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RPL (05-1709)P.O. Box 1504 .4 • 1��j rV VOICE (760) 777-7012 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 `FAX. (760) 777-7 ' INSPECTIONS (760)777-71515 3 BUILDING & SAFETY DEPARTMENT Application Number: ty�� ` 7�_q Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: (0n/r1CA Groh Architect or Engineer's Address: Lic. No.: N -A BUILDING PERMIT DECLARATIONS ' 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 Li cep in full force and effect.vXe / �/ /, cense Class l License NO' ! v ate ) Contractors 'TQ OWNER -BUILDER DECLARATION I 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.). U 1, as owner of the property, am exclusively contracting with licensed contractors to construct tfie 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.). L) I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION 1 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 i sued. M workers' cQm ensation insurance carneyand policy umber are' arrier Sfax Q y �I Ly)(( p Policy Number✓ _ 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. 16te QJ Applicant /^ 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 ($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 A / ti IV Lender'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 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 Ouinta, 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 county to enter upon the ve-mentioned property r i spection purposes. Dat cs �/ .tL� 0 t/ Signature (Applicant or Agent): r� t ' Application Number . . 05-00001709 Permit . . . . BLDG POOL PERMIT Additional desc.. Permit Fee 437.00 Plan Check Fee 284.05 Issue Date . . Valuation 54502 Expiration Date 11/01/05 Qty Unit Charge Per Extension BASE FEE 414.50 5.00 4.5000 ---------------------------7----------------------------- THOU BLDG.50,0017100,000 22.50 Permit . . . MECH POOL Additional desc *Permit.Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation' 0 Expiration Date 11/01/05 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 11/01/05 Qty Unit Charge Per Extension, BASE FEE 15.00 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 Expiration Date 11/01/05 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 1-41 OUTLETS 3.00 Permit . . . WALL/FENCE PERMIT Additional desc Permit Fee* 15.00 Plan Check Fee .00 Issue Date Valuation . . . . ,498. Expiration Date 11/01/05 Qty Unit Charge Per Extension BASE FEE 15.00 -------------------------------------- Special-Notes and Comments POOL & SPA ONLY..25 L.F. 5' GARDEN WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -.PLASTER - i --------------- ------------------- ------------ ------------- -------------- Application Number 05-00001709 Special Notes and Comments INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary. Charged Paid Credited...` Due' Permit Fee Total. 556.00 00 .00 556.00, Plan Check Total 310.05 .00 .00 310.05 Grand Total 866.05. .00- .00 866.05 May PS '(I!; 06. 41 a' Jay Garnett _ (9511 302-766$ p 1 05/04/05 ..WED 17:35 FAXJrNmm @J 001 •. r..... .e � o rspovv+a's a w+-� 1 li i i �l �j - Apti19, 2005 - Mt. WiUiatn K Uawflon 57-145 Mountain View La (,Ninta CA 92253 Rc: Pool & Spa Application ' near Mr. Uotwsaw, x r llpvtil review your resnbtilittcd ph= and haw-' �- -. • -- BBQ is not appr�wed and must ve aubinivxdf r at their .4R= &tr- !tir �e pool and spa.` Y �+c Ifou ahvuld have any y yucstiow,picasc.,]v not hesitate to cantact ame. " - N C. Pa n. CAM CCAAQ Asst Assemi'A 'vu Magage; For the ArcEtitectural/lAlldscape Co>,nloittcc - C:e: file • y ' Pest Office Isom 1690 • La Quints, C OMbmia 92247• Phone (760) 77&.5100 - l+ea (76)776-5111' \�> TOM ,WEIS.K . 2.6 \\� . 450.3 450 FG `�, _ fir•, ; . ' EG C 45 I 30 �, aI _ �;l q�srs� n 5/..s(r 11#x57.50 S450�T]W7.6.1 450.:16 TF 9g6 3eR 25' 10 O 500, AD — 1-- ,��p�'2 r r'�`:. • - FFa 815 Sp -(� •,• ' P� e` � �f .'. ✓ , ' Pi- 57 - 44 450 8 p. N1 45 5 . 5, AD�_ '2 449 g S�— • A 15 TC . , Fl --GB 450.3 MOUNT] VIEW' 0 4 7.65 FL FG / G PAD=450:80 2 75 0�645 z 57-125 MOUNTAIN VIEW — • - ES —0.1 •fir e',s rdr •2 • t.( r A04 vet is 450.47 =0:2 45 0 45Q26 , FS 76 40 FS �o 7.64 TC \ 450.18 z �� 1 44 . 450.05 _ti h t IM1 FS � AN WM u.s 4 ,ted �; 5030 Opp 5690 7W J• 4 h 44g Y 0D s I a' \ ✓ �` AC 450.8 e .M 20 .:_ 449.81FG ( •�•„ - t .;: . (� � , , \•' AC �. FS\ 6 1 II e reit ` I �(I 4 I A( I ?' A?y lu X10 5 _ s, SVC `� X49 g h• 1 ' C! I I I = 452.0 \. 4498 -0.3 Cb• (. ` 448 q8 WM l� w