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RPL (05-2574)P.O. BOX 1504 ' 78-495 CALLE.TAMPICO ..LA QUINTA, CALIFORNIA 92253 Application Number: 05-00002574 Property Address: — 1340`NATIONAL DR 8 - APN: 767-570-004- - - Application description: -POOL - RESIDENTIAL ' Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 Applicant: K. jN %eA C 7-0jt2 Architect or Eng BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CHITWOOD HOYT -- 81-340 NATIONAL DRIVE LA QUINTA, CA 92253 -------------------------------------------------- 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. Licese lass: License No.: Dat 1 Contract •U S 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 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 k� 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).: (—) 1, 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 _ 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.). (_) 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: LQPERAIIT Contractor: PICASSO POOLS, INC WCC: STATE, FUND WC: 1709395 CSLB: 810111 - VOICE (760) 777-7012 FAX (760) 777-7011 . INSPECTIONS (760) 777-7153 12/01/05 07/31/06 Date: 6/24/05 ------------------------------------------------ WORKER'S 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 Y issued. 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 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 370000 of the Lab ode, I shall fortith comply with those provisions. D§fe: E'6. 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. 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 issuedasa 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 ilding construction, and hereby authorize representatives :of th' unty�I^t{o�enter upon the above-mentioned p perty for in ecti purposes. a: "1 Signature (Applicant or Agent): _� Application Number 05-00002574 Permit . . . . . BLDG POOL PERMIT Additional desc . Permit Fee . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 12/21/05 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ----------------------------------------------------------------------------- THOU BLDG 2,001-25,000 117.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 �- Issue Date Valuation . . . . 0 Expiration Date 12/21/05 _ 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 12/21/05 - 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 12/21/05 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 LQPERMIT LQPERA11T Application.Number 05-00002574 ---- --------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE -NOT INCLUDED IN PERMIT. Fee summary Charged Paid: . Credited Due Permit Fee Total 266.00 00 .00 266.00 Plan Check Total 131.30 .00 .00 131.30 Grand Total 397.30 .00 ..00 397.30 L �Vn Perini ;r i ' p_ P. 23unoer LSI D=cription. Cotttrac�r �Ac. Q c3s> l • Add,— Cm'. ST. Zip': 4C Telc hon w stat. Lic_ of Addr= Cm. -ST Zia'. Tel`pbanc: Staff U.C. -Marne?of Can a¢?t:rson: •Tc1cpfnne '� Df Cbntaa Pfrson: I jL -CIY of L2 Quin.t2' Bul7drng. E Safery Division P.O. Boz 1504, 784?5. Cabe i an, pito . !a Quinta, CA 9v3 - (760) 7777T70 12 Building Permit Applic-3 -on and Tracking kownes N=C: Lh �Addr=.- , ST. Zip: \S 7VII-cirphonc: 15CD 4 1 l ��{' Projc:s Dcsta-iptioti�a �E�tZ�!adll!L1Ulm a r- Construction T epc Oec: n -assn-�::;>;t:•:;::--<,.�_?„v:;�i�=-_ Prtije`r ripe (circ ie one J: New4dd'n ;:�itr R.^p�- Demo S.q.'rt : Stories: I U:ks: APPLICANT: DO NOT WRITE BELOW THIS LINE R Submitral I Rcq'd I R�'d C _ . _ TPUCT.'ING Ps__FP.ITT.FEES Yat Secs I I l Pan Check submined J�aU ` lirm I Amruut Str:rat sal Tales I I Reviewed_ ready for corrections I P:an Check Dgpos�l Trus Ca1= I Called Contact Pcrson. Pian Check Blanc Tile _ Cess Plans picked up I Constuutiioa mood plain plan I I - Plan resubmiaed Aieeisanicsl ' Gracing pin R n:int•. rctdv for corrrctiowA suc I Electrical � . Subenutaaar List ' ( Called Contact Person I Plumbing -Giaat Ded I Plans picked up S_tii.l. H:).AFProval I I Plans resubmitted ; -Grading '"Revirw. read.. for cort-fctiottsitssue Developer Ir' ca Fee Planning approval I: I Called Can.met PersonI A_LP.P. I I.Pub.'Wks Appr I Datc of permit muc 1 + Total PcrmiE,�Fus - - - - -� -- T T ..-------_ _._-_�- _---- -- - � -- � k i -. ��,,� i I � I I�