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RPL (04-5412)tc��ttG(/ BUILDING & SAFETY DEPARTMENT G.� 0 P Yj BOX�� 5� 4 (760) 777-7012 t� - 9pl OF, 78-495 CAyLL+' TAMPICO FAX (760) 777-7011 14AA Q�UlItNT}AJCrALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 r`TM ®F �,QuicaTA BUILDING PERMIT Application Number*.. . 04700005412 Date 7/12/04 Property Address 57005 MOUNTAIN VIEW APN 762 -350 -008 - .Application description POOL - RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation 19000 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 92121 (160)-39.8-9222 WCC: STATE FUND WC: 04600061168 01/01/05 `CSLB: 656.128... 10/31/04 CCC: C8 -C27 -C29-053' Permit BLDG POOL PERMIT Additional desc Permit Fee 198.00 Plan Check Fee 128.70 Issue Date Valuation 19000 Qty Unit Charge Per Extension. BASE FEE' 45-00 17.00 9.000.0 THOU BLDG 2,001-25;000. 153.00, 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..0 0 1:00:'' 9.0000 EA MECH FURNACE <=100K 9.00 --------------- Permit . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00. Plan Check F'ee 11.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15..00 P:O. BOX 1504 • ��IG '1 � VOICE (760) 777-7012 78-495 CAL'LE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: _ Jr' 41a I Date: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION Fhe by affirm under penalty of perjury that I am licensed under visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals and my License is'n ull force -and effect.se Class n �Li�e e N 0 f ZZ�� 7 LJ OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of 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 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.). (; 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 Aof the work for whic this permit is issued. i I have and will main workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is i ued. My work compensation ins nce carrier and policy number ares artier icy Number _dyG 60C� _ 1 certify that in the perforthance of. the work for whih rmit 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, ! shou d become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WO kERS' COMPENSAfIQ4 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. 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 Lenders 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 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, indemnity 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. Almy permit issued as a result of this application becomes null and voidfalove-men rk 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 coI agree o comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county enter upo the oned property for inspection purposes. ate 6 Snatu re (Applicant or Agent): Page 2 Application Number 04-00005412 Date '7/12/04 Qty Unit Charge Per Extension 1..00 30.0000 EA ELEC•PRIVATE SWIMMING POOL" 30.00 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, VAULT„ PER APPROVED PLANS. ALARMS/BARRIERS SHALL BE IN PLACE AT ' PRE-PLASTER-INSPECTION.EQUIPMENT ' ENCLOSURE 'NOT INCLUDED Fee -summary Charged Paid Credited Due --------1--------------------------------------- ---------- Permit Fee Total 300.00 .00 .00 300.00 Plan Check Total 154.20 .00 .00 154.20 Grand Total 454..20 .00 ,.00 454.20 ,.t ..'�� ^:C �,. v ,.r; d :..:, .. �;::: .e.�..y...: .., ,... ..:w { ,..,.. y„,. ,r .: �.. F. ..'.:M ..:C �?.: 1 r?`- �, ., v ✓ t - t ,Y ..,.;,.> z ¢Y ..t d. .... v .. .� � ,:. ...._. > .. .2r ,« •.�;:,. ,. ,ir...s "�.,..._�.. xRi,a r ,. 4 u3 ... .. . �...� ak. k < .w.at A vc. f�4`x v�#a�.. z.^3_a . �'a.. � :+G:.. x. , > ¢:. _.. .... _ . - ..:i• , ..::.. , ' .� -;mi ., >a.,. .. .. x �.