RPL (04-3572)'� • ��GI
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BUILDING & SAFETY' DEPARTMENT
c - P.O. BOX 1504 (760) 777=7012
OFTt�'9 . 78-495 CALLS TAMPIco FAX (760) 777-7011
LA Q.UINTA, CALIFORNIA 92253 INSPECTION REQUESTS'(760) 777-7153
BUILDING PERMIT------�
Application Number- 04=0.0003572? Date .4/19/04
Property Address 7'9980 MERION
APN: 762-110-001-1 -28340 -
Application description". POOL - RESIDENTIAL
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation 25.500
Owner ;'Contractor '
^ ---
o . .
SAGE..RONALD H " TOPMtAN BUILDERS
416 SW 335TH ST P.O. BOX 10202
FEDERAL WAY _WA 98023 PALM
DESERT.—CA 92255
(760): 772-.7296
WCC: .AU INS. SRVC
,WC: _ 00500019402 01/01/05.
CSLB: 455121 11/30/05
CCC.. B - C2 9
----------------
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 FURNANCE <=100K 9.00
-----------------------------
------------------
--------------
Permit . . . BLDG POOL PERMIT
Additional desc
Permit Fee . . 258.50 Plan Check Fee - 168.03
Issue Date Valuation 25500
Qty Unit Charge. Per Extension'
BASE FEE 252..00'
1.00 •6.5000 THOU BLDG 25,'001-50,000 6.50
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
n -BA E FEE 15.00
1.00 130.00 EA IJ EL PRIVATE SWIMMING POOL 30.00
---------------- -
APR ' 2 3.2004
CITY Of SLA oUIWTn
Fda6� Rd ;E OEPT.
P.O. BOX 1504 KW
VOICE (760) 777-7012
78-495 CALLE TAM►ICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4 4 a
INSPECTIONS (760) 777-7153
Application Number:
Applicant:
Applicant's Mailing Address:
BUILDING & SAFETY DEPARTMENT
Date:--/ - GJ—
Architect
J—Architect or Engineer.
Architect or Engineer's Address:
Lic. No..
tWILVING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm underpenaltypeenniarlttyy 1a perfhrry that I am licensed under provisiorhs a mh
and myChapter 9 (caenang w8h Section 7000) a a Division 3 the Business and Proleuionals
License 0020 s U �--nJ%S force and effect.n Went* No. 'tr=Z5 1
I hereby arty. underOWNER$UILDER DECLARATION
penalty a a perjuy �Sm.
from the Confrsckxs' Stale License Law for the following reason (sec 7031.5. Business and Professions Code: Any
city or canriY that requies a pemit bprove.demoislor repair any sbuctue, prior b Its Iss once, also requires the appiant for the permit b fie a siprhed
statement riot he or she r ug he d pursuaisions a the Contractors' State License Law (Cinpbr 9 (Common Chit with Section 7000) a Division 3 a the Business
and Professions�) a riot he a ache k exempt tnerefihom and the basis for the alleged exertplim Any violation a Section 7031.5 by any appkwt for a pert subjects
OI, Pyr a not more than five hundred dollars (M).r
a owner a the
DrOPWtY. or my employees with wages as their sole Compensation, wil do the worf4 and the strucl re is not Intended or offered for sate (Sec. 7044,
Business and Professions Code: The Cw*ad*W Stele Lkense Law does not apply to an owner of property who builds or improves thereon. and who does the work
himself or herself or though his or her own employees, provided that the improvements we not intended of offered for sate. If, howeyer, the I A I g or inpovement is
sold within one year Of Completion. the owner -builder wit have the burden a proving that he or she did not hM or improve for the purpose of sate.}
(..) 1. as owner a the property. am apply to an owner f p ope ykenu
who a cw aaas b Construct the project (Sec 7044. Bust ess and Processions Code: The Co lracbrs'
Stab License Law does not apply b an owner a property who
the contractors! State license Law.). bolds or it proves thereon, and who contracts for the projects with a Contractors) licensee pursuant b
U 1 am exempt under Sec. . B.& P.C. for this reason
Dab Owner
1 hereby affirm urhder WARS' COMPENSATION DECLARATION
_ Pem�Y a perjury one a the following declarations:
I of the wok for sulmaintain a consent b self -insure for workers' congener adon, as provided for by Section 3700 a the bubo Code. for the performance
Permit is issued.
_ 1 have and will maintain wokats' compensation irwmnee, as required by Section 3700 of the Labor Code. for the performance of the wok ter which this per" is
can ier Ay is � 06cy insurance carrier JC and hry 31 npanknumbet : OZ
_ I cerw that, b the periommanee a th vp(k Joor which tat permit is issued'. I" not employ a nr Penson In any Tamer so as to become subject b the workers'
complyforthwith compensation �1 On N i should became subject b the waters' Compensation provisions a Section 3700 a the Labor Code. I shat
Date -� •�'
WARNING: FAILURE TO SECURE OR?.AND
ON COVERAGE IS UNLAWFUL, ANDS JECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE 100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR COORNEYS FEES..
1 hereby alum nraer penalty a perjury thn CONSTRUCTION LENDING AGENCY
le^dag agWICY for the performance at the wok for which this permit Is issued (Sec. 3097. Civ. C.).
Lender's Name
Lender's Address
IMPORTANT Appicatim is APPLICANT ACKNOWLEDGEMENT
thereby made b the Director a Buidng and Safety for a Permit subject b the cm t sus era restrictions set forth on this appicsoon.
1. Each Person upon whose behalf this application is made, each person at whose request and for %those benefit work is performed under or pursuard to any pemhit
Issued as a result a this appication. the owner, and the applicant, each agrees to, and shaft, defend. kxkmwhify and hold ;armless the City of Le Quints. Its
, agents and employees for any act or omission related to the wort be Performed under or totlowtng issuance a IN
2. Any permit issued as a result a this application becomes rwn and void w work is not commenced within 180 days from date a issuance a such permit of
cessation of work for 180 days wM subject pemmit to caroepation.
I Certify that I have read this application and state that the above informafio
corhstruction, era hereby authorize representatives a this county b enter ��r-,M7M"e,1Xoprty!O00f1p1rwiam as city and county ordinances and state laws rolstirmg b 1>t,ildirq
(� for inspection purposes Date 1 r Signature (Applicant or Agent): —
Page 2
Application
Number 04-00003572,
Date 4/19/04
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 PLPE 1-4 OUTLETS
3.00
Special Notes and'Comments
POOL & SPA.
FIREPIT, BBQ.ANSI.
Z21-58-1998.
ALARMS BARRIERS SHALL BE IN
PLACE PRIOR
TO PREPLASTER INSPECTION,.
Fee summary
Charged Paid Credited
Due
Permit Fee
Total 360.50 .00 .00
360.50
Plan Check
Total 193.53 .00 .00
193.53
Grand Total
554.03 .00 00
554.03
v
yrg B1
NSM 511`":
2. POOL TO BE CARIBBEM BLUE FE55LE TEC
# r GUARTZITE STONEGUAR
AATERLINE ANP FACE OF ..
BEAM, SEE STONE
5. FIREPIT TO BE i BANIN& (PER LA
GUINT�ra� " CITY . .�
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AND
As
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COLOREP, SEE
SAMPLES.
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CAP AND SrACKEP STONE SPI Y
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SLIDEFILL LINE LINE
lip,i
P -TRAP N/A BACK AA514 ToJ-1614TS
aw aw
C46 LINE 2M 511.85
IN
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SET EQUIPMENT
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SAYTUT NO AuerR N/A
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y INSPECTION Dr
♦r ., ._ �II�II
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FENi
DEEP END RAMP ..NQ
TO MEET ALL LOCAL CODE REOUIREMENT5 5 Y BUYER PRIOR TO
LOVESEAT-)M5 EXTENDED 2nd 57EF NQ
-or BOND BEAM�!
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(1) TAKE NOTICE THAT POOL AND EWIPMENT LOCATION 15 SUBi To ACCEPTANCE Or LOCAL BUILDIN& DEPARTMENT AT 71ME
• -. ISSUANCE OF PERMIT
`
♦ . - r♦r • * il'. full
•UNDERGROUND. CONDITIONS OR DAMAGE
TO Mr r_ OR ♦ _r ITEMS IN THE ACCESS AREA
MEET INSPECTION ♦ �l
,, r , r ♦ LOCALCOVES FOR - ♦ENCLOSURE ♦- TO PREPLASTER
FOOL IMMEDIATELYr _ ♦ INSTRUCTION5PO NOT USE RUE35i H05FJ
„. � 15 THE SOLE PROPERTY
14AT THIS
.._
-,1, ^_+ EI - r. LAK
I44 ♦
SII
I OMER APPROVES FLAX POOL, AND EQUIPMENT LOCATIONS AND HA5 READ
I
THE RESPONSIBILITIES AND NOTICES ABOVE.
i
DATE
4 ,III
610NNI'UREZ
DATE
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ti PO -FOR:
11
NAME(S) 5A&E REVVENCE
STREET '7c[— ME I N Y C iy L. 1NTA
PHONE #15 OFFICE Vf I L B CH ARGE-0 IE T4- E APRRIB V ED
LOT # TAT # PI ANS AND L&CARD ARE NOT ON
MAP'OOOKPA&E# THE SITE FOR A SCHEDULED
MAIL .55 INSPECTION. GTy
CONSTPUCTION OFFICE PHONE #
5CAd-E: DATE:OftAm EKY: 501-D C3Y: CHECKED ay.
1 /8"—l'—a" 3-2-04 .J ISN 10H
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