RPL (05-0605)79615 Marigold Lane
05-0605
Ip .,
P..O. Box 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
a+vaa.✓ai v an. UncCl I LJCrnRIMCIVI
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number .
. . . . [05 :-ff0_006 605 Date
2/16/05
Property Address . .
. . . 79615 MARIGOLD LN
APN:
604-083-001-64 .-22982 -
Application description
-POOL - RESIDENTIAL
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
30000
. a
Owner
Contractor
------------------------
-----------------------,-s
' MONAStERIOS RUBEN A
CAIPO, GUILLERMO W.
*NOT ON FILE
- 38077 CROCUS LANE
UNKNOWN
CA 99999 PALM DESERT
CA 92211
(760) 200-1000
WCC: EXEMPT
WC:, - EXEMPT
07/31/05
CSLB: 816693
01/31/07
CCC: B-053
Permit . . . . . .
BLDG POOL PERMIT
Additional-desc
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date . . .
Valuation . . . .
24265
Qty Unit Charge
Per ,
Extension
BASE FEE
45.00
23.00 9.0000
-----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
207.00
Permit . . . . . .
MECH 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 . . . . .
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
11.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
30.00
----------------------------------------------------------------------------
Permit• . . . . . .
PLUMBING
,
Additional desc
Permit Fee
33.00 Plan Check Fee
8.25
.tet~
P.O. Box 1504
78-495 CALLE TAMPICO
` tG��t�iriV
VOICE (760) 777-7012
LA QUINTA, CALIFORNIA 92253 'ti FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY'iDEPA'RTMENT
Application Number: Date-.;?- 16 -05 -
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
/V�
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisiop of Chapter 9 (commencin with Section 7000) of Division 3 of the Business and Professionals
Ede, and my License is in full force and effect. %�] f7� �/ v � 3
✓License Clas License No. '✓ r L ^' � /
ate B Contractor
OWNER-BUILDE DECLARATION
I hereby affirm under penalty of perjury that I 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 Contractors' 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 ($500).):
U 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 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 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.).
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 Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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.
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 insurance car " d policy number are:
f/ Carrier Policy Numb
_ I certify that, in the performance of the work f hich 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 a e at, i I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with thoseprovisio
Applica4l//
WARNING: FAILURE TO SECURE WORKERS' COMPENSATERAGE 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, ANDA ORNEY'S 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 A(
IMPORTANT Application is hereby made to the Director of Building and Safety for a
1. Each person upon whose behalf this application is made, each person at
issued as a result of this application, the owner, and the applicant, each
officers, agents and employees for any act or omission related to the wo
2. Any permit issued as a result of this application becomes nulla ::i
d
cessation of work for 180 days will subject permit to cancel on.
I certify that I have re d this application and state that the above info alio i
construction, and he by authorize representatives of this county t enter pon a
- /ale G p�r Signature (Applicant or Agent):
it subject to the conditions and restrictions set forth on this application.
e request and for whose benefit work is performed under or pursuant to any permit
s to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its
ig performed under or following issuance of this permit.
is not commenced within 180 days from date of issuance of such permit, or
Vto comply with all city and county ordinances and state laws relating to building
ioned property for inspection purposes.
Page 2
Application Number 05-00000605
Date 2/16/05
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 81.00 Plan Check Fee
.00
Issue Date . . . . Valuation . .
. . 5375
Qty Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
Special Notes and -Comments
------------
POOL & SPA. 215 L.F. 6' BLOCK WALL, CITY
STANDARD. 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 435.00 .00 .00
435.00
Plan Check Total 189.30 .00 .00
189.30
Grand Total 624.30 .00 .00''
624.30
h EXISTING SIDEWALK
}
Owner:
MR. & MRS. RUBEN MONASTERIO r
Project location
79615 MARIGOLD LA QUINTA, CA.
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Owner: -
MR. & MRS. RUBEN MONASTERIO
• rO LI I l l o I'' I'Y10 a I o -
Project Location : F E -CM ' 6dM3mu
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