioned pr r i 'ection purposes.
' Lender's Name:
D ' Signature(Applicant or Age
Lender's Address:
LQPERMIT
Application Number . . . . 06-00000342
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 207.00 Plan Check Fee 134.55
Issue Date . . . . Valuation . . . . 20000
Expiration Date 7/22/06 `
Qty Unit Charge Per Extension
BASE FEE 45.00
18.00 9.0000 THOU BLDG 2, 001-25, 000 162.00
----------------------------------------------------------------------------
Permit MECH POOL
Additional desc .
Permit Fee . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . 0
Expiration Date 7/22/06
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 . . 7/22/06
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 7/22/06
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 ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number . . . . . 06-00000342 t
------------------- ---------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE-PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 311.00 .00 .00 311.00
Plan Check Total 160.55 .00 .00 160.55
Grand Total 471.55 .00 .00 471.55
LQ PERMIT
Bin# City of La Quints
Bai1dmg at Safety DWon
Permit# P.O. Box 1504, 78-495 Calle Tampico
03 , b 1a QLdnta,CA 92253-(760) 777.7012
�` Binding Permit Application and Tracldng Sheet
Project Address: s Owner's Name: /I--'I 64-az
! , X f 1
A P.Number. ea e- Aza( Address: gn� 6 3 -C.�lz
Legal Description: City,ST,Zip: �Q CJS ZZ
v:..
Contractor: n" s Telephone:
Address: , 0, 5 o�.,�Z83 Project Description: Pad, Lvot
City,ST,zip: t�.
Telephone: 5-64——
State Lic.#: "City .#;
Arch.,Engr.,D:sipw.
Address:
City,ST,Zip:
Telephone: Construction Type: Occupancy:
State Lic.#: Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq.FL: #Stori #Units:
Telephone#of Contact Person: —� �,p Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
F 'd RWd TRACKING PERMIT FEES
Plan Check submitted f Item Amount
l(#les. Reviewed,ready for corrections Plan Cheek Deposit
es. Called Contact Person Plan Check Balance.
alcs. Ptana picked Cooatraetlou
in pin Plans resubmitted Mechanical
plan 2"Review,ready for corrections/issue Electrical
Sabcoutactor List Called Contact Person Plumbing
Grant Deed Plans picked up S.M.L
H.OA.Approval Plans resubmitted Grading
IN HOUSE.- ''i Review,ready for eormetionalissue Developer Impact Fee
Planning Approval Called Conine t Person A.LP.P.
Pub.Wks.A4Wr Date of permit Law
Schodl Fee:
Total Permit Fees
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