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RPL (04-6217)P.O. Box 1504, 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number 04-000.0.6y217 IDLI 4 Property Address . . . . 79406 MISSION DR W APN: 649-590-021- -SEP 2 7 2004 Application description POOL - RESIDENTIALProperty Zoning . . . . . . . LOW DENSITY RESIDE TY OF LA QUINTA Application valuation . . . . 30000 FINANCE DEPT. Owner Contractor -- - - - - - - - - - - - - - =- - - - - - -- ------------------ - - - - - - LEE DRUMMOND INDIAN CREEK CONSTRUCTION 79406 MISSION DRIVE WEST 28231 HORIZON ROAD LA QUINTA CA 92253 CATHEDRAL CITY CA 92234 (760) 275-9779 WCC: EXEMPT WC: EXEMPT 02/14/05 CSLB: 805577 03/31/06 CCC: A - --------------------------------------------------------------------------- Permit BLDG POOL PERMIT Additional desc Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 30000 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 ---------------------------------------------------------------------------- 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 ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per 1.00 30.0000 EA Extension BASE FEE 15.00 ELEC PRIVATE SWIMMING POOL 30.00 P.O. BOX 1504 • '�C��� rt 78-495 CALLS TAMPICO VOICE (760) 777-7012FAX (760) 777-701 I LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING 8t: SAFETY DEPARTMENT Application Number: Date: 1411., aq Applicant: I Architect or Engineer: Applicant's Mailing Address: 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code; and ss Lice is in full force and effect. / 80557 /License Class License No. Date —2ntractor�tArJ ��L 1,�71✓�J(R�/G�1 oq� 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 Owne 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 workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number I certify that, in the performance of the work for which this 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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those proyisions. „ WARNING: FAILURE TO SECURE WORKERS' C ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN LLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTER , AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that the a 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 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 informatio rect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county me n ve-mentioned property for inspection purposes. ate 1 ^ signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006217 Date 9/09/04 ---------------------------------------------------------------------7------ 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 Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN PLACE'AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited ----------------- Due ------------------------------ Permit Fee Total 386.50 .00 .00 ---------- 386.50 Plan Check Total 210.43 .00 .00 210.43 Grand Total 596.93 .00 .00 596.93 GOLF COURSE i PL 2 6'O w , PL +18" PL To 610 r STACKED 5PILLWAY QUARTZITE a T wo B E E N P G 5 H r916m BENCH - r SKIMMER Wo ' A RE -INSPECTION FEE OF $3( i. LL BE CHARGED IF THE APPROVE ao Pf ANS AND JOB CARD ARE-NQT_O ----------------- T E Tt FOR A SCHEDULED IN PEP ON. NO FX aPTIONS! f.. DEMO EXI5TING CONCRETE aNTY OF LA QUINTAL DING & SAFETY C APPROVEC :0 CO STRUCTIC EPTCI OF H vDIAN CREEK INSTRUCTION Pools & Spas 275-9779 28-321 Horizon Road 805577 Cathedral City, CA 92234. DRUMMOND, RESIDENCE 79-406 M15510N DRIVE WEST RANCHO LA QUINTA, CA DATE: 07-03-04 SCALE: DRAWN bY: CHRIS APPROVED 13Y: CITY OF LA QUINTA SUB -CONTRACTOR LIST Q v®� �1�01 c23�K "Q-20 ,�� JOB ADDRESS -` ' I r'«(� oR J"f T -PERMIT NUMBER OWNER BUILDER L�� �P-UP'I/`� This form shall be posted on the 'ob with the BuildiM Inspection Card at all times in a cons icuous place. Only persons appearing on this list or their employees are authorized to work _L_..... -- ♦.. +►.:.+ �:�.+ -ct ha annrnvarl by tha Building Division Drior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance on tills )oD. Hfly Gnaijyca w u.110 ..aI ...... Yr-• .— -, - - -- , II information requested below must be completed by applicant. "On File" is not an acceptable response. . m permit. For each applicable ble trade a q of building p 9 .. ... ::::.::::............::::::..............:::::.:::::.:...........::::::...... . ..... 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