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RPL (07-2720)54840 Avenida Madero 07-2720 7'411 P.O. BOX 1504 ^ `. VOICE 760 777-7012 ;Y fi10 8-495 CALLE TAMPICO _ ' ' FAX (760)' 777-7011 :k LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT _ INSPECTIONS (760) 777-7153 • BUILDING PERMIT . - ` Date: 10/08/07' • - APPlicion Number ' 070.0.002720' Owner, _ ti Property Address: 54840 .AVENIDA MADERO '.» ' •: SACUY RESIDENCE - .. _ ; APN: 774-265-027-20 _000000 Y'`;- 199 MESA DRIVE _ Application description: POOL .- RESIDENTIAL `. »_ COSTA MESA, 'CA Property Zoning: COVE RESIDENTIAL- P,- ----------- ----- - --- --- 'y f r 'Application valuation: 12000 f Contractor: OCT 10 2 / Applicant: Architect or Engineer: Owner.'. CITY OF LAQUINTA f . ' "? FIN DEPT - s. . s - - - - - - - _ - _ _ _ _ _ _ - _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -- _ _ _ _ _ _ _ - _ _ _ - - - J - s LICENSED CONTRACTOR'S DECLARATION " '. ',WORKER'S COMPENSATION DECLARATION; ' -- ,?I hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with _ _ I hereby affirmunder penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and -effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided ,- License Class: License No.: - , } • for by Section 3700 of the Labor Code,for the performance of the work for,which this permit is _ issued. - Date: • Contractor. - 1 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 - 'WNER-BUILDER,DECLIIRATION - - 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 Policy Number ' following reason ISec. 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 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 become subject 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 I should beJall 'ubject to the workers' 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 labor Code, I swith comply with those provisions. that he or -she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7037.5 by - P app,icantlfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ` ,1"Date: ` . Ap'- plicant _ f" ` .1Ias 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' COMPNS ION 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 ND- IVIL 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 NOD 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, AN TTORNEY'S FEES. ' _ one year of completion, the owner -builder will have the burden of proving that he or she did not build or - - , ,. ' _ f. improve for the purpose of sale.). - - APPLICANT ACKNOWLEDGEMENT - ' r , 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 contractors) licensed I.' 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'Quinta, its officers, agents and employees for any act or omission related to the work being .» 7 1• _ , _ - performed under or following issuance of this permit. .ry Date: U b I •-*Owned' - 2. Any permit issued as a result of this application becomes null and void if work is not commenced V V- • ' within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject _ CONSTRU TI LENDING AGENCY - permit to cancellation. - . • •.I her affirm under penalty of perjury that there is a con truct on lending agency for the performance of the _ - I certify that I have read this application and'state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.).I city and county ordinances and state laws relating to building truction, and hereby authorize representatives. Lender's Name - wu" "t- enter upon e above-mentioned property f , . _ n th b a of this county to t open s cYon rposes _z ,__ ,rt - _ _ .r_ SignatureaApplicant-or_Agentl_ - 11 Lender's Address: » ._ . - F„ _. -r Y .y.- '• i- . ,c ,.r.... . _ `wl - LQPERA1IT f. , . Application Number . ._ 07-00002720 ' Permit BLDG POOL PERMIT Additional desc.'. . Permit -Fee' 135.00 Plan Check Fee 87:75 Issue Date Valuation 12000 Expiration Date-. 4/05/08 Qty .Unit Charge Per Extension BASE FEE 45.00 10.00 9.0000 THOU BLDG 2,001-25,000 90.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date 4/05/.08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 Permit ELEC POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation 0 Expiration Date 4/05/08 . 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 4/05/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.0.0 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.001. 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00. ------------------------------- Special Notes and Comments ------------- POOL, ALARMS/BARRIERS SHALL BE IN PLACE LQPERMIT . Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking. Sheet Permit # Project Address: 9CM0 V'A A "`vla Owner's Name: T6v✓t i'v- /_ L11 A. P. Number: r7'74 -2(,5-02 `7 Address: Legal Description: City, ST, Zi : dit ­✓ /} I V 4 t. wv1 - t Contractor: ' 't V) Telephone. e `1 _ I 64-6 3d Address: , D, 9f L Project Description: City, ST, ZipV/ MP( / '`ll. t ' , Telephone: "10 63 0 5 9"101/63o5 G v✓ O o L State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): ew . Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: P J. Estimated Value of Project: 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMrr FEES Plan Sets Plan Check submitted ' Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Callcd Contact Person. Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan' 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees OCT 06. av . By .