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05-0641 (RPL)1 T4hf 4 4 Q" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT z Number . . . . . 3dress . . . . . APN: Application description Property Zoning . . . . . Application valuation . . Owner ------------------------ LEMKE SUSAN J 8477 N CRESTWOOD PL WEST TERRA HAUTE IN 47885 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 X05-000-00641 Date 2/22/05 80625 CEDAR CREST 762-060-013- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 18000 Contractor -------- - --------------- CANYON VIEW POOLS, INC. 3465 LA CAMPANA WAY, #4 PALM SPRINGS CA 92262 WCC: AU INS WC: 00500024508, 01/01/06 CSLB: 779165 05/31/06 CCC: A -B ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 198.00 Plan Check 'Fee 128.70 Issue Date . . . . Valuation 18776 Qty Unit Charge Per Extension BASE FEE 45.00 17.00 9.0000 THOU BLDG 2,001-25,000 153.00 ---------------------------------------------------------------------------'- 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 . . . . . . 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�� VOICE (760) 777-7012 T-Vf 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 057 — 0 (0`f' / I Date: � _" Applicant: Applicant's Mailing Address: C D/V TRAC TOe Architect or Engineer: Architect or Engineer's Address: 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 bode, and m Lic nse . ' full force and effect. /� � Viicense Class License No. 2� / �01 ) elate e/ /�� Contractors WNER43UILDER 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 1, 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 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. M wo e ' p ation insurance carrier�nd ppllsyrpggral� ,/�^/�j� amer Y- Policy Number. / rV (/ (/ D._ `� (/�j _ I ceEpfy that, in the performanc f 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 , and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall �j forthwith comply with those provis' Q6 ✓ — �� 5 A,,plicant -/ WARNING: FAILURE TO SECURE W RKERS' C OVP ENSATION C GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND 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 ILIA 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 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 cor t. 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 r upon be mentioned roperty for inspection purposes. /ate �� / �0 ✓ Signature (Applicant or Agent): Application Number Issue Date . . . . 05-00000641 Valuation Page 2 Date 2/22/05 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 ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 224 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. 14 L.F. 4' EQUIPMENT BLOCK WALL. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. Fee summary Charged Paid ----------------- ---------- ---------- Permit Fee Total 315.00 .00 Plan Check Total 154.20 .00 Grand Total 469.20 .00 Credited Due .00 315.00 .00 154.20 .00 469.20 760-320-3667 _ MIMOU-V_ ] EW/SAUNDERS PAGE 02_ .__ v2/09/05,REVIS10N `r0 CITY OF LA QUINT BUILDING & SAFETY DEP-r. AN DATED 02/01/05 0' APPROVED FOR CONSTRUCTION ----------GOL COURTS ----------------- --- ---------- - ----------------------' DA Zf 0� BY Cil+ A RE -INSPECTION FEE OF $5.; FAPPROVED VVILL ',)t CHARGED IF TH_ PLANS AND JOB CARD ARE NOT ON 13'7 THE SITE FOR A SCHEDULED INSPECTION. --- -- ��---_ _ EXC.E TIONS! X - - -- *6" RAISED -CURB I+t \ T7 / SPA %� 5' 38 23 LF +16" —_ i��.'m ` 1 :a0 3 «__ 24'6 - T532 811- 97 81 - 9'7 V a) C i �` _i" 7'5 Scale in Feet 0123456 &L4 DECK DRAINS TIED IN TO EXISTING LANDSCAPE DRAINS OR ROUTED TO FRONT OF PROPERTY FOR PROPER DRAINAGE 0 CANYON VIEW FOOLS Jay Bishop Lemke Residence oftim:7M778 80625 Cedar Crest La Q ui i nta, CA 92235 CITY ®F A QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRU TION . DATE-�LL Y 111