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05-0821 (RPL)P.O. Box 1504 OF94� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 D BUILDING PERMIT MaR 14 INS BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Wa P�tio Number . . . . ��5-00Q0.0821 Date 3/11/05 y Address . . .. . . 53725 AVENIDA RUBIO APN: 774-112-029-12 -000000- Application description . . . POOL - RESIDENTIAL Property Zoning COVE RESIDENTIAL Application valuation 8000 Owner CORNEL ENTERPRISES 51-105 AVENIDA VILLA STE 101 LA QUINTA CA 92253 Contractor CORONEL CONSTRUCTION P.O. BOX 389 LA QUINTA CA 92247 (760) .564-4604 WCC: STATE FUND WC: 174445305 01/01/06 CSLB: 634981 01/31/06 CCC: B -C13 ---------------------------------------------------------------------------- Permit . . . . . . BLDG'POOL PERMIT Additional desc Permit Fee 99.00 Plan Check Fee 64.35 Issue Date Valuation . . . . 8000 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 ---------------------------------------------------------------------------- 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 ----------7----------------7----------------7------------------------------- Permit . . . . . PLUMBING Additional desc P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA,'CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application ;umber: o3-- 0 77 7 Applicant: I Architect or Engineer: Date: S. 1q. Applicant's Mailing Address: (?�tv -rr-,�Cro/-c Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS g LICENSED CONTRACTOR'S DECLARATION I hereby affirm unser penalty of perjury that I am licensed under provisions of Qbapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licen is in full force and effect. a 1 tens/e Class L' ense No. O D&t� `moi-1�f-t�5 Contractor OWNER -BUILDER DECLARATION I hereby affirm uncer 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 of county that -equires 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 CSde) 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 •he 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 asd 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 Licen 3e 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 wider Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm uncer 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. 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 workers' �ss�ed. �41C kers' compensation insurance carrier policy numb[ are: arrier �S-.�.��c Z Policy Number ,5i _ I certify that, in the performance of the work for which this pe it is is ued, I shall not employ any person in any manner so as to become subject to the workers' compensationlaws of Cal p ia, and agree th I sho beco subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall fort iwith comply with thos p visions. Dkte 3--x-4-05 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE GE 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 0= THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm uncer 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 Quinta, its officerE, 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 ab "nformati n is torr . I ag ee to mply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this co ty o enter pon th ab e- enti ed property for inspection purposes. Date S"1,� Signature (Applicant or Agent): a Page 2 Application Number 05-00000821 Date 3/11/05 Permit Fee . . . . 33.00 Plan Check Fee . . 8.25 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 & SPA. ALARMS/BARRIERS SHALL BE IN 'PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN . PERMIT. Fee summary ----------------- Charged Paid Credited Due Permit Fee ---------- ---------- ---------- Total 201.00 .00 .00 ---------- 201.00 Plan Check Total 89.85 .00 .00 89.85 Grand Total 290.85 .00 .00 290.85