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BLCK (05-4806)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 'Applicant: Architect or Enc P JA BUILDING &.SAFETY DEPARTMENT BUILDING PERMIT 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. License Class: B C27 C53 'cense No.: 810111 ate:rj'a,1 ontractor: se+r 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 they. 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).: (_) 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 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 ofproving that he or she did not build or improve for the purpose of sale.). (_ 1 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 projectswitha contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 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: ` LQPERMIT Owner: CHARLES ROE 81255 NATIONAL DRIVE LA QUINTA, CA 92253 Contractor: PICASSO POOLS, INC 78078 COUNTRY CLUB DR,.4206 PALM DESERT, CA 92211 (760) 345-'4600 Lic. No.: 810111 VOICE (7 60) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/26/05 ---------------------------------------------- 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, A 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' 370�theant. r Code, I shall forthwithcomply with those provisions. atei // e/Jlr�? 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' 1$ 100,0001. 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. 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 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 unty to enter upon t ove-mentioned property for inspection purposes. gn ature (Applicant or Agent): CJ/hr��++�� Application Number: ( 005-000.0.004806 Property Address: �81?55 NATIONAL—DR APN: 767 -500 -012 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 64 'Applicant: Architect or Enc P JA BUILDING &.SAFETY DEPARTMENT BUILDING PERMIT 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. License Class: B C27 C53 'cense No.: 810111 ate:rj'a,1 ontractor: se+r 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 they. 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).: (_) 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 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 ofproving that he or she did not build or improve for the purpose of sale.). (_ 1 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 projectswitha contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 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: ` LQPERMIT Owner: CHARLES ROE 81255 NATIONAL DRIVE LA QUINTA, CA 92253 Contractor: PICASSO POOLS, INC 78078 COUNTRY CLUB DR,.4206 PALM DESERT, CA 92211 (760) 345-'4600 Lic. No.: 810111 VOICE (7 60) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/26/05 ---------------------------------------------- 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, A 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' 370�theant. r Code, I shall forthwithcomply with those provisions. atei // e/Jlr�? 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' 1$ 100,0001. 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. 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 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 unty to enter upon t ove-mentioned property for inspection purposes. gn ature (Applicant or Agent): CJ/hr��++�� Application Number . . . 05-00004806 Permit . . . WALL/FENCE PERMIT ' Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 64 Expiration Date 4/24/06 Qty Unit Charge Per Extension BASE FEE 15.00 - ----------------------------------------------------------------------------- Special Notes and Comments 4 L.F. 4' EQUIPMENT WALL, CITY STANDARD Fee summary Charged Paid Credited Due ----------- ---------- Permit Fee Total 15:00 ..00 ---------- .00 15.00 Plan Check Total .00 .00 .00 .00 Grand Total .15.00 .00 00 15.00 Oct•26, 2005 4:48PM PICASSO POOLS No•1694 P• 2 -Crty of L2 Qu'lm'- • - B�rliarng• � S�� Dassnrs • • . P.O. Bar 1504, 7,F9S• Cabe T2mocp . iPerFru> La QrArua, Gq 92. 53 - (760) i7-7012 c�Uly BuRdfnc- Permit Applicadon and Tradda, Shy. ; i Prc�em Adams P042 lei s Cin•. ST. Zip: 9 �� Cputrar i dcphor �.'1` 1 7 .Ads 3vi , l' Proles )aesq ipriori TcJEq, I-LILZMRna-, Ch)., ST- Td�b ZiF- FCan�uction T1 - Sw= k;L A: " - Proje:l n•pr -jr- ] t=o- t�e'.af CLQ?et5aa Sq. Ft:,f Srorics f : L -i= •Tcl=k c Df Cfm= Value orPmir� APfUCAM:-DO NOT WRITE SaOW THLS LINE Sabmi�xl { R.eq'd I He'd 77tACxINE PEI"tfIT Ft5 1ptn c;g + Plan Cbrck submimd hun /�manot Strnfl=l Lsl= I ' R,'wi—ed. rt2dy for corremons Pao Chrck Deese ;r= Cam Called Coasaes Persao . Plan Cbeci: 9240= •i t�e_a C PEaris picked up I Caasrrvetioa ;Toad➢L=p Plan ; Plans r=bmicLd ' hrncaaaical Lradi1� pPan ;476M rcndh- for CD, MLioasiasnr ]tctricil Snbmarrce�r 1 of I . Capert JCDF=ct Ptrsoo I l'iumbi� - I Giaosi ]les Plans pitixd up �4LL . • I f3:J.�AFproai •! '�'laos resubmirsrd •Grad'rag •M RCU5^- Revirw. rtad}• for mrrrrbonsrmue � I)t vrlaper l:ulan ret Plsamen, L prmal Called Conrad Ptmn I.Pua �pfrr • Aau otpermit iscne - . 7-7 Q Oct,26. 2005 4:49PM PICASSO POOLS' No 1694 P .3.= PICrS50 i CC?L:i 78 078 COUNTRY CL�3 DR. 4266 BERMUDA DUNES, CA, 92203 CITY STANDARD WALL - 4' HIGH. 6' WIDE 4' LONG EQUIPMENT BLOCK WALL STUCCO AND PAINT TO MATCH.HOME P/E icy c' �u �