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RPL (05-2117)P.O. BOX 1504 �^�. VOICE 760 777-7012, . 78-495 CALLE TAMPICO FAX (760) 777-7011 .LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT. INSPECTIONS (760)777-715's BUILDING PERMIT Date:- 6/01/05 Application Number: 05-0000211:7�; _ Owner. Property Address: ------------------------ ------ APN: 79765 MORRIS AVE MONTANO RENATO B Application description: 604-511-010-17 -24197 - 79-785 MORRIS AVENUE Property Zoning: POOL - RESIDENTIAL LA QUINTA, CA 92253 Application valuation: PARKS & RE =OF Contractor: Applicant: Architect or EngiCALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: BB10SO510 01/01/06 Lic. No.: --------------- e -------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ereby affirm under penalty of perjury that I am license er provisions of Chapter 9 Icommenan with 1 hereby affirm under penalty of perjury one of the following declarations: S. 'on 7000) of 'vision the Business and Profes als ode, and myY��}}��n��^+ n f 11 rc rid effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class-. rise No.:.rf {jrJ�-� . for by Section 3700 of the Labor Code, for the performance of the work for which this permit is / issued. te: Contramor:y 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 OWNER -B ILDER DECLARATION insurance carrier and policy number are: hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier 656128 10/31/•016olicy Number C8 C27 C29 C53 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of thAho hich this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to becoo the workers' compensation laws of California, • permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become seworkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000).of, Division 3 of the Business and Professions Code) or 37 0 of the Labor Cod , n hall fortly with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by Def r0 Applicant, _ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: e: Applicant: / - 1 _ 1 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 WARNING: FAILURE TO SECURE W KERS' COMP SAT] COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does. not apply to an owner of property'who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A VIL FINES UP TO ONE HUNDRED THOUSAND and who does the`work himself or herself through his or her own employees, provided that the DOLLARS 15100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). - - - , APPLICANT ACKNOWLEDGEMENT •' 1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Appiication is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. _ property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1- I am exempt under Sec. , B.&P.C. for this reason- the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the workbeing - - performed under or following issuance of this permit. ' Date: Owner: - 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 cessati work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above informatio is correct .l agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.L city and county ordinances and state laws relating to building construction, hereb authorize representatives of this I t to enter upon the above-mentioned pr pe ' r ' spa ti n p rpos . _Lender's Name: //� .• DStf;: Signature (Applicant or Agentl: Lender's Address: LQPER IIT Application Number . . 05-0.0002117• :Permit BLDG POOL PERMIT Additional desc . Permit Fee 180.00 -Plan Check Fee 117.00 Issue Date . . . Valuation 17000 Expiration Date .. 11/28/05 Qty. Unit Charge Per Extension BASE FEE 45.00 15.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 135.00• Permit MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee Issue Date . . Valuation. -0 Expiration.Date 11/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 11.0000 -------------------------------------------------------------------------- EA MECH FURNACE >100K •11.00. Permit . . . ELEC POOL PERMIT_ -RES Additional.desc . Permit Fee . . . 45.00 Plan Check Fee .11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30..00 4 Permit . . . PLUMBING Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/28/05 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 ONLY. GAS & ELECTRIC STUB IBM # Permit # 05, ;q_// Project Address: Q A. P. Number: Legal Description: Contractor: COIL - Address: ® Boy 1.21%0 City, ST, Zip: 66n cA d E4' p •Tele hone: State Lie. # : f Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic: #: Name of Contact Person: Telephone # of Contact Person: City ®f La Quinta ( Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: Address: City, ST, Zip:. seL'sTelehone: 5`•;i2w:%3i:%rli':.i`•'cy.;;:y::. pf< ;:::-::.>%::•<;>>::n::'-,:^>: Project Description: 066 0 A- ,t— Lie. #; .fe<Yl^' < Construction Type: Occupancy: ll Project type (circle one): Ne Add'n Alter Repair Demo >s< S . Ft.: # Stories: # Unrts: Estimated Value of Project:• • APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'dRecd r: TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan. Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. I•I.O;A. Approval ; Plans resubmitted Grading .IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact'Fee' Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees r: �.�... ��., � �„' �I� .III ,.�J__