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06-0177 (RPL) IIIIIIIIIIIIIIIIIIIIIIIII 19 P.O. BOX 1504 — IE 4 � 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: 1/12/06 Application Number: 06-00000177 Owner: Property Address: 80777 CALLE AZUL CANE APN: 762-240-003-38 -300962- 80-777 CALLE AZUL Application description: POOL - RESIDENTIAL D a LA QUINTA, CA 92253 Property Zoning: MEDIUM DENSITY RES Application valuation: 20000 JAN 27 2006 Contractor: Applicant: Architect or ngi CITY OF LA QUINTA FAMILY POOL CONSTRUCTION FINANCE DEPT. P O BOX 283 (� LA QUINTA, CA 92247 (760)564-3655 . : Lic. No. : 658996 ---- ------------------------- ------------- -- ------ - --------- ------ --------------- ---------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)of Division 3 of the Business a Professionals Code,and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self-insure for workers'compensation,as provided license CI s: C53 License No.: 658996 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is ! issued. ate. Contractor K 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 WNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm undei penalty of perjury hat I a exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1344032-2005 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the performance of the work 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 t become 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 sho u fact 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 3700 of the Labor Co hall forthwith 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).: acE7 te( Q`,I Applicant: (_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 WARNING: FAILURE TO SECURPKERS'IOMPENSATION 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 CES 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 ADDST 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, I—) 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 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 CONSTRUCTION LENDING AGENCY permit to cancellation. 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 abov is correct. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city and co my ordinances and state laws relating t in c struction,and hereby authorize representatives of this co y't_In ner upon the above-mentioned pr n spection purposes. Lender's Name: �/f ,, Date:? Signature(Applicant or Agent): Lender's Address: LQPERMIT �e Application Number . . . . . 06-00000177 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date 7/11/06 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 7/11/06 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 7/11/06 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 7/11/06 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 . . . . . 06-00000177 rr ---------------------------------------------------------------------------- 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 LQPERMIT T Bin# City of La Quints Bud/ding ar Safety DMIon Pennk# P.O. Box 1504, 78-495 Calfe Tampico OC !a Quints,CA 92253-(760) 777-7012 Building Permit Application and Tracking Sheet Project Address: �© L Owner's Name: A P.Number. Address: Legal Description: City,ST,Zip: U Contractor: �j Telephone: Address: ® Project Description: V 0 1 ,j' �- Ctty,ST,Zip: ( ZSr Telephone: (p State Lie.#: City #z Arch.,Engr.,Designer. 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.Ft: #Stori' : T7Units: Telephone#of Contact Person: Estimated Value of Project: 4000 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec'•d TRACING PERMIT FEES Pita Sets Plan Check submitted Z Item Amount ' Structural(files. Reviewed,ready for corrections Plan Check Deposit Truss Calm Called Contact Person Plan Check Balance. Title 24 Calcs. Pians picked up Construction Flood plain plus Plans resubmitted Mechanical Grading plan 2-!Review,ready for correctionVissue Electrical Subeoatactor List Called Contact Person Plumbing Grant Dad Plans picked up S.M.L H.O.A.Approval Plana resubmitted Grading INHOUSE-- ka Review,ready for correction/issue Developer Impact Fee Planing Approval Called Contact Person I A.I.P.P. Pob.Wks.Appr Date of permit issue School Fees Total Permit Fees S'010atWdl CITY OF LA QUINTA �'erwdr I 3,G,�o I �'eiwdr BUILDING & SAFETY DEPT. r8' APPROVED 00 FOR CONSTRUCTION 4' o ��i G'1N0 DATE I 0(O BY l c YY' 1`y I �i GftN� ��5/D�NG� 80777 GAL-Lf lizuL PU,ETtt AZUL 1� 1/ LOI'I"lI� i Construction P00% S pas roud oins C7�0>5�4-3G5� Lic, #6!58996