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05-4316 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t�1,44&Quum Application Number: 05-0000431_6 Property Address: 81355 NATIONAL DR. O APN: 767-570-002- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15200 Applicant: Architect or Engineer: wl � LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/26/05 0 Owner: BURNETT Q 81-355 NATIONAL DRIVE SEP 9 0 1005 LA QUINTA, CA 92253 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: License No.: /t Contractor: � : �-2 OWNE -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 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 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 Contractor: PICASSO POOLS, INC WCC: STATE FUND WC: 1709395" 12/01/05 CSLB: 810111 07/31/06 ------- - - -- -- -----t�---------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of p jury one. the following declarations: 1 have and will mainta a cert icata of consent to self -insure for workers' compensation, as provided for by Section 370 of th Labor Code, for the performance of the work for which this permit is issued. I have and will maintain ork rs' compensation insurance, as required by Section 3700 of the Labor Code, for the performa of the work for which this permit is issued. My workers' compensation insurance carrier and polic 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 3700 of the labor Co e, I shall forthwith ct`ly with those provisions. 6-a a: e: -1 Applicant: CZ 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 toJoui ing construction, and hereby authorize representatives of, tthh5pounty to enter upon the above-mentioneo d perty for ins tion purposes. Date/ Signature (Applicant or Agent): LQPERMrr Application.Number . . . . . 05-00004316 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 17.1.00 Plan Check Fee 111.15: Issue Date . . . . Valuation- 15136 Expiration Date 3/25/06 Qty Unit."Charge Per Extension BASE FEE 45.00 14.00 9.0000 THOU BLDG 2,001-25,000 126.00 Permit . ... MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 ` Expiration Date 3/25/06 Qty Unit Charge Per Extension BASE FEE 15.00.. 1.00 11.0000 EA MECH FURNACE 5100K 11.'00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check -Fee 11.25 - Issue Date . . . . Issue Valuation 0 Expiration Date .3/25/06 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 3/25/06 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 Permit . . . . WALL/FENCE PERMIT LQPERMrr Application Number . . 05-00004316 Permit. WALL/FENCE PERMIT Additional desc ` Permit Fee 15.00 Plan Check Fee r00., Issue Date,Valuation 64` Expiration'Date 3/25/06 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------------ --------------------- Special Notes and Comments POOL & SPA ONLY. 4 L.F: 4' EQUIPMENT. BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TOPRE-PLASTER INSPECTION. .. 'Foo cnmrri�ry - ('h�rrrcA Dpi ri ('ror0i t'oA T1..c LQPERMIT I IBinCjty of Quim2.. . Bu17�.BESafery Dnrsion P.O. Boz I.504, 78 : 93. Caiie Tangy = . IIPennfr Ir 2 -Quints, CA 92233 - (750) 7 T7012 Kdldin; Permit Application and Trackin J I Project AddtmEs I I P_. Adtir---s: Zip: �GepJ.J i Legal Desaipucn. Cin•. ST. Ctitttracs�r Dcsta•iptioti: A ^ , .� Proic� I City. S. gip•CID I f , 5tat; Lis 01 1 \ I Ciro Lic- r: C2)D �: : P rciL: Adart-- t Cin•, ST. Zip: - - -- -- =- _ _ _ - - Canslnttxion Typ: O:F' i TeL-phone == _ "sV' —L`:= ' - -- Prtije=t T -,-De (eirde one): iv�r Add'n h=r R.^p�r: Dano' i Stat: Lic. t: - -_ I r Stories: L'rim: � .I.ame�nf•Co>gatt:�ersor: _ Sq. rt_: f -T6_q)h enc r :)f Cbnm= Person: 4 k®© �tnnated Value orProi j APPLICANT: DO NOT WRI T c BELOW THIS LINE Submimal I. Rcq'd , R�'d TPUCF:ING ° i_fMT FEF ' Plan SetsI I I Plan &.k submitted I i I StrtCt�1 .mics RevieKed reads for corrections , Plan Chest Dcltos if Truss C21c.1 1111 Called Contact Person - I Plan Check E42nct Title 24 Cis picked up Gonstruetinn Plans pis\I I ' Tl'ood plats plan I I Plans resubmitted I Mectmniea) I Gradinz pan I I -" Rnirw. rctdr for correctionvi=sue I El_czzrieal Subeontaabr List ' I Called Contact Person I Plumbing IS_41 "G'ram Des Plans picked up .1. IIi 0_-�.AFProval I Pians rsubmined I Grading ` "Review. read v for corrtttioasitssue ` Dcvcloper lsttpac� rr . I Plaamit� t�proval (: I CaIied Contact Person F. I.F.P. I I;Pub. Wks. Appr I �' Datc or pertnit issue iTotal Permit qtr$ - ti