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RPL (04-5091)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).17.7-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71153 Qty Unit Charge Per 5-xteW� BASE FEE 1.00 9.0000 EA MECH FURNACE <=100K 9 - ------------- 7 ------------------------ ------- C11 Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 15.00 Plan Check Fee Issue"DateValuation . . . Expiration Date 12/22/0`4 on .75 . 0 BUILDING.. PERMIT Application Number . �0.00-. 0'91 - Date . . . �7 -0 P 6/22/04, 'Property Address 56805 MOUNTAIN VIEW APN: 762-320-0'10-9 -29147 Application description . . . POOL -'RESIDENTIAL Property Zoning . . . . . .. .. LOW DENSITY RESIDENTIAL Application valuation 18000" Owner contractor --------------- -------- CRV GOLF WEST ------------------------ CALIFORNIA,'POOLS & SPAS' C/O ALEX ZIKAKIS P.O. BOX 1280 9255 TOWNE CENTER DR 520 COACHELLA CA 92236 SAN DIEGO CA .9212.1 .(760`.). 398-9222 STATE FUND WC: 04600061168 01/01/05 CSLB:1 10/31/04,, .6561218 CCC: C.8 -C27 -C29-053 --------------------------------------------------------- Permit . . . . . . ---------------- BLDG POOL PERMIT 7 ------- .Additional desc Permit Fee 189.00 Plan Check Fee.— '122.85 Issue Date Valuation . . . .. 18000 Expiration.Date 12/22/04 Qty Unit Charge 'Per, Extension BAS]i'* FEE 4S.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 Expiration Date 12/22/04 Qty Unit Charge Per 5-xteW� BASE FEE 1.00 9.0000 EA MECH FURNACE <=100K 9 - ------------- 7 ------------------------ ------- C11 Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 15.00 Plan Check Fee Issue"DateValuation . . . Expiration Date 12/22/0`4 on .75 . 0 P.O. Box 1504• �� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 5 U q,I Date: (0 -07� __0L7 Applicant: Architect or Engineer: •.. Address:, 1� Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LI NSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under pr visi Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and myLi en li f II rc�and effect cense Class ✓Lice OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Co-iit�ractors' 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 fora permit subjects the applicant to a civil penalty of not more than rive 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 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.). 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. , BA P.C. for this reason Date Owner WORKERS' 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 is u d. My `fGrkers' co pensation i ce carrier a is num er e: Carrier ��-(�[ 'Policy NumbPlIshoul certi y at, in the performance of the work for whp it 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 thabecome subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prpyisions. WARNING: FAILURE TO SECURE WO KERS' C MPE 10 COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND D R 0,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 Lendee's Address 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 r uest 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 s defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work bein erformed )der or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work not commen 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 i ation is co . agree to com y with all city and county ordinances and state laws relating lo building constru/ction, adherey authorize representatives of this coun o ter upon the o -mentioned roperty for inspection purposes. ate �/ gnature (Applicant or Agent): Page 2 Application Number . . . . 04-00005091 Date 6%22/04 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25. Issue Date. Valuation .0 Expiration Date 12/22/04 . u 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 2.61.00 .00 00 261.00 Plan Check Total 140..85, .00 .00 140.85 Total :� 40,1- 85 . 00, .00 401.85 ,Grand