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RPL (04-5436)l' P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number '. . . . . 04-00005436 Date' 7/13/04 Property Address . . ... . . 51520 AVENIDA NAVARRO APN: 773-145-002-23 -000000- Application description . . . POOL - RESIDENTIAL Property Zoning COVE RESIDENTIAL ,Application valuation*. 11500 Owner Contractor ANDREWS BRUCE R MASTER POOLS AND SPAS 51520 AVENIDA-NAVARRO '73555 HIGHWAY 111 LA QUIN.TA CA"9225.3 PALM DESERT.; CA 92260. (7 60) 346-6115 WCC: STATE FUND WC: 157.6431 07/01/05 CSLB: 2389.47 03/31/05 CCC: C53. . Permit BLDG POOL PERMIT Additional desc Permit Fee . . . . 135.00 Plan Check Fee 87.75 Issue Date . . . . . Valuation 11500 Expiration Date, 1/13/05 Qty Unit Charge Per Extension BASE FEE 45.00 10.00 9.0000 THOU BLDG .2,00.1-25,000 ;. ,,9.0.00 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee . . . .. 45.00 Plan Check'Fee 11.25 Issue Date Valuation 0 Expiration Date.. 1/13/05 1. Qty Unit Charge Pere Extension BASE�FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit PLUMBING Additional desc Permit Fee 27.00 Plan Check Fee 6.75 Issue Date Valuation 0 Expiration Date 1/13/05 Qty Unit Charge Per Extension P:O. Box 1504 • ��G��/ 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Dq- 5�3� Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or Engineer's Address: AD IA. Lic. No.: BUILDING PERMIT DECLARATIONS 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 and my License is in full force- and effect. -,"License / 9-3'3 J/ 9 7 Class •G �� incense No. /gate `7-13 -y' 1/ torl"(.F-sT" P, le S 41 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 file 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 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.). U I am exempt under Sec. . 1 , 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 seiNnsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance -9. 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: Cartier SS%rte F'v t Policy Number `�� !r -< J 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 Code, l shall forthwith comply with those provisions. c pli WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND D 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 Lender's Address 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 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. 1 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 county to enter upon the above-mentioned property for inspection purposes. Date —E7 Signature (Applicant or A �`� Page 2, Application Number . . . .' . 04-00005436_ Date 7/13/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged -- - - - - - - - - - -- - - Paid Credited Due ------ - - - - -- Permit Fee Total .207.00 ---- - - - - --- .00 --- - - - - -- .00 ---- - - - - - - 207.00 Plan Check Total 105.75 .00 .00 105.75 Grand Total 312.75 00 .00 312.75 v. HATMSTAC4F STONE EX15T bFT TALL FOR ILLUSTRATION WATER FEATURE Top oF. GAP ♦18. BLOCK i�iALL NOT INCLUDED IN WITH MASTER POOLS ONLY GON7RAG t SPA So m w.sramw� STOVE ggg ll y irCL row 7W"c - BAR 7Ea'Itlll+ I I y c i r.+. TO.LTICfb I I 8 m�p e I 4 ' ® r I ^ In coNGrxsTE I I QG =Q ` <Q- � EXISTING CONCRETI TO REMAIN I X • Z Q tu I IZ bTi. � Z,< V1�f41Q min x w -� I I r to I �O u Itl�l�f`�i�irJ4 I 126WA -rem. S o2.0 AvC� ��V Yu IdentlflGatiOn Inforxnatlon ilh Assessment Number: ?13145002-11 yN I WA By on�9 ` 4 01-W-04Tax Property Typa: Real p Rate Area: Lo Quints W -8111 Number: 000642584 I Address Information Property Address:' 51520 AVENIDA NAVA4�RD LLA 11I�TA�� ��'��� F BUILDING & SAFETY DEPT.. -� APPROVED LOT.23 ELK 110 MB O18/O'1a SANTA CARMELITA AT VALE LA QUINTA NO SCR CONSTRUCTION I J hem I \ GUSTOMER SIGNATURE DATE_ VICINITY MAp: -PITA. v.