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RPL (05-2571)60655 Living Stone Dr 05-2571 Date: 6/24/05 C Application Number:OS-00002571 Owner: Property Address: 60655 LIVING STONE DR SHEA LA QUINTA APN: 764-270-999-10 -300234- C/O JEFF MCQUEEN Application description: POOL - RESIDENTIAL 8800 N GAINEY CENTER 350 Property Zoning: ' MEDIUM HIGH DENSITY RES *• SCOTTSDALE,. AZ 85258 .Application valuation: 6000 Contractor: nRP►c Applicant: Architect or Engineer: CALIFORNIA POOLS & SPAS E.CF-CO)EPT 0 }� WCC: SEABRIGHT INS m WC: BB1050510 01/01/0 CIT AQUI rA CSLB: 656128 10/31/0. ©N i� c iO/e ./V. /A -- + -----------------------------------=----------.-------------------------------------- ------------- LICENSE CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - hereby affirm under penalty of perjury that-) am lic sed un er provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 70001 of 'si the Busin s and Prof ion Code, a d -my i is 'r;Mrce and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Cla s: Lice o.: �( (�1S for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: D Contractor: - 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 1 OWNER -BUILDER DECLARATION. - insurance carrier and policy number are: � , „, m / /&46 (i% w I hereby affirm under penalty of perjury that I am exempt from the Contractor's StateLicense Law for the Carrier C8 C27 C29 C53' Policy Number b�7 ! 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 th 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 to bec a sub ct 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' shou ecome ub t the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 0 of the Labor Co shall forhwit omply 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).: SApplicant•- 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 W KERS' COMPEN ON 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 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 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 Ouinta, 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 above informa rrect. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to build' constructio reby authorize representatives of this coun y t enter upon the above-mentioned grope . f inspe io os Lender's Name: Date: /� Signature (Applicant or Agent)' - Lender's Address: ' LQPERA11T Application Number . . . . . 05-00002571 Permit . . . . . BLDG POOL PERMIT Additional desc . Permit Fee 81.00 Plan Check Fee •52.65 Issue.Date. . . . . Valuation . . . . 6000 Expiration Date 12/21/05 Qty. Unit Charge Per. Extension BASE FEE 45.00 4.00, 9.0000. ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 36.00 Permit . . . MECH POOL Additional. desc . Permit Fee . . 24.00 Plan Check Fee 6.00 Issue Date . . . Valuation 0 Expiration Date 12/21/05 Qty Unit Charge Per Extension ` BASE FEE 15.00 1.00 9.0000 ---------------------------------------------------------------------------- EA MECH FURNACE <=100K 9.00 Permit . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 12/21/05 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 . . . . 27.00 Plan .Check Fee— 6.75 Issue Date Valuation . . . . 0 Expiration Date 12/21/05 -Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 SPA ONLY. GFI &.GAS STUB FOR -FUTURE LQPERMIT - Application Number 05-00002571 ----------------------------------------------------------------------------- Special Notes and Comments APPLIANCES.ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 177.:00 .00 .00 177.00 Plan Check Total 76.65 .00 00 76.65 Grand Total 253.65 .00 .00 253.65' LQPEnIfT 1 1. �•-Tlt 1 , I I I j i 1 w I I t SII