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RPL (04-6150)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 . INSPECTION REQUESTS (760),777-7153 BUILDING PERMIT Application Number x'04-00006150 Property Address . . . 80090 MERION APN:. 762-140-003- - Application description . . . POOL - RESIDENTIA Property Zoning . . . . . . LOW DENSITY RESIL Applicati-on valuation 17000 Date 9/•03/04 .. �� SPP Q7 9afik Owner •' Contractor `" .� ----------------------- WEST -------------&inC#t419�1 .PGA CALIFORNIA OOLS hi&,R95 IPA, �S>fi 80'-090 MERION _ P.O. .BOX 1280 LA QUINTA ::�'CA 92253 COACHELLA CA 92236 (760) 39879222 WCC: STATE FUND WC: 04600061168 01/0.1/05 CSLB: 656128 10/31./04 CCC: C8 -C27 -C29 -.C53 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 ---I------------- 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 2,001-25,00-0 135.00 - 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. 3.0.00 P.O. BOX 1504 T4&f 78-495 CALLE TAMPICD LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed u p sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Lic�r�se is ' force and effect. License Class (� rise Date Contracto —�� OWNER -BUILDER 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 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. I have and.will maintain orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance.of the work for which this permit is __ / rssu crkers' ompensation insurance tamer ar golf nu beyar Carrier y'-(.CIiJ Policy Number(a�6� [��6 _ I certify that, in the performance of the work for which tsrisrm issued, I shall not employ any person in any manner so as to become subject to the workers' with compensation laws of California, and agree that, if I sh uld be a subject to the workers' compensation provisions of Section 3700 of the labor Code, I shall fort/ham/comply with those pro ' ns. Date " Applicant WARNING: FAILURE TO SECURE WOR ERS' COMPENSATIO ERAGE 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.). Lenders 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 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 Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not 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 information is ect. 1 gree to comply with all city and county ordinances and state laws relating to building construction, nd hereby authorize representatives of this county nter upo abov -mentioned property for inspection purposes. Date 6 Signature (Applicant or Agen . Page 2 Application Number 04-00.006150 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 3.00 Permit . . WALL/FENCE PERMIT Additional desc Permit Fee . . . 15.00 Plan Check Fee .00 Issue Date Valuation 80 Qty Unit Charge Per Extension BASE FEE ----------------------------------------------------------------------- 15.00 Special Notes and Comments POOL & SPA..FIREPIT 496 AGAL. 5 LF `. 4' BLOCK WALL CITY STND. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee Total 2.97.00 00 0.0 297.00 Plan.Check Total 142.50, .00 .00 .142.50 Grand Total 439.50 .00 .00 439.50 .. i __________ ______ _ _ __ ,._ . '..r ,. . .'. :'..: .: .µms.-. a , _. ai`.. c _ .a: _. ,: .a. n A". ,. ..._ i :.c. _ .... .... ., x _,. �. .. .. .,. >_...tr .�... ., :.,, e_.. d ., .,,. a.,... ,3. ' �p . �.., '.-�::;.: .z. !a .. .,4.. ,.. :•;. :;v: .. , ,... -..: ,.. ..,.. .. - .. < _ t ,s.... ... -fit ...v. 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