05-5564 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00005564
Property Address: 57325 PASEO DEL LAGO
APN: 762-240-003-45 -300961-
Application description: STRUCTURES OTHER TTA
Property Zoning: MEDIUM DENSITY RES
Application valuation: . . 6000
Applicant: Architec or
4.4 QW4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
DEC 2 8 1005 Dll
LA
---------------------------------------------------
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.
License Class: C8{ C27. C29 License No.: 839002
,A,ate: I /f f V) Contractor/ Y
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
followingreason(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 statementthat 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:ofthe 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 fora permit subjects the applicant to a civil penalty of. not 'more than fiye•hundred dollars ($500).:
(_ 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 oroffered Jor sale (Sec. 704'4, .Business and Professions Code: -The
Contractors' State License Law does not apply town owner of property who builds or improves thereon,
_ and who does the work himself,orherself -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.).
(_) lam exempt under Sec. , B.&P.C. for this reason
J
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
Owner:
PUERTA AZUL PARTNERS
17700 SW UPPER BOONES
SUITE 100
PORTLAND, OR 97,224
Contractor:
RIPARIAN ENVIRONMENTS
P.O. BOX 13990
PALM DESERT, CA.92255
(760)398-9997
Lic. No.: 839002
VOICE (760) 777-70121 '
FAX (760) 777-'0+11
INSPECTIONS (760) 777-7153
FERRY RD
Date: 12/27/05
WORKER'S 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 -w- maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, -foi the -performance of the work for which this permit is issued:' My workers' compensation
insurance carrier and policy number are:'
Carrier STATE FUND Policy Number 1769754-2005
_ I certify that, in the performance of the work for whichthispermit 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
37700 of the Labor C de, I shall forthwith comply with those provisions.
IV 1 Applicant/ .(&S
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 madeto 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 to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Day Signature (Applicant or Agentl: I(
Application Number . . . . . 05-00005564
Permit
BUILDING PERMIT
Additional desc
Permit Fee . . . .
81.00
Plan Check
Fee
52.65
Issue Date . . . .
Valuation
. . .
. 6000
Expiration Date*...
6/25/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
4.00 9.0000
--------- -------------------------------
THOU BLDG 2,001-25,000
------------------------------------
36.00
Permit . . . . . . .
ELEC-MISCELLANEOUS.
Additional desc
Permit. Fee
26.00
Plan Check
Fee
6..50
I.9s'ue D ate.
Valuation
'
Expiration Date
6/25/06
.0
Qty: Unit Charge
Per.
Extension.�
BASE, FEE
15. 0.0
1.00. 11.00.00.EA
----------- -------------------------------
ELEC MISC
-------------
----------
11.00
---------------
Permit
PLUMBING
Additional':-desc
Permit,j Fee,
18.00
Plan Check
Fee
4 .50
Issue DaEet'',
Valua ion
0.
Expit.ataon Date
6/25,0611
Qty UnitChar9 e.
-*Per
Extension
BASE *.FEE .
i5.00
1.00 ..3.0000
EKPLB GAS PIPE
1-4 OUTLETS
3.00
-
------------------------------------- -----------------------------------
Special -Notes and Comments
FIREPLACE
----------- ---------
bther.*Fees . . . . .
-----------------------
. . . . ENERGY:REVIEW.FEE
-----------
7
-----
5.27,
'Fee summary. Charged
----------------- ------
Paid
--- ----------
Credited
---------- ----------
Due
Permit Fee Total
7
-125.60
'.00
.00
125.00
Plan -Check Total
0.65 -
.00
.00:
63.65
Other Fee Total
5.21
.00
.00
5.27
Grand Totdl--
193.92 *�
.00
.00
193.92
LQPERMIT
Bin #
City of La Qu'inta
Building & Safety Division .
P.O. Box 1304, .78=495 Calle Tampico
La Quinta, CA'92253_- (760)777-7012
Building Permit AppI catlon: and Tracking Sheet
Permit #
Project Address: �z .� oQ.LI � �
A. P. Number: I��J P f �el `(
" �"� 12- -e- �O
�.Owner'sName'.:._,'� of✓ -Cc�
•Address:� Pct r o
Legal Description: ('tom kc),j 1`e—
Contractor: AGI '- 14N — Ullzd,vA iNT-3
City, ST, Zip: L_` Q ✓tai
Telephone:
Address: ?IJ .o It •
ProjecctyDescription:
City, ST, Zip: 64:
l f2 I�l
Telephone: 2
State Lic. #.City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:(MG✓��f�
Construction. Type: Occupancy:
?.Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:. _ j
Estimated Value of Project:
APPLICANT .'DO,NOT'WRITE"BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Ian Sets
Plan Check -submitted
Item Amount
Structural Calcs.
Reviewed, ready. for corrections
Plan Check Deposit ...
Truss Calcs.
Called Contact Person
•Plan Check Balance
Energy Calcs.
Plans picked up
Construction T
Floodplain plan
Plans resubmitted
Mechanical
Grading. plan .
2wd Review, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person .
Plumbin
gio
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A:I:P.P.
Pub. Wks. Appr
Date of permit issue
�
School Fees
Total Permit Fees
0 OUTDOOR
� -
LIVING
PRODUCTSTM
Envision the beauty and charm of an outdoor fireplace.
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• OLP's firebox measures 30"x 30"
• A traditional running bond patter in all fireboxes
is standard.
ODL-model 30ON
Outdoor living Products (OLP) are manufactured with Glass
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fiberglass strands, sand, and acrylic allows our line of products
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Our team at OLP has four generations of experience with
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have designed and built have been enjoyed for -many years
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Quality -Service -Innovation -Pride.
Outdoor Living Products are covered under a one year
warranty and a five year limited warranty'
!a
Gas requirements
1. Fitted with 1/2" male adapter for your gas line.
Fireplace placement Do not place OLP model 300
under overhead combustible areas. Use only in well ventilated
areas. This product is for outdoor use only.
'Cracking and damage to exterior surface and color due to improper use 72"
are not covered in this warranty
40"
Dealer Information
APPROVED BY COMMUNITY O9WLOPMENTQ6EPARTMEM
DY
Mo Qi+Sa.. DAT€ Z • 2 - US
CXHIBIT _ /�lodef �lAtis
,CASE NO.
56" I
60"
i- 30" a
1( _3/2 r05 :47 _16OA35564
)/11%2005 09:10 FAX 382 D16 7765
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1 W-1ER I FL
OUTDOOR LIVING PRODUCTS
TECHNICAL AL DATA.
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