04-5947 (RPL)49590 Marne Ct
04-5947
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 . . . . . C04--0.0.005947______,7 Date 8./16/04
Property Address . . .. . 49590 MARNE CT
APN: 649-630-053- - -
Application description POOL -RESIDENTIAL
Property Zoning . . LOW DENSITY RESIDENTIAL
Applicati.on valuation . . 18000
Owner Contractor
------------------------ ------------- ----------
PM RENAISSANCE, LLC CALIFORNIA POOLS & SPAS
9968 HIBERT STREET, STE. 102 P.O. BOX 1280
SAN DIEGO CA 92131 COACHELLA CA 92236
(760) 398-9222 '+
WCC: STATE FUND
WC: 04600061168 01/61/05
CSLB: 656128 10/31/04
CCC: C8 -C27 -C29-053
Permit. . . . . . . BLDG POOL PERMIT
Additional desc
Permit Fee 189.00 Plan Check Fee '122.85
Issue Date . . . Valuation . . 18000
Qty - Unit Charge Per Extension
BASE FEE 45.00
16.00 9.0000 THOU BLDG.2,001-25,000,., 144.00,
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
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
--------------------------------------------------------------------
Permit . . . . PLUMBING
Additional desc
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . Valuation 0
A.
Qty Unit Charge Per O
Extension
2.0.0 6.0000 EA PLBBASEFIXTURE FEE 1EAU $ 2004 1 ' 00
CITY OF LA QUANTA I
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92.253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 594I I Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Ch
Lic. No.:
BUILDING PERMIT DECLARATIONS
L ENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensedfe, pr visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Pelle, and my Lice i ull force and effect. /License Class RP
ate (OL
I / I OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt fr lh (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
is a My wo ' compensation ante carrier a d o is number
amer Policy Nu b CJ
_ I certify that, in the performance of the work for hicht is 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 agree at, if I hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those isions.
/ate an
WARNING: FAILURE TO SECURE W KERS' C ENSATION 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 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 w est 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, eac grees to, an shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the being perfo ed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and vo i ork is not co menced 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 a information is rrec . I agre comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this ount to enter upo the ove- ntioned property for inspection purposes.
ate l Sig (Applicantor gen
Page 2
Application Number . . . . . 04-00005947
Date: 8/"16/04
Qty Unit Charge Per
Extension
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
T-------------=---------------------------------------------------
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
Special -Notes and Comments
POOL/SPA, WATER FEATURE BBQ(ANSI
Z21-58-1995). ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited
Due
Permit Fee Total 291.00 .00. .00
291.00
Plan Check Total 148.35 ..00 .00
148.35
Grand Total 439.35 .00 .00
439.35
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