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RPL (04-4688)50470 Los Verdes Way 04-4688 s + j 1 ^ g IVIf 7 N • . BUILDING & SAFETY DEPARTMENT rRAULC 4F 04 (760),777,7012 FAX (760) 777=7011 ` OF LE AMPICO LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT 4 Application Number04-00004688 Date 6/01/04 .Property Address .50470 LOS VERDES WY APN: 772-250.-999-96 -30357 - . . :• Application description POOL - RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL App.l.icaton valuation. 65 Owner Contractor. ------------- TOLL CA V CALIFORNIA' POOLS & SPAS C/O •KEVIN. D DUERMIT P.O. BOX 1280 . .'8 9'0.1: E. MOUNTAIN' VIEW 200. ! COACHELLA. CA .92236 SCOTTSDALE AZ 85258. ,(760) 39.8-9222 WCC.: STATE FUND WC: 04600061168 ..0.1/01/05 CSLB.: 65612.8 10/31/04 CCC:. C8 -C27. -C29-053 Permit MECI4 POOL Additional desc :Permit Fee 24.00 -Plan. Check Fee .. 6.00 Issue Date Valuation 0 Qty. Unit.Charge Per :Extension BASE.FEE .15.00: 1.00 9.0000 EA.. ..MECH FURNACE <=100K 9.00 Permit BLDG POOL -PERMIT Additional desc.. Permit Fee 189..00. Plan Check Fee 122.85 ..:..T.ssue Date Valuation1 .000 Qty Unit Charge Per Extension BASE .-FEE .45'.00 16..00 9.0000 THOU BLDG 2,001'-25;000 1-44:00 Permit ELEC'POOL PERMIT -RES Additional desc Permit Fee 45.00. Plan Check Fee 11.25 Issue Date': Valuation 0' Qty Unit Charge. Per Extension BASE FEE 15.00 7V i7N P.O. Box 1504 VOICE (760) 7 -77 -'7'07P2- 78 -495 77-70b278-495 CALLS TAMPICO .. : FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 . BUILDING & SAFETY DEPARTMENT Application Number: 0 /, 411 g Date: Applicant: Applicant's Mailing Address: Architect or Enginee . Architect or E I ress: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wM Section 7000) of Division 3 of the Business and Professionals Code, and my Lice r► Is in full force and effect. License Class License No. (o ZJ Date ®f Contractor 4-k"W ` OWNER43UILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 am exempt from the Contractors' 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 Contractofs' Stats License Law (Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions ) or.that he or she is exempt therefrom and the basis for the alleged exemption. Any vlolation of Section 7031.5 by any applicant for a pemrit subjects the applicant to a civil penalty of not more than five hundred dollars (=500).), U 1, 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 or 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 wiltiln 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.). U 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 contractor(s) licensed pursuant to the ContraCODrs' State License Law.). U I am exempt under Sec. . B.& PA. for this reason Date Owner._. WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations:. _ 1 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. II haveandwill maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is P, ensattoncarrier and mber . Carrier ` Policy 042 / /Uall _ 1 certify that, in fire performance of the work for which this permit is issued, l shag not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, If. 1 should became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall ft rrthwwith comply with those prons. /fin 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 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 Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to 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 shag, defend. Indemnify and hold hamdess 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 pemdt 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 perrdt to cancellation. 1 certify that I have read this application and state that the above information is correct 1 agree to comply with ail city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent): Application Number . . . . . 04-00004688 Page 2 Date 6/01/04 Qty Unit Charge Per Extension 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 -----------------------------7---------------------------------------------- Permit . . ... . . PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 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 --------=---------------------------------- Permit . . . . . . WALL/FENCE --------------------------------- PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 65 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA BBQ ANSI Z21-58-1995 6 LF 5' WALL CITY STND. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 306.00 -------------------- 00 .00 306.00 Plan Check Total 148.35 .00 .00 148.35 Grand Total 454.35 .00 .00 454.35.