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RPL (04-4848)' BUILDING & SAFETY DEPARTMENT O. Box 1504 (760).777-7012 �4 C�'•OF'�¢ ---� 78-495 CALLE TAMPICO FAX (760) 777-7011 ift.,,......2volA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 FINANCEDEPT.' . BUILDING PERMIT Application Number . . . . .,04--0-00=0°4-848 Date, 6/09/04 Property Address . . . . . . 79442 MISSION DR W APN: .649-5.90-024-58 -000000- Application description . . . POOL - RESIDENTIAL .Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation 18000 Owner Contractor TD DESERT DEV LTD PARTNERSHIP CALIFORNIA POOLS & SPAS .79285 RANCHO LA QUI NTA DR P.O. BOX 1280 LA QUINTA CA 92253 COACHELLA CA 922.36 (760) 398-9222 WCC: STATE FUND WC:: 04600061168 01/01/05 CSLB: 656128 . 10/31/04 CCC: C8 -C27 -C29-053 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 . . . . . . 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 Extension BASE FEE 15.00 1.00 30.0000 EA.. ELEC PRIVATE SWIMMING'POOL 30.00 •�� ` P.O. Box 1504 78-495 IrALLE TAMPICO VOICE (760) 777_701: LA QUINTA, CALIFORNIA 92253 FAX (760) 777.'011 INSPECTIONS (760) 777-715? BUILDING 8 SAFETY DEPARTMENT Application Number: Applicant: � 4 Date: / -/O -0�1 Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: I Lic. No. BUILDING PERMIT DECLARATIONS I hereby affirm under penaltyof ry LICENSED CONTRACTOR'S DECLARATION peau that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals and my License is in full force and effect. License Class Lr ense No. Date ontractor I hereby affirm under persalt of OWNER43UILDER DECLARATION Y 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 aro not intended or offered for safe. 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. , B.& P.C. for this reason Date • Owner I hereby affirm under persaltof WORKERS' COMPENSATION DECLARATION Y 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. 1 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 `' • Y e compensation' nce tamer poli nu a Carrier olicy Number/ _ I certify that in the performance of the work for which this pelt rs issued, I shall not em to an workers' compensation laws of California, and agree tha 1 I should become subject to the workers' comppensabon Provisionsyro Sso aection 337700 of t s to bacon* sto 010 ubject ode, I shell forthwith comply with those provisions. Date c 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury that there isa construction TendNSTRUCTION LENDING AGENCY Lender's Name If 9 agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Address 1 11 IMPORTANT Application tion is hereby made to the Director of Building APPLICANT aCKNOWLEDGEMENT 1. Each ty o permit subject to the and restrictions set forth on this application. 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 hartnbas t City of La Quint', its officers, agents and employees for any actor 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 wRhin ta0 dayti from date of issuance of such psmtit or cessation of work for 1a0 days will subject permit v cancella ' n. I certify that I have read this application and state that the above info ti is correct I agree to comply with all city and county, ordinances and state laws relating to building construction, and hereby authorize representatives of this county to to upon a ti ed property for inspection purposes. atenature (Applicant or Agent): Page 2 Application Number . . . . . 04-00004848 ----------------------------------- Date 6/09/04 ---------------------------------------- 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 ------------------------------------------------ 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 291.00 .00 .00 ---------- 291.00 Plan Check Total 148.35 .00 .00 148.35 Grand Total 439.35 .00 .00 439.35