RPL (04-6154)49505 Marne Ct
04-6154
t
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 04-0000-6154— Date 9/03/04
Property Address . . . . . . .-4-95-0-5 MARNE CT
APN: 649-630-063- 7
D - -
Application description . . POOL - RESIDENTIAL
Property Zoning . . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . 17000 SCS' 07 200
Owner Contractor CITY CF - QUINTA
- - - - - Fly NCE -SEPT.,
TRANS WEST HOUSING CALIFORNIA POOLS & SPAS
49505 MARNE COURT P.O. BOX 1280
LA QUINTA -.CA 92253. COACHELLA CA 92236
(760) 398-9222
WCC: STATE FUND
WC: 04600061168 01/01/05
CSLB: 656128 10/31/04
CCC: C8 -C27 -C29-053
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Permit . . . . MECH POOL `
Additional desc
Permit Fee . . . . 24.00 Plan Check Fee 3.75
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 . . . . 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
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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
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
P.O. Box 1504 • I
78-495 CaLLE TAMPICO VOICE (760) 777-7012FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
i
Application Number:—
Applicant: 7
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or En i er' ddress:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licen2EF=
mencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Liceyrq irp l force and effect. LicensF7_
_; i
Date / Contractor
1a OWNER -BUILDER DECLARATION
I hereby affirm under.penalty of perjury that I am exempt from 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 tP)s 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
is ed y worke compensation insurance carrier cy u ry
Carrier Policy Number Zl; d
I certify that, in the performance of the work for which t s 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 that, if I ho Id be me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply withthose pr i ons.
Date Applicant
WARNING: FAILURE TO SECURE WO ERS' COM S TON, COV RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (k100 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
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 shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the wo erformed under or following issuance of this permit.'
2. Any permit issued as a result of this application becomes null and void if rk is n 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 I have read this application and state that the above info ation is co I agre to comply with all city and county ordinances and state laws relating to building
construction, nd hereby authorize representatives of this county a er upon a e- ntioned property for inspection purposes.
c
Date 6 Signature (Applicant or Agent):
Page 2
Application Number . . . . . 04-00006154
Date 9/03/04
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
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3.00
Special Notes and Comments
POOLS.& SPA. BBQ ANSI Z21-58-1995. ALARMS
7 BARRIERS SHALL BE INIPLACE PRIOR TO
PREPL ASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED IN PERMIT.
Fee summary Charged Paid Credited
-----------------
Due
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Permit Fee Total 282.00 .00 .00
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282.00
Plan Check Total 140.25 .00 .00
140.25
Grand Total 422.25 .00 .00
422.25