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RPL (04-7034)J BUILDING & SAFETY, DEPARTMENT (760)777-7012 1Ico. FAX (760) 777-7011 RNIA 92253 INSPECTION REQUESTS (760) 777-7153 3UILDING PERMIT Application Number, r 04-:00007034--- —, Date 11/02/04 Property Address �_.151680 AVENIDA NAVARRO- APN: 773-145-009=15--0-0-0-000-. Application description .. POOL - RESIDENTIAL Property Zoning COVE RESIDENTIAL Application valuation.. 15000 Owner Contractor JOE BIRDSELL VICTORIA LANDSCAPES/WATERFALL 51680 AVE. NAVARRO 8.2365 HIGHWAY 111, SUITE #104 LA QUINTAL CA 92253 INDIO CA 92201 (760) 863-3808 WCC: EVEREST.NTNL WC: 3800002849041 08/26/05 CSLB: 801813 12/31/05 CCC: C27-053 Permit . . . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee..-. 6.00 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 Permit BLDG POOL PERMIT Additional desc.: Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date Valuation . . . . 15000 Qty Unit Charge Per Extension BASE FEE 45.0.0' 13.00 . 9.0000 THOU BLDG 21,001-25,000 117:00 .Permit . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue. Date Valuation . . . 0 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 P.O. BOX 1504 • '�� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: tZ Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: i t,'4'd Architect or Engineer's d ess: 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 Code, and my Lic s ism Pi rce and effect. �% License'Class� License No. 0 0 Date i� Q Contractor OWNER-BUILDE 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. , 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 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 Policy Number 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 Califo ie, and agree that, if uld become subject to the workers' compensation provisions of Section 3700 of the labor Code, 1 shall forthwith comply with those ravisions. �� Date �� v Applica WARNING: FAILURE TO SECURE WOR ERS' 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. 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, indemnify and hold harmless the City of La Ouinta, 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 100 days from date of issuance of such permit, or cessation of work for 180 days will subject permit toc llation. I certify that I have read this application and state that the abov information is con, re to mpty with all city and county ordinances and state laws relating to building construction, no h reby authorize representatives of this co ty t6 enter u n he a ove-menti d property for inspection purposes. Date ` �/ Signature (Applicant or Agentd). v Page 2 1 Number . . . . . 04-00007034 rk Issue Date . . . . Valuation 0 Page 2 Application Number . . . . . 04-00007034 Date 11,/02/04 Issue Date . . . . Valuation 0 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 & S'PA ONLY. ALARMS/BARRIERS. SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT, INCLUDED IN PERMIT. Fee summary' Charged Paid Credited Due Permit Fee Total 264.00 .00 .00 264.00 Plan Check Total 130.80 .00 .00 130.80 Grand Total 394.80 .00 .00 394.80 • =RESIDENCE X5,0 CITY OF LA QUINTF LIGHT BUILDING & SAFETY DEF q SWITCH APPROVED 51-680 CALLE NAVARR® FO C NSTRUCTION LA QUINTA, CA. 92253 I ( C� BY DATE PATIO 90 17'0 C TWO CAR O` GARAGE l� 9'6� sE�� PLANTER U . ,. AREA. 14'3 I 400 st decking \ gate a 18'6 ru. L 4'4 A RE -INSPECTION FEE OF 8'0F�i WILL BE CHARGED IF THE APPF�t: 7Pu-4i4ND LEDU 3' 20'0 DRIVEWAY -9" •_.: PLANS AND JOB CARD ARE NO'i h PLANTER THE SITE FOR A SCHEDi.JILL3 +6„ 6'OA INSPECTION. POOL NO EXCEPTIONS! EQUIP 51-680 CALLS NAVARRO 4'0 LA QUINTA, CA. 92253 APPROACH � NEW WALL 5' MIN. STREET RESIDENCE `a LIGHT `-5'0 SWITCH A RE -INSPECTION FEE Of $30 / WILL BE CHARGED IF THE APPROVED 51-650 CALLS NAVARO PLANS AND JOB CARD ARE NOT ON LA QUINTA, CA. 92253 THE SITE FOR A. SCHEDULED INSPECTION. PATIO 9'0 N0 EXCEPTIONS! 17'0 TWO CAR GARAGE PLANTER 9'6 EEP EN SEAL AREA I It LP 20'0 DRIVEWAY -9° •:.:. PLANTER +6.1 6'0kREA POOL i EQUIP 51-650 CALLE NAVARRO 4'0 LA QUIN'TA, CA. 92.253 - APPROACH NEW WALL 5' MIN. STREET