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06-3827 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ' Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: T4ht 4 XP Q" 06-00003827 81570 BALBOA CT 764-280-999-8 -300237- STRUCTURES OTHER THAN BUILDINGS MEDIUM HIGH DENSITY RES 1500 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury tha I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine d Professionals Code, and my License is in full force and effect. License Clas :.0 C27 C29 LicenseNo.: 656128 f�tr.clo,: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and P fessions 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).: 1 _ I 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.). 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.). (_ 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: LQPERMfT Owner: HUSZER 81570 BALBOA CT. LA QUINTA, CA 92253 U Contractor: (' CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/25/06 �4�A44MY� h�It�RF `f'c. 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. _1 have and will maintain work rs' compensation insurance, as required by Section 3700 of the Labor Code, for the performance f the work for which this permit is issued. My workers' compensation insurance carrier and poll number are: Carrier SEABRIGHT Policy Number BB1060510 I certify that, in the perfor ce hew for which this permit is issued, I shall not.employ any person in any manners to b ome subject to the workers' compensation laws of California, and agree that, if I sho Id ecome bject to the workers' compensation provisions of Section /3700 of the Labor Co , haq forthNth comply with those provisions. WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TgTHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, I TEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made t the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this pplication. 1 . Each person upon whose behal this application is made, each person at whose request and for whose benefit work is perform 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 abo matioa is correct. I agree to comply with all City and c rfty ordinances and state laws relating to buildin co strut , n, and hereby authorize representatives of thi ounty tgRgier upon the ove-mentioned property ' pkction urposes. (Applicant or Agent): Application Number . . . . . 06-00003827 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee 22.75 Issue Date . . . . Valuation . . . . 1.500 Expiration Date 4/23/07 Qty •Unit Charge Per Extension BASE FEE 15.00 10.00 2.0000 ------------------------------------------------------ FIND BLDG 501-2,000 ----------------- 20.00 ----- .Permit . . . PLUMBING Additional desc . Permit Fee . . . . 18.00- Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/23/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 --------------------- -------------------------------------------------------- Special Notes and Comments FIREPIT PER APPROVED PLAN ONLY. Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total. ---------- 53.00 -------------------- .00 .00 53.00 Plan Check Total 27.25 .00 .00 27.25 Grand Total 80.25 .00 .00 80.25 LQPERMIT 7 GAS SHUTOFF VALVE GRAVEL LOCATED WITHIN 36° L AHTOR OF UNIT (TYP.) . 3-1/2' R F.S. N •�18 A. . METAL GAS RISER — jj 2" 0 DRAIN OR PROVIDE 12" DIAM. OPENING IN FOOTING GAS LINES. SHALL BE INSTALLED PER CPC FOR DEPTH, COURSE COVERAGE, AND PLACEMENT. SAND . WATER PROOF MEMBRANE STONE CAP #4 TIE STEEL #4 BAR VERT. AT. 32" O.C. 8x8x8 CMU; SOLID GROUT L311 CLR GRAVEL SUMP 3 CU. FT.. CRUSHED ROCK n OUTDOOR FIRE RING - STONE CAP IIJSIDE DIMENS��! - i C -- fl -4 TI E STSEL Ai WATE K pK®o11 I✓ 5UI,FA4a5 I_E H - I '.R o LIT CDO a SGALr GAS SIRS ts.T LJ v:L.. 7A G1XB1XB.OI� CMU S -OLID eFZOU i F'{R [N�