RPL (04-6149)49445 Marne Ct
04-6149
BUILDING &.SAFETY DEPARTMENT
P.O. BOX 1504 ? ;_ (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number
Property Address
APN:
Application description . . .
Property Zoning.. . . . .
Application valuation
04==00006149
49445 Mk
CT
649-630-061'-
POOL
49-630-061=POOL - RESIDENTIA
.LOW-DENSITY RESID
17000•,
Date 9./02/04
Dl -- l
9T -IAL
11 SEP 07, 2004
Owner
Contractorl
CITY OFI.AQUINTA
FINANCE
- - -
DEPT.
PM RENAISSANCE,
LLC
CALIFORNIA.POOLS & SPAS
9968 HIBERT STREET,
STE. 102-
'P. -O. BOX 1280
SAN DIEGO
CA.92131
COACHELLA-CA
'922.36
(760) 398-9222
WCC: STATE -FUND
WC: 04600061168.
01/01/05
CSLB: 656128
10/31/04
CCC: C8-C27-C29-053
-----------------------------------------------------------------------=-' 5=---
Permit . . . .
. . BLDG POOL PERMIT
r
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
9.0000 THOU. BLDG.
2, 001-25, 000"-'-
135.00
Permit
MECH POOL
Additional desc
Permit Fee
24.00
Plan Check Fee
6.00
Issue Date
Valuation
0
Qty Unite
Charge Per
Extension
BASE
FEE
1.5.00
1.0.0
9..0000 EA MECH
FURNACE '<=TOOK
9:00
Permit . . . .
. ELEC POOL PERMIT -RES
Additional desc
4f+
Permit Fee
.45.00
Plan Check Fee
11.25
Issue Date
Valuation _
0
Qty Unit
Charge Per
Extension
BASE
FEE
15.00
1.00. 30.0000
EA ELEC
PRIVATE -SWIMMING POOL
.3.0.00
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number: 0 — & 14 q Date:
Applicant: I Architect or Engineer:
Appllcant-s Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIO
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under visions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licse i II force and effect. :!k 15[01 _
cense Class _ C: J . rise N
0
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from a Contractors' State License Law for the following reason (Sec. 7031 .5, Businass and Professions Code: Any
r the permit file a signed
Professions
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant fo
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Secti
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 tion 7000) o Division 3 of the Business
by any applicant fora 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 1 am exempt under Sec. , BA P.C. for this reason
Date : Owner
WORKERS' COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following deciaratiops:
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.
I have and. will maintai orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance -of the work for which this permit is
iss ed. worke compensation insur a carrier ol}'cy u r are
Cartier !/L cy Number
_ I certify that, in the performance oft a work for w +ch is it 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 th if shoul become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pyQsions.
WARNING: FAILURE TO SECURE WOVKERS' COfv PENSA401*60VERAGE 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 ATTORNEY'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
Lender's Address
IMPORTANT Application is hereby made to the Director of Buildingand Safety ACKNOWLEDGEMENT
y 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 anyit
y act or omission related to the work being performed under or following issuance of this permit.
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Quinta, its perm
officers, agents and employees for an
2. Any permit issued as a result of this application becomes null and void if r of 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 1 have read this application and state that the above info ation is corr I ag a to comply with all city and county ordinances and state laws relating to building
construction, nd he by authorize representatives of this county en er upon the ab ve entioned
property for inspection purposes.
Date ignature (Applicant or Agent):
y
Page 2
Application Number 04-00006149
Date 9/02/04
-----------------------------------------------------
,Permit. . . . . . PLUMBING
Additional desc
Permit Fee 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation
0
Qty Unit Charge Per l
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
142.50
Grand Total 424.50 .00 .00
424.50