RPL (06-2226)61045 Living Stone Dr
06-2226
Property Zoning:
,...Application valuation:
06-00002226
61045, LIVING STONE DR
764-270-999-43 -300234-
POOL - RESIDENTIAL
.MEDIUM HIGH DENSITY RES
37000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
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 Licenseis in full force and effect.
License Class: C53 License No.: 518742
Date: Contractor:
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 ($5001.:
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 _) 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) 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:
Owner:
BOB WIEDENMANN
61-045 LIVING STONE DR.
LA QUINTA, CA 92253
Contractor:
AMERICAN POOL CONSTRU
P.O. BOX 11996
PALM DESERT,'CA 9225.5
(760)340-2588
Lic. No.: 518742
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: - 6/01/06
u
FNCJUL 07 200671D.
CITY OF LA QUINTA
-------------------------------------------------
WORKER'S
------------ ---
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 0001188-2005 -
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
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: . Applicant:
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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
i
APPLICANT ACKNOWLEDGEMENT
IMPORTANT - Application is hereby madeto 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 issuedas 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 hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Lender's Address:
7
I
Application Number . . . . 0.6-00002226
Permit BLDG POOL -PERMIT'
Additional desc
,
Permit.Fee" 330.00 Plan Check Fee
214.50
Issue Date Valuation"
37000 -
Expiration Date 11/28/06
•_ Qty Unit Charge Per
Extension
BASE FEE
:252.00
12.00 6.5000 THOU BLDG 25,001-50,000
-----------------------------------------------------------------------------
78.00
Permit , . . MECH POOL
Additional desc .
Permit Fee . . . 24:00 Plan Check Fee
6.00
Issue Date Valuation
0
Expiration Date 11/28/06
Qty Unit Charge Per
Extension
BASE FEE
15.00'
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 11/2.8/06
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 ." 11/28/06
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.',PERMIT DOES NOT INCLUDE
IT
-4
Application Number.
06-00002226
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Special Notes `and Comments
--
EQUIPMENT WALLS.
Fee summary Charged
-----------
Paid.
Credited.
Permit .Fee Total 432.00
Plan Check Total 240.00
---------__
00
---------- --
•00
Due
432.00
Grand Total 672.00
•00
00
00
240.00
.00
672.00
r