06-1574 (SOTB) Lion's Gate Entry Fountain Mai 05 06 08: 43a FRANK GRESIK 7605648276 p. 1
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78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760)777-7153
BUILDING PERMIT
Date: 6/05/06
Application Number: 06-00001574 Owner:
Property Address: 80844 AVENUE 58 LIONS GATE HOA
APN: 762-250-027- - - 68-950 ADELINA ROAD a
Application description: STRUCTURES OTHER THAN BUILDINGS CATHEDRAL CITY, CA 9' 4 p
Property Zoning: LOW DENSITY RESIDENTIAL (325)000-9500
Application valuation: 10000 D 05
.: JUN J
Contractor:
Applicant: Architect or Engineer: A & R COMPLETE POOL S RV of�A(
P.O. BOX 103 C�TY of
aEPT.
EPT,
LA QUINTA, CA 92247
(760)772-0752
Lic. No. : 841981
-- - - ---------------------- - --------------------------------- ---- - -------- --------------- ------- --
LICENSED CONTRA OR'S D RATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury th t I am licens d and provisi of Chapter 9�(commencing I hereby affirm under penalty of perjury oneof the following declarations:
Section 7000)ofDivision 3 of .e Busin a d Profe ionals de,an my License is i _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License CI s: C53 Lic No. 841981 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
//�� issued.
Date: '� V Contra or: _ 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
OWNER-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0050251
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 hich this ermit 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%tbecorn subjeo o the kers'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 shoule su lect to a wor s'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 or Code fort ith co ly wit 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 � Applican
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 WARNING: FAILURE TO SECURE WORKERS'COMPENSATION 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 PENALTIES 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 COST 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,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 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 thUnn
rmation is correct. kagreecomply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relatingtoction,and reb atatives
of this c unty o enter upon the above-mentioned prn purp es.Lender's Name: -
Dat' Signature(Applicant or Agent):
Lender's Address:
LQPERMIT .
Application Number . . . 06-00001574
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 117.00 Plan Check Fee 76.05
Issue Date . . . . Valuation 10000
Expiration Date 12/02/06
Qty Unit Charge Per Extension
Rte. ' BASE FEE 45.00
8.00 9.0000 THOU BLDG 2, 001-25, 000 72 .00
---------------------------- ------------------------------------------------
Permit . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 16.50 Plan Check Fee 4.13
Issue Date . . . Valuation 0
Expiration Date 12/02/06
Qty Unit Charge Per Extension
BASE FEE 15.00
2 .00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 1.50
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Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 21.00 Plan Check Fee 5.25
Issue Date . . . . Valuation 0
Expiration Date 12/02/06
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.0000 EA PLB FIXTURE 6.00
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Special Notes and Comments
REMOVE & REINSTALL EXISTING ENTRY GATES
TO INSTALL NEW WATER FEATURE.
INVESTIGATION FEE ASSESSED PER 1997
UNIFORM ADMINISTRATIVE CODE $304.5 FOR
WORK BEGUN WITHOUT BUILDING PERMIT.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 154.50 .00 .00 154.50
Plan Check Total 85.43 .00 .00 85.43
Grand Total 239.93 .00 .00 239.93
LQPERMIT