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RPL (05-0207))x 1504 CALLE TAMPICO NTA, CALIFORNIA 92253 .mber rroperzy tiaaress . . . APN: Application description Property Zoning . . . . . Application valuation . . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 5-00 0000207 Date 1/31/05 81120 NATIONAL DR- 767-600-003- POOL'- RESIDENTIAL LOW DENSITY RESIDENTIAL 28000 Owner Contractor EHLINE CO. VICTORIA LANDSCAPES/WATERFALL 81-120 NATIONAL DR. 82.365 HIGHWAY 111, SUITE #104 LA QUINTA CA 92253 INDIO CA 92201 (760) 863-3808 WCC: EVEREST NTNL WC:- .38000028 49041 08/26/05 CSLB: 801813 12/31/05 CCC: C27-053 Permit . . BLDG POOL PERMIT Additional desc " Permit Fee . . . . 271.50 Plan Check Fee 176.48 Issue Date . . . . Valuation . . . . 28000 Expiration Date 7/28/05 Qty. Unit Charge Per Extension BASE FEE 252.00 3.00 6.5000 THOU BLDG 25,001-50,000 19.50 `1 -----------------------------------------------•----------=------------------ Permit . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee'. 6.00 Issue Date . . . . Valuation .". 0 Expiration Date 7/28/05 Qty Unit Charge Per Extension . BASE FEE 15.00 1.00 9.0000 ---------------------------------------------------------------------------- EA MECH FURNACE <=100K 9.00 Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 -------------------------- EA ELEC ------------ PRIVATE SWIMMING POOL ----------------------- 3'0.00. --------- - - - - -- P.O. BOC 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: a Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED'CONTRACTOR'S DECLARATION I hereby affirm under penalty of pe ury 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 e 11 fol c nd ect.D ry License Class°[icense No. (� D,3te Contracto 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 rile 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 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 1 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 issued. My workers' compensation insurance carrier and policy number are: Carrier ( Policy Number _ 1 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 Califomia, nd agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall ��,y forthwith comply with those pr is ns. ^ "6ate,2 A Applicant - (UY' WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, 4 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 Lender's Address ' s 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 Ouinta, its officers, agents and employees for any act or omission related to the work being perforated 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 atwve int tion 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 coun a ter upon the abov ned property for inspection purposes. 1// Date � Signature (Applicant or Agent): �A i. Page 2 Application Number . . . . . 05-00000207 Date 1/31/05 Permit . . . . . . PLUMBING Additional desc Permit Fee . . 33.00 Plan Check Fee 8.25 Issue Date . . . Valuation . . . . 0 Expiration Date... 7/28/05 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 1-4 OUTLETS 3.00 Special Notes and Comments POOL & SPA ONLY. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged.. Paid Credited Due Permit Fee Total 373.50 .00 .00 373.50 Plan Check Total 201.98 .00 .00 201.98 Grand Total 575.48 .00 .00 575.48 .-. _ r �. t ate,• . • a '•n- � 2. ERLUEM ' . Builders & Developers ` Scott Young - ' , General Superintendent 78-900 Avenue 47 Suite 102 La Quinta, CA 92253 ` s (760) 771-8130 / Fax (760) 777-8790 F Cell (760) 469-7175 syoung@ehlinedevco.com « _email: www.ehlinedevco.com • y¢ .• , J • +ter , •. , r.• � ' .. + _ � .. •.. , ' ! r. r , , - , 1• .. « � � }�• " • Y' - mfr . - _ �.77o Cfi 4 ` T :*.tewM+�ai..•ux.�n �`.•:J.+w ��i. a+l :r•-•? ax.r.�fi.s -Y / .��('�e j'�. vvsv..rex.:..e"�=r "aa-J`'�^,�-7�R3`�'r4�� wit`. .. .�'� � :�"3✓f��