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PLBG (09-1231)a P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 • u�l'�Gv . BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: LICENSED COI hereby affirm underpe ty of perjury that I am )scans Section 70 I of ivisi n 3 of the Business and Prole License Cla te: ractor: Architect or Engineer: aIR s ATION tas.-�m ns o Chapter 9 (commencing with license is in full force and effect. 95843 �� m exempt from th DECl/ARgiION , I hereby affirm under penalty o am exempt from the Con a or's 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 sheLis licensed pursuant to the provisions of the Contractor's 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).: (_ 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 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 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.). (_ 1 1, 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there 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 LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-71'53 Date: 12/02/09 Owner: OLSON 79808 MORRIS AVE LA QUINTA, CA 92253 Contractor: HERITAGE POOLS A// PO Box11996 PALM DESERT, A 92 5 (760)340-2588 Lic. No.: 495843 ry0,p WORKER'S COMPENSATION DECL'Af\VIOY 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 th' rmit is issued. My workers' compensation insurance carrier and polic Carrier STATE FUND Policy Numb r 10 6258 I certify that, in the rformance of the work for ich is p it is issued, I shall not em loy any person in any anner so as to become sub' ct a wor s' compensation laws alifornia, d a r h , if I should become su ' to er 'compensatZ sof Section 0 of th La ode, shall fo iply ise provisio WARNING: FAILLIME TO SEClht6JNDBK&KS' O6MeFJdSPf ON COVERAGJKS UNL FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 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. 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 performedunder 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 Quinta, its officers, agents and employee f r any act or omission rel rd to the work being performed under or following issuance of It' pmit. 2. 'Any permit issued as a result of this application comes null and void i w k is n commenced within 180 days from date of issuance of such ion o w r 0 days will subjec permit to cancellation. I certify that I have read'this application and state at the above information i c r I re to%omply w' all �f`lhi y-and county rd' ances and state laws relati to building constructs d au or' a represen ives ount toe er upon th@e-mentio a for inspecti rpo Dale: nature (Applicant or gent): - Application Number. - =09-00001231 Property Address: 79808 MORRIS AVE APN: 604-511-003-10 -24197 - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 600 Applicant: LICENSED COI hereby affirm underpe ty of perjury that I am )scans Section 70 I of ivisi n 3 of the Business and Prole License Cla te: ractor: Architect or Engineer: aIR s ATION tas.-�m ns o Chapter 9 (commencing with license is in full force and effect. 95843 �� m exempt from th DECl/ARgiION , I hereby affirm under penalty o am exempt from the Con a or's 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 sheLis licensed pursuant to the provisions of the Contractor's 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).: (_ 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 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 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.). (_ 1 1, 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there 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 LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-71'53 Date: 12/02/09 Owner: OLSON 79808 MORRIS AVE LA QUINTA, CA 92253 Contractor: HERITAGE POOLS A// PO Box11996 PALM DESERT, A 92 5 (760)340-2588 Lic. No.: 495843 ry0,p WORKER'S COMPENSATION DECL'Af\VIOY 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 th' rmit is issued. My workers' compensation insurance carrier and polic Carrier STATE FUND Policy Numb r 10 6258 I certify that, in the rformance of the work for ich is p it is issued, I shall not em loy any person in any anner so as to become sub' ct a wor s' compensation laws alifornia, d a r h , if I should become su ' to er 'compensatZ sof Section 0 of th La ode, shall fo iply ise provisio WARNING: FAILLIME TO SEClht6JNDBK&KS' O6MeFJdSPf ON COVERAGJKS UNL FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 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. 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 performedunder 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 Quinta, its officers, agents and employee f r any act or omission rel rd to the work being performed under or following issuance of It' pmit. 2. 'Any permit issued as a result of this application comes null and void i w k is n commenced within 180 days from date of issuance of such ion o w r 0 days will subjec permit to cancellation. I certify that I have read'this application and state at the above information i c r I re to%omply w' all �f`lhi y-and county rd' ances and state laws relati to building constructs d au or' a represen ives ount toe er upon th@e-mentio a for inspecti rpo Dale: nature (Applicant or gent): LQPERMIT Application Number . . . . . 09-00001231, Permit . . . PLUMBING Additional desc . Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 5/31/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ------- Special Notes and Comments 34 L.F. 1/2" GAS LINE (SLEEVED) FOR INSTALLATION OF FIREPLACE. 2007 CODES. -----------------_------------------------------------------- - Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- Paid Credited --- Due ----------------- - _ Permit Fee Total 18.00 .00 .00 18.00 Plan Check Total 4.50• .00 .00 4.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 23.50 .00 .00 23.50 LQPERMIT Bin # AX Permit # ` Project Address: City of LQ Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet r� Owner's Name: A. P. Number: Address: - 01140yvts eve _ ,Legal Description: City, ST, Zip: 91Z 5 Contractor:�( •:H4:.:CvJ:.'<::<:^G6>!i3Ki:Fr>.'.:i:(ii::i,vr�: :c.>:;:.::.:.::::..::........�.;::;::.:.: •.•;: Telephone: 36- -/ Address: ,V Project Description: City, ST, Zip: Telephone: e' (/M p' 4 ;?:i+.:3>'':::.;fr : i .';.•„": 3:: <::;:::' State Lic. # : City Lic. Arch:, Engr., Designer: N Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: �,..::�:;„::,,>•<::�:s,:: :?`r?%a'<rzz?< r. ^ `•<'%.!;>'.c� ° e>> 1 C%- Construction Type: Occupancy: Project type circle one): New Add'n Alter Repair Demo Sq. Ft: # Stories: # Units: Telephone # of Contact Person: �/- Z� 5-li 1 c-E/Estimated Value of Project: U. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal' Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. 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 2°” Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees . ?CoPE aF U/oeL l —30503 94WPL4e� W/Gits (Argy) Cmf A F4 ('nnl (' do Acid WA5# "E-xISfln�� �ECrGr Nd- P��/Say