RPL (04-3614)49410 Loren Ct
04-3614
. 2 f G ifUGt/
OF eO p $UILDING & SAFETY DEPARTMENT-
- ..
Ox 1.504 (760) 777-7012
OF78-495 CALLE TAMPICO FAX (760) 777-7011
LA .QUINTA. CALIFORN.IA 92253 INSPECTION REQUESTS (760)..777-7153
BUILDING PERMIT
-Application Number0.4-000034-61
f Date
4/21/04
Property Address . . .
4-9410TLOREN CT
•APN:
-649-6307014-36 -29053 -
Application description..
POOL -.RESIDENTIAL
.Property.Zoning..
LOW DENSITY RESIDENTIAL
Application valuation..*
1.7000
Owner.
Contractor
-------------
LA QUINTA JEFFERSON FIFTY
CALIFORNIA POOLS.&.SPAS
.7315`5.FIDDLENECK
P.O. BOX 1280
:PALM .DESERT. Ck 92260..
.. COACHELLACA
922.36
(760) :398-9222.:'. .
-
.WCC: STATE. FUND
:.
WC:. 04600061168
01:/01/05
CSLB.:. 656128.`.
10/31/.04
CCC:... '.C8-C27-C297C53
.:
Permit BLDG
POOL PERMIT
Additional desc'. .
Permit Fee. • . . . 180.00
Plan Check Fee
117.00
Issue_ Date
-Valuation
17000
Qty -Unit Charge Per
Extension
'BASE FEE
45:00
15.00 9.000'0 THOU
BLDG 2,00.1-25;.000
135.00
Permit MECH
POOL;':
Additional desc
Permit Fee ..
24.00 Plan Check Fee
Issue Date . . . .
Valuation- ... .
0
Qty. Unit Charge`•Per
EXtensi.on
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
f Issue Date
Valuation
0
Qty Unit Charge. Per
Extension
BASE FEE
15.00
.1.00 30.0000 EA
ELEC PRIVATE. SWIMMING POOL
30.00
P.O. BoX 1504 e ', %
78-495 CALLS TAMPICO i c VOICE (760) 777-7012
11
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Date:
Architect or Engineer.
Architect or Engineer's Address:
Lic. No..
BUILDING PERMIT DECLARATIONS
1 hereby affirm CONTRACTOR'S DECLARATION
m under
Pity of perjury that I am ioensed under provisions of Chapter 9 oamrencig with Sec6ai TOW) of Division 3 of the Business and ftlescionels
Code. and my License isinf i oa and effdct /
/ Oerrae Class _ L -) j / No. co 2
I hereby ofrrmt under OWNW-BUILDER DECLARATION
penalty or perjury tmt 1 am exempt Irom to Corwacbis' Stab License Law for the lollowiry reason (Sec. 7031.5. Business and Probssiorrc Code: Any
citY or wA*Y Int M- *m= a perm* b ==butt, shier. improve. demoisf>, or repair any sbuctrae. Prior b Its ksuanoe. also roqures Ire apprrCant for the permit b tie a signed
stabrw that he or the Is ioensed pursuant b tie provkions of tie Contractors• Syle Uoense law POPIOr 9 (Corrrnencing with Section 7000) of Division 3 of the Business
In sib ) or riot he or she k exempt wg6om and the basis for we staged Any violation of Section 7031.5 by any apple= t for a permit subjects
"apU I. pl owner Old* Y of not more than Eve hundred dotars %500 i
property. or mY e: The s with wages as ries sole oomPensatian. VA do toe work, and the <bucoxe k not intended or offered for sob (Sec 7044,
Business and Professions Code The Cantrsaots• Sate License Law does not appy b an owner of property who builds or improves thereon, and who does the work
hirnuff of herself or trough his or her own empbyees• pavided tot the i Vrcvemerks are not intended or aft for sale. It. however. the buidrg or improvement is
Mid Within One Year Of Completion, the owner-bul der wig have the burden of graft riot he or she did not build at Improve for the purpose of sale.).
V L as owner of the property. an axdrrsney contracting with - - I - I d contracbrc In construct tie project (Sec. 7044. Business and Professions Code: The Contractors•
Stale License Law does not appy b an owner of property who builds Or improves thei,eon, and who contracts for the p.ojeets with a contractor(s) licensed pursuant to
the Cw*vcbW State License Law.).
U 1 am exempt under Sec. _ . B.3 P.C. for tis reason
Gate Owner
affirm under WARS' COMPENSATION DECLARATION
I hereby at
De Y at pe fry ore of the browing declarations:
— I have and Surf maintain a certificate of consent b self4mun for workers• compensadort, as provided for by Section 3700 of the labor Code, for the pertomronoe
of the wok for whict
h his peat k ksued
/ — I have and wl maintain workers' compensation Insurance, as required by Section 3700 o(Ihe tabor Code. for the performance of the watt for wrhidr this pew k
ed. y wo ens' Compensation cwrw awb (nyrp e / (
eafrrier o E Nunbet — p0/7 TM a
v b the peAomance oft" wok for whkh tis Pemrit is issued. I" not employ any person in any roamer so as to beoorne subject brie workers•
oomper%6350n taws of CaUdmiaagree thaL t I elwuld become sublet to wor
rie kers'
bRtwtth Comply With elm „ 17 A compensation promAsions of section 3700 0l the Labor Code. I shall
o teAppioart
WARNING: FAILURE TO SECURE WORKERS• COMPENSATION COVERAGE IS UNLAWFUL. AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE .HUNDRED THOUSAND DOLLARS (f 100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR TI
SECTION 3706 OF THE LABOR CODE. MEREST. AND ATTORNEY'S FEES. .
1 hereby affirm under CONSTRUCTION LENDING AGENCY
DAY d trot trete is a Cocoon Wxrwq agency for to Perbmmarmoe of the work for which this Penn' is issued (Sec. 3097. Civ. C.).
Lenders Name
Lenders Address
IMPORTANT Application k APPLICANT ACKNOWLEDGEMENT
_ hereby mode b the Oirecfor of Building and Safety lex a permit Subject b the conditions and restrictions set kith on this application.
1
Issued
u a s on Is mand ade, each person atwtgse request and for %Rose benert wok k performed under or pursuant b arty peri*
olr*=, agents and emplOYees lex any act a fiM the omission related b thew OPPkaF0. each to. and ct performed defend. indemnify and hold hornless the City of l a Oukta. Rs
2 Any Per it Issued as a result of tis application becomes nun and void it vlwk s not n wlatht n A ysBrom dateo!this
k su a Such pemiL «
cessation of work for 160 days will subject permit b canceration.
I certify that I have read tis application and stab that the above km( ,IS correct. I agree b with ad wan cit and
Construction. and hereby authorize representatives at this county ei• on above nen ' YY ordinances and state lawns relating b building; for inspection purposes.
✓ -_b i f lure (Applicant or Agent):
/
•
Y
Page 2
Application Number . . . 04-00003614
------------------------------------------------------'------------------'---
Date 4/21%04
1
Permit . . . . . PLUMBING
Additional desc
Permit Fee . . . . 3.3.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. . 0
QtyUnit 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. ALARMS/BARRIERS SHALL
BE.IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
Paid Credited,
Due.
Permit Fee Total 282.00
.00 .'00
282.00
Plan Check Total 142.50
.00 .00
142.5.0
Grand Total 424.50
.00 .00
424.50