SOTB (05-3553)-P.O. BOX 1504
7$495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
(U5-00003553
Property Address:
81295 NATIONAL DR '
AM
767-500-014- -
Application description:
STRUCTURES OTHER THAN B
Property Zoning:
LOW DENSITY_ RESIDENTIAL
Application valuation:
2200
Applicant:
Tity/ 4 4 Q"
Architect or Engineer:
Al/a/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
EMERLING
81-295 NATIONAL DRIVE
M72005
LA QUINTA, CA 92253
Contractor:
PICASSO POOLS, INC
WCC: STATE FUND
WC: 1709395
CSLB: 810111
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 Busines and Professionals Code, and my License is in full force and effect.
License Class: 'cense o.:
-01 rhu-b
Date:'Cont ract r:
OWNER -BUILDER DECLARATION
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 the
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 1$5001.:
(_ 1 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 of proving 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 projects with a 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
1 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 .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 -
Date: 8/11/05
-12/01/05
07/31/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the folldwing declarations:
_ (.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 B C27 C53 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 asto become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
700 of the Labor Code,, IIshall fo [with comply with those provisions.
atFT e: �? Applicane' '•�i[ c��
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.
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 co my to enter upon the above-mentioned propert jar rasp ct n urposes.
D i
/16
ate: o Signature (Applicant,
LQPERMIT _ '
Application Number
05-00003553
Permit . . -BUILDING
PERMIT
Additional desc .
Permit Fee
54.00
Plan .Check Fee
35.10
Issue Date . . . .
Valuation
2200
Expiration Date
2/07/06"
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
1.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
9.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee,
16.35
Plan Check Fee
4.09,
Issue Date
Valuation . . .
. 0
Expiration.Date
2./07/06
Qty Unit Charge
Per
Extension.
BASE
FEE
15.00
3.00 .4500
----------------------------------------------------------------------------
EA ELEC
DEVICE/FIXTURE >20.
1.35
Permit
PLUMBING
Additional desc
Permit Fee
.18.00
Plan Check Fee
4.50
Issue Date
Valuation
0
Expiration Date
2/07/06
Qty Unit.Charge
Per
Extension
BASE
FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
-----------------------------------------7----------------
Special Notes and Comments
BBQ #3020914.
---------------------=-------------------------------------------------'-----
Other Fees
ENERGY REVIEW FEE
3.51
Fee summary Charged
Paid Credited
Due.
Permit Fee Total
88.35
.00 .00
88.3-5
Plan Check Total
43.69
.00 .00
43.69
Other Fee Total
3.51
.00 .00
3.51
Grand Total
135.55
` .00 .00
135.55
LQPERMIT _ '
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.0ty of L2 Quin.t2
Building. E SafPry- Derision •
P.O. Boz 1504, 78-495. Ca11e Tanpico .
is Quinca,- CA 51 3 - (760) 777-7012
-Ruitding- Permit Application and Tracking. Sheer.
z9c,Pro3etl mer s Name:
A.. P. Ni=b=Adaress:.
� - 5 y >u
Legal D=mipaon.
Cin•. ST. Zip: a C
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CottttacorQ
1 elephot c: 3 -
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ProjectDesciption: 3D I
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City. ST. Zip•
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Telephon
Statci.zc
City Lic. #: �M
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Telephone:
State Ur-:
=_ _ -x Y`> < "= >= : _ = ; << . Construction I y c: Ota �-:
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- - - Project type (circle one): Nets• Add'n Ait--r Reps - Dano
Natne�of-Coteau?etson:
$q. Ft_: r Stories R Ltrits
Tcl=annc of Cbntaa Person:nig
5 _ 4 ®® -mated Valve orPmiC^—*' ® r 00
APPL•1CANT : DO NOT WRITE BELOW THIS UNE
Submivai I
Req'd (
Rec'd
TRaCF;7NG
P-_R!.ffT FEES
Tian SetsI
i
Plan Check submittedI
q 0
Item I
:Amsunt
St=t:ral %ales: I
(
Reviewed. ready for corrections I
Plan Check Dcr.es:-i
Truss Cair– I
Called Contact Person.
Plan Check Bafancc
Ttie'z Cess.
I
Plans picked up I
Construction SOTO
f
:Mbbd plaits plan I
I
Plans resubmitted I
Mechanical
jGradiur pian I
I
„Recant. rctdc for eorrettionsrossue
Electrical +
i
Subenut2c%ar List
I
Calicd Contact Person I
Plumbing
'31 i 0 omT
-Crani Deni
Plans picked up
S �►i_l.
i
H 0–AFproval
I
''Plans resubmitted
I
'Grading
T.N HOUSS-
I -
,
'"'-Reviect• ready for correc-tiouvissue
Developer Impan Fee
{
Planning Lpproval '�.
I
Called Contact Person
I.Fub. Wks Appr
I
Datc of permit issue
I
Total PermiEtFets
�J