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SOTB (05-3634)P.O. BOX 1504 �8-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: T4ht 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 05-00003634 81205 MUIRFIELD VILLAGE 762-410-008- - - STRUCTURES OTHER THAN BUILDINGS LOW DENSITY RESIDENTIAL 1220 fnn Architect or Engineer P /a Owner: CHESWORTH 81205 MUIRFIELD VILLAGE LA QUINTA, CA 9.2253 Contractor: AUG 17 2005 u PICASSO-POOLS, INC 78078 COUNTRY CLUB DR, #206 7WA ily OF La QUI PALM DESERT, CA 92211 Fit CE IDV -r (760)345-4600 Lic. No.: 810111 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 my License is in full force and effect. LicenseClass: B C27 C53 LicenseNo.: 810111 '1(2 _? ,4n-tr.cto,: ai CQ�" 09c, �1� . OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor'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 she is 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, as owner of the property, at 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 on� 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, 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 contraGtor(s) licensed pursuant to the Contractors' State License Law.). 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: LQPERNUT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/15/05 WORKER'S 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 STATE FUND Policy Number 1709395 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 provisions. Date 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 4$1 00,000�. 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. I . 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 Quinta, 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 information 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'Fou9ty to enter upon the above-mentioned property for inspectM purpo es. 1K S. ate___ Q� - Dal. re (Applicant or Agent): Lts . 4*7� V Application Number . . . . . 05-00003634 Permit . . . . . . BUILDING PERMIT Additional desc Permit'Fee . . . . 31.00 Plan Check Fee 20.15 Issue Date . . . . Valuation . . . . 1220 Expiration Dat.e 2/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 2.0000 ---------------- ----------------------------------------------------------- HND BLDG 501"2,000 16.00 Permit . . . . . . PLUMBING. Additional desc Permit Fee . . . . 18.00 Plan Check Fee 4.50. Issue Date . . . . Valuation. 0 Expiration.Date 2/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS L 3.00 ----------------------------------- ---------------------------------------- Special Notes and Comments FIREPIT PER APPROVED PLANS (ANSI Z223.1) ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 2.02 Fee summary Charged ----------------- ---------- ---------- Paid Credited Due Permit Fee Total 49.00 ------- ---------- .00 .0.0 49.00 Plan Check Total 24.'�5 .00 .00 24.65 Other Fee Total 2.02 .00 .00 2.02 Grand Total- 75.67 .00 .00 75.67 LQPERMIT COONCRE GAS SHUTOFF VALVE- I =F SCALE 'F- 0KvRaDnRr-Al N'% %A'^G- Em T,,C P�-, p- 00- llm� FCITY OF LA QUINTA BUILDING & SAFETY DEPT. B APPROVED FOR CONSTRUCTION DATEf 1�5 tin # iPerm 0 -t - L2 Quin t2' ty of Buficupg. 8z safery aivi�jorl P. 0. Box 1.504, 78—'-F:5. Cafle Tar, OcD a Quinm, CA F=3 - (760) T/7-7012 Building Pejmr�t Applic-2don and Tracking .V ]:�Mjccl Addrtss: jLqW.ro-ncr�s lan�jj y �L, ffjXV L j kni, P. �i=b=- Lzzal D=criplion. Cirv. ST. Zm: I- C_ H�O.A_AFproral C_ i tirphon r: Comm= on. -Grading Addr ri A I -It 0- 'c= Dzscrintiari: 3-uls, �kk au�)br -ZrOL aa TN HC4U=-_ 4- C*M,. SIT Review. re2dv for correcrion'sAmsue .4 Tel-cphon -r A ;x stac L.;i,-OTY OF tA QU BUILDING- J-2, S_.A_F=EZy nFp-T- Aimi- F=- D=== -APPROVED. A -1-P P. FOR -CONSTRUCTION. ory.-ST- Zip- DATE- . . . . . . ..... Tel--phanc: n I ypc: 0CCL-_-Z=-: i St= LJr_ t: Pr6j= npe (Cirtit: one): N --%V Add*n -Aitcr R=zir. riano. 411 $q. FL: siorits- ..TcJ=bonc Df Cb.nm= ?=-son: ng�545-4t,()Q ��rnmcd Value 0FT1MjC= APPLICANT: -DO NOT WRFIME BELOW THIS LINE Totai-Pemif-Ft= Rcq'd Rx—_'d TRACKJNG FEERMUT FEES Tqan SC!S Pl2n Check submined I'ltem Anbgunt Snuc:rx2l Calm Rrvie-etL rt26y for- correctims Plan Check Dczaszi Truss Czi=- Called Con= Pcnon. I -in C - P PL h=k ;:�nct -Ti �le 2-4 Plans picked up :Flbod plain plan ?lam rcsubmiried McciXanic2l --FG- _Z. 2- Rnim. rcad-v for cor-r-tctionsassuc I Electrical SubcDn't2ct-jr, L'M1 ailed COR12CT Pr�SOn I rlumbin:: /_1 ;& C-, i+ V ',Gr2w De=e Plans picked up C ILL H�O.A_AFproral 'Pi2n.,; rtsubmit-rd -Grading TN HC4U=-_ Review. re2dv for correcrion'sAmsue Dcyciaper Inxf2n Fcr (:aIlcd Cor,.t= Person A -1-P P. Totai-Pemif-Ft=