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10-1401 (RPL)P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: c 10-00001401 Property Address: 81661 RUSTIC CANYON DR APN: 764-280-999-33 -300237- Application description: POOL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation:' 28000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. Lic Class: C10 C53 License No.:. 63433.8 Date:i ntractor: P, OWNER -BUILDER DECLARATION u 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 ($500).: (_) 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.). ' (_) 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: Pit Lender's Address: LQPERMIT Owner: ARMSTRONG 81661 RUSTIC CANYON DRIVE LA QUINTA, CA 92253 Contractor: RODRIGUEZ LANDSCAPE 79461 40TH AVENUE BERMUDA DUNES, CA 92 (760)345-8302 Lic. No.: 634338 VOICE (76.0) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/23/10 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. VII 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 MANFCTR ALLIANC Policy Number 2010010117887Z 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, I shallforthwith comply with those provisions.s.' bale o, 3 -11 plicant: �l l / t-(�.Ss 6t R� - J-7 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 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 cessationof 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 thiscounty to enter up the above-mentioned property for inspection purposes. /'c Pte: v 1 gnature (Applicant or Agent) AA �in5CA_-- LQPERAIIT Application Number . . . . . 10-00001401 Permit BLDG POOL PERMIT Additional desc'. Permit Fee . . 271.50 Plan Check Fee 176.48 Issue Date . . . . Valuation . . . . 28000 Expiration Date 6/21/11 Qty Unit Charge Per Extension BASE FEE 252.00 3.00 6.5000 ----------------------------------------------------------------------------- THOU BLDG 25,001-50,000 19.50 Permit MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 6/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 6/21/11 .Qty Unit Charge Per Extension BASE FEE, 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 3.0.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/21/11 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 Application Number . . . . . 10-00001401 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . 15.00 Plan Check Fee .. .00 Issue Date . . . . Valuation 240 Expiration Date 6/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------------ ------------------------------ Special Notes and Comments POOL/SPA, M, FYREPIT, 15 L.F. 4' BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT•PRE-PLASTER INSPECTION. 2007/2008 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 Fee summary Charged Paid Credited Due ---------- ---------- Permit Fee Total - 390.50 .00 .00 390.50 Plan Check Total 202.48 .00 .00 202.48 Other Fee Total 2.00 .00 .00 2.00 Grand Total 594.98 .00 .00 594.98 LQPERMIT .. Bin City of LaQ uinta But(ding 8i Safety Division P.O. Box 1504, 78-49S Calle Tampkn - to Qulnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Pennk \ �� u Project Address: A. P. Number: a Owner's Name en Address: ' •, Legal Description: �- Contractor: RI Telephone: (� Address: 0 Project Description: City, ST, Zip: C Telephone: 6 .3q5 SCJ `n State Lic. # : 33 tatty Lie. #; Arch., Engr., Designer. Address: City-, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction. Type- 00cupancy: Project type (circle one): ew Add'n Alter Repair Demo - Sq. Ft.: '°I # Stories: #Units: Telephone # of Contact Person: a- Estimated Value of Project aLoan APPLICANT: DO NOT WFM BELOW THIS UNE # Submittal Req'd Reed TRACIKING PERMPP FEES Pian Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan ChedkDeporit Truss Cala Called Contact Person Pian Cheek Balance Title 24 Cales. Plans picked np Construction Flood pin plan Plan resubmitted Mechanical Grading plan 2-! Review, ready for comectionLquue Electrical r Sabeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- - - — 3" Review, ready for cormetionstisme Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pab. Wks. Appr Date of permit lane, School Feu Total Permit Fees A� TIVAk kJ ZlRd0Hd A HHJNVgd ' aNPI urvxa-c-------------------- --� W _ ❑rlDDd I a ❑goo 1-0 lie -IQ '� k + �N LC'J c0 HMCO - a + i- ��. "60,41M.1cm �%Ls 1 NF � 11� I RIMM N dJ w Q If- +� 2iR,LNV'Id Ll � ElP,&,1aEq ❑ ❑ ❑ ------------ __ c4z I � cp � U 'yam U W z o o CDU Z U U Q U V W (j i z Q 00 G x Q Q I r� Z A Q H U 2 0- CD z z ° �4a Z ° °tu LU R ° N 1-U, Lu LU �%naaQQ Qom ° W O� O Q LH� � so Q Z ° IL a° a <¢ou _ J 1L v Q ° z= z m _i° 3 �kj< � w ¢ ~ ID z N �= A=13 a IDdJ � V V iu ; �i � � w 9 In Q��° N iH QL�Oa� w �dd� o� Q o � v- v- z z � 0 ' 8 ° -bk3- 5 �� z �o=N arr� 8 a� �� oQa< ooW No¢OL o� = ci tri 't ui z r aS O = cv tti �t ui .fl 1 co w Q U A v) A� 0 0o �F wr o F> H w E-E 0 zE"a 0 o a U U moo F z w IM U Az w qU� �P CA Aw p"wu�i w EU�