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RPL (04-3537),gyp BUILDING &.SAFETY DEPARTMENT �1;��u.0. BOX 1504 (7.60)-777=7012 C` OF 78-495 CALLS TA-MPICo ° 'FAX (760) 7774DI I `LA .Q.UINTA, CALIFORNIA 92253 ANSPECTION REQUESTS (760).777-7153- BUILDING-PERMIT 760)777-7153BUILDINGPERMIT Application Number. G 04-000.0353.7--T, Date 4/16/04 Property Address 79918 MISSION DRIVE EAST APN: 649.-750-009- - - Applicati'.on description POOL RESIDENTIAL "Property Zoning LOW DENSITY RESIDENTIAL Application valuation 18000 Owner Contractor T D DESERT DEV CALIFORNI'APOOLS;& SPAS.' P O 'BOX -•,1716 P O: BOX 1280 LA. QUINTA - ' CA .92:253-. COACHELLA CA 92236 (760) :.398'-9222 WCC: STATE FUND WC.::.. 0;4600061.16.8; 01/..0.1/05 CSLB:, 656128 - 10/31/04 CCC.: ..... C8 -.C27 -.C29-053 --------- ------------ . •:.- --:------------------ ,---------------------- PermitMECH`POOT; Additional desc :Permit Fee a 24..00 Plan Check.Fee.. '6.00 Issue Date. . . . Valuation 0 Qty Unit. Charge Pere Extension BASE.FEE 15:00 1.00. 9.0000 EA MECH-FURNANCE <=100K 9.00 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 de_sc Permit Fee 45..00 Plan Check Fee 11.25 Issue.Date Valuation. 0 r Qty'.: Unit Charge ..Per Extension BASE .FEE 15.00 .1.00 30.0000 EA BLEC PRIVATE SWIMMING POOL 30.0.0 P.O. Box 1504 40UW4 VOICE (760) 777-7012 79-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 Application Number. Applicant: Applicant's Mailing Address: BUILDING & SAFETY DEPARTMENT Date: 7"- 21 - o Architect or Engineer. Architect or Engineer's Address: Uc. No. BUILDING PERMIT DECLARATIONS . LICENSED CONTRACTOR`S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and-ftlessionats coda, and my License is in full and effect 12 -License Class - No. 91. Daft - l contractor .1 hereby afrimh under penalty or perjury toot I am OWNS 43UtIM DECLARATION city or county that requires t perm" a construct all from the Contractors' State License Law for the following reason (Sea 7031.5. Business and Professions Code: Any irrmprove. demofish, Or repair any strucb e, prior to its issuance. also requires the applicant for the permit b file a signed statement that he or she Is licensed pursuant to the provisloims of the Cw*actcra• State License Law (Chapter a (commending with Section 7000) of Division 3 of the Business and Professbns Code) or drat 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 mon; than rive hundred dollars (5500).): U [.as owner. of the property. or my employees with wages as their sore Compensation. -will do the work, and the structure is not Intended or offered for sale (Sea 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. howeyer. the builduhg or improvement is sold within one year of completion, the owtier-bulkler will have the burden of proving that he or she did not build or improve for the purpose of sale.). U 1. as owner of.the property. am exclusively contracting with licensed contractors to construct the project (Sea 7044. Business and Professions Code: The Contractors' State License Law does not appy to an owner of property who builds or improves thereon, and who contracts for the projects with a eonaactoc(s) licensed pursuant to the CWftctDW state License Law.). U I am exempt under Sec . BA P.C. for this reason Date" Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penally of perjury one of the following declarations: I have and will maintain a certificate of consent to silt -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 workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which tills permit is �5o �k,.ers�' r bmpensation insurance carrier a �ori numbet Grbcarrier area that, In ing perorrnance of the work for which this pemM is issued, l shall not employ any person in any manner so as to become subject b the workers' compensation laws of California W agree that. if 1 should became subject b the workers' compensation provisions of Section 3700 of the Labor Code. l shall faMwi with.comply th those P, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 37013 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that where is a construction lerhdmg agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name Lenders Address APPUCANT ACKNOWLEDGEMENT IMPORTANT Application Is hereby made to the Director of Building and Safety for 8 -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 3s performed under or pursuant to any pemnit 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 Ouhra, its officers. agents end employees for any ad or Mission related to the work being performed under of 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 pemdt, or cessation of wok for leo days will subject permit to cancellation. I certify that I have read this application and slate that the above Information is correct. 1 agree to comply with all city and county ordinances and state taws retating to building constructan and hereby authorize representatives of this county to upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent): r Page 2 Application Number 04-00003537 Date 4/16/04 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 6.000,0 EA PLB FIXTURE 12.00 1.00 )3.0.000 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. BQ ANSI Z21-58-1.995.. ALARMS BARRIERS SHALL BE IN.PLACE PRIOR TO . PREPLASTER INSPECTION. 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