RPL (04-3496)0 04
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• , F �pQul��A BUILDING & SAFETY DEPARTMENT
c 9FS�� OX 1504 (760) 777-7012
OF 78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153
BUILDING PERMIT _
Application Number 04-00003496 Date 4/19/04
Property Address 7'9430 -MISSION DR W.
APN: 649-210-067- - -
Application description.'. POOL - RESIDENTIAL
Property Zoning . . . . . . . •LOW DENSITY.RESIDENTIAL
Application valuation 19.000
Owner. Contractor
T D DESERT DEV CALIFORNIA POOLS & SPAS
P 0 BOX 1716 P.O. BOX 1280
LA QUINTA CA 92253 COACHELLA CA 92236.
(760). 398`-9222
WCC: STATE -FUND
WC: 046.00061168 01/01/05.
CSLB: 656128 10,/31/04
CCC.: C8 -C27. -C29-053
Permit MECH'POOL
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 9.0000 EA 'MECH FURNANCE <=100K 18.0.0
Permit . . . BLDG -POOL PERMIT
Additional desc
Permit'Fee . . . . 198.00 Plan Check Fee.. 128.70
Issue Date Valuation . . 19000
Qty Unit Charge Per Extension
BASE FEE 45,00-
17.00
5..0017.00 •9.0000 THOU BLDG 2,001=25,000 153.00
-
--------------------------------=------------------------------------------
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
r
P.O. Box 1504ot
cu
UWA VOICE (760) 777-7012 '
78-495 CALLE TAM►ICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 a INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number.
Applicant:
Applicant's naming Address:
Architect or Engineer.
/V,O/v J---
Architect or Engineer's Address:
Uc. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 helode. a d nvyirm under penalty a perjury d e I am licensed under provisions d Chapter 9 (commencing with Section 7000) a Division 3 a the Business and Prolessionals
License Class --C LicenseC' - f once and effect Jr6 /Z0
License No.
Date- contractor
I hereby affirm under penalty a perjury that I am ovyftER$utLDER DECLARATION
city or county that requires a permit b e700rta from the Contractors' Stab License Law for the followYq reason (Sec, 7031.5. Business and Professions Code: Any
cor13buct, alter, impr'ov'e. demolish, or repair any sbuctum prior b its 11 41130 requires the applicant for to permit to Sea signed
statement that he or she Is licensed pursuant to ft provisions of the Contract W Stab License Law (Chapter 9 (Commencing with section 7000) of Division 3 of to Business
and Professions Code) «Oat he or she Is exempt fhere{rom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
Ore apPII 10 a civil penalty of not more than rive hundred dollars
U I. as owner Of Ye pnopecty. 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
himself
o and Professions Code: The Contracbfs' State License Law does not appy b an owner a property who builds or improves thereon, and who does the work
hinmr herself a through his or timer own employees, provided that the improverrrerts are not intended or offered for sale. if. howeyer, the buid'rg or improvement is
sold within one year of completion, the owner, braider will have the burden Of pr0wV that he or she cid not build or improve for the purpose of sale.)_
U 1. as owner of the property. am exclusively contracting with 5, - sed contractors to construct the project (Sec. 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 Contractor(s) licensed pursuant to
the Contractors' State license Law.).
U I am exempt under Sec . BA P.C. for this reason
Date Owner
I hereby affirm under penally d perjury one a OreWORKERS'COMPENSATION DECLARATION
_ I have and will maintain a certificate d to declarations: for workers'
a the work for which this per.. is issued coo.O^ provided for by section 3700 of the Labor Code. for Me performance
_ 1 have and will maintain workers' compensation insurance, as required by Section 3700 d the Labor Code. for the performance a the work for which Otis permit Is
MY dAcers' 'orrmpnxmsation insurance carrier and umber are:
carter G) X116 P'
° ' that, in the perfor ar" d the work for which the peril is issued. 1001 not employ any person in any mamer so as to become subject to the workers'
compensation laws of Calibmmia, and agree Yat, If I should become subjed b the wodwscompensation Provisions of Section 3700 of the Labor Code. l slim
foRfmwWfm.comply with Gose
Date '0 Appicarmt
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFtiL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE AORCHUNDRED E. KrSANp DOLLARS (i/00.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, M EREST. AND ATTORNEYS FEES. .
rtn under
CONSTRUCTION LENDING AGENCY
1 hereby afi
penalty d Perjury that Mere is a construction lending agency for the'performance a the work for which this permit Is issued (Sec. 3097. Civ. C.).
Lenders Name
Lenders Address
IMPORTANT APPLICANT ACKNOWLEDGEMENT
Application is tin wt made to the Director io Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. IssuedEach a person upon w� pplicaehaff this application is made. each person at whose request and for whose benefit work is perfoned under or pursuant Io any permit
. application, Ye owner. and the applicant, each agrees 10. and shall. defend, indemnity and hold harmless the City ala Ouinta. Its
OffiCMagents and employees for any ad or omission retated to the work being performed under or following issuance of this peffr#L
2. Any permit Issued as a result Of this application becomes nuo and void if work is not commenced within 180 days from date of issuance of such pens' or
cessation of work for 180 days will subject permit to cancellation.
1 certify, that I have read this application arid state that the above IrdOrmalign is correct 1 agree to comply with all city and county ordinances and state laws
construction, and hereby authorize representatives a this county to above-mentioned property for inspection purposes.reb"�"'g
.
Date Signature (Applicant or Agent):
i
Page 2
Application Number . . . . 04-00003496
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 PIPE 1-4 OUTLETS
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3.00
Special Notes and Comments
POOL AND SPA'. BBQ ANSI.Z21-58-1995.
FIREPIT 496 AGAL. ALARMS BARRIERS SHALL
BE IN PLACE PRIOR TO PREPLASTER
INSPECTION..
Fee summary Charged Paid Credited
Due
Permit .Fee Total 309.00 .00 .00
309.00
Plan Check Total 156.45 .00 .00
156.45
Grand Total 465.45 .00 .00
465.45