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07-3199 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY. DEPARTMENT BUILDING PERMIT Application Number: 07-00003199 4 Property Address: 81700 RUSTIC CANYON .DR APN: 764-280-999-131 -300237- Application description: POOL - RESIDENTIAL Property Zonjnq: MEDIUM HbQH DENSITY RES Application valuation: 28000 Applicant: `� Architect or Engineer: '� 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 7anProfessio als Code, and my License is in full force and effect. License Class: C53 LicenseNo.: 840397 Date: V Contractor: OWN -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exe pt 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 70001 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).: (_ 1 1, 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.). (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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: Lender's Address: LQPERMIT Owner: CHRIS WALT 81700 RUSTIC CANYON DRIVE LA QUINTA, CA 92253 Contractor: LOZANO PROF POOL P.O. BOX 11272 PALM DESERT, CA (760)275-4647 LiC. No.: 840397 CONST, 92255 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/03/08 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' compensati , 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'EXEMPT Policy Number EXEMPT 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 beco a subje t to the workers' compensation provisions of Section 3700 of the Labor Cod , I sh forthw' comply with those provisions. Date: — 3'—V(, Appli21 cant: WARNING: FAILURE TO SECURE WORKERS' COM SATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE 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 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 build' g co structio and hereby authorize representatives of this county to enter upon the above-mentioned prop for ' spectio urposes. Date: (— z _Uf7 Signature (Applicant or. Agent.: t Application Number . . . ._. 07-00003199 Permit . . . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . r Valuation . . . . 0 Expiration Date 7/01/08 Qty Unit Charge` Per Extension BASE FEE 15.00- 1.00 11.0000 EA' MECH FURNACE '>100K 11.00 Permit . . . BLDG, POOL PERMIT. Additional desc Permit Fee 271.50 Plan Check Fee 176.48 Issue Date . . . . Valuation . . . . 27680 Expiration Date 7/01/08 Qty Unit Charge Per Extension BASE FEE 252.00 3.00, 6..5000 ----------------------------------------------------------------------------- THOU BLDG 25,001-50,000 19.50 • Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee— 11'.25' Issue Date Valuation 0' Expiration Date 7/01/08 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 -' Issue Date . a . . Valuation . . . 0 Expiration Date 7/01/08 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 LQPERMIT Application Number . . . . . 07-00003199 Permit. . . . . WALL/FENCE PERMIT - Additional desc . Permit Fee 15.00., Plan Check Fee .00 Issue Date Valuation - 320 Expiration Date 7/01/08 Qty Unit Charge Per Extension BASE FEE 15.00 Special Notes_ and Comments ---- POOL/SPA, 20 L.F. 4' EQUIPMENT WALL, CITY.STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT:PRE-PLASTER INSPECTION. Fee summaryCharged Paid Credited Due _ - Permit Fee Total 390.50 .00 .00 390.50 Plan Check Total 202.48 .00 .00 202,.48 Grand Total 592.98 .00 .00 592.98 Bin # of -La, -,Q nta •� ,City * M Building & Safety Division , P:O. Box 1504, 78-495 Calle Tampico Permit # \(� �. , - La QuintaCA 92253 (760) 777-7012. '• ' ` J$uilding Permit Application and Tracking Sheet f .Project Address: 54 t-7 V v Owner's Name: AL ' A. P, Number: �} Address: 6:1- 7b vC,-4A J 1J Legal Description: City, ST, Zip: .Contractor: A Kc, Lo l U L Telephone:. Address:: PO --' b /'L • 1 60 Project Description:�- ,City; ST, Zip:`e,,—N' �.'`. C� Telephone: State Lic. # : Q O 3. City Lin. #:' S9 f U Arch.' Engr.', Designer:'.Address: 'City, ST, Zip: - 1, M,. Telephone: r Construction Type: Occupanc State Lic. #: Project type (circle one): New Add' 1 Alter Repair Demo Sq. Ft`. #Stories: # Units: Name of Contact Person: M t`l �!L 5 7 q ✓l l� Telephone # of Contact Person: % (0 - Estimated Value of Project: O04C APPLICANT:'DO�NOT WRITE BELOW THIS LINE •� " Submittal "Req'd Recd TRACKING. PERMIT. FEES Plan Sets` • Plan Check submitted `%� 4 Item Amount _ Structural Calcs.; Reviewed,•ready for corrections Plan ChecicDeposit ' Truss Calcs. Called Contact Person Plan CheckBalance ' Energy Calcs. Plans picked up -: -Constructim Floodplain plan " `' f Plans resubmitted Mechanical { Grading. plan 2nd Review, ready for corrections/issue Electrical t Subcontactor List r. Called Contact Person Plumbing, Grant•Deed , Plans picked up S.M.I. + , - H:O.A. Approval Plans resubmitted _ Grading iN HOUSE:- ' . ''d Review, ready for-corrections/issue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr i .. Date'of permit issue _ h School,Fees - .. 1 Total Permit Fees t A - -. rs - 7 4 �� { - • r �r' . i • • ' r . ' ' i ' - T �i /\/v1 O .- .. l' Z o o � v , (� LEI Cc CS y t c1' i -CIT . SUB -CONTRACTOR ��UK . ~~~~'^^D~^'-~ - �b—| ' This form shall be posted on the w th,the. Builhing Inspection Card at all times in a conspicuous l2lace. Onlypersonsappmahn0onthis|iotmrthe/ronm_o1oyoeoereouthor�ad to on this job. /\nv changes /s~ 66 by the Buikdi' ' �oion ' to* of work. unak' Fai|tonk/.result in a stoppage of work and/or the voidance. ' � .�ato��a |�must approved k/commencement oo'n��U ' of building permit. For each applicable tra.de, all intormation requested below must be completed by applicant. --un i-iie-! is not an acceptame response. ` ......... Company Name Classification License Number Exp. Date Carrier,Name Policy Number Exp. Date License Number Exp. Date (e.g. A, B -8) (xxxxxx). Ae.g. State Fund, CalComp) (Format Varies) (xx/xX' /xx) (xxxxY (kx/xx/xx) C_ 341 EZ `