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04-4125 (RPL) (2)4 z��t�iEv N .__ ulreTo► 1r BUILDING & SAFETY'7DEPARTMENT 4�DEP (760),777-7012 -P.O. BOX 1504 FAX (760) 777-7011 cF 9 0>: 78-495 CALLE TAMPICO INSPECTION REQUESTS (760).777-7153 'ft�' LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number . . . . . 04-00004125 Date 5/12/04 Property Address . . . . . . - .S%- ot-3 vS �zol_ APN: 775-360-010-20 -28961 Application description POOL - RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 30000 511910 ¢ Owner ------------------------ Contractor RON & VICTORIA GRAY -------------=---------- CONSTRUCTION DESIGN SYSTEMS, I 80632 BELLRIVE 78401 HIGHWAY 111, SUITE F-2 LA QUINTA CA 92253 LA QUINTA CA 92253 (76 0) 771-3593 WCC: STATE FUND WC: 1709785-03 02/01/05 CSLB: 767086 08/31/05 CCC: A -B --------------------------------------------------------------------'-------- Permit . . . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/12/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ------------------------------------ • Permit . . . . . . ---------------------------------- BLDG POOL PERMIT ------ Additional desc . . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 30000 Expiration Date 5/12/05 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 ---------------------------------------------- Permit . . . . . . ----------------------------- ELEC POOL PERMIT -RES Additional desc Permit Fee. 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 5/12/05 Qty Unit -Charge Per Extension P.O. BOX 1504ICE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 Application Number: Applicant: Applicant's Mailing Address: BUILDING & SAFETY DEPARTMENT Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirmunder"pen ty 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 Lice is force and effect.J�, I Ucense Class license No. t Date t' O Contracto OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Aoy 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 Contractors' 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, 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 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.). (� 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarafions: I have and will maintain a certificate of consent to self4nsure 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 will maintain workers' compensation, insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pen -nit is issue . �ork-e• mpensation insurance carter n olicynu pr ret Carie[y✓ �'�1� ' Policy Number / /Y _ I certify that, in the performance of the work for which(his permitms issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, a ree that, if 1 sho / subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall � forthwith comply with those pro ' ions. j Date `� 0omApplicant WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE ISN WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITI TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 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 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 penton 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 cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above in n is correct 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this conn o ante pon the ntion roperty for inspection purposes. Date '� Signature (Applicant or Agent) a'o Page 2 Application Number . . . . . 04-00004125 Date 5/12/04 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 . . . . Valuation . . . . 0 Expiration Date . . 5/12/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA P -LB 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 ONLY. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged ----------------- ---------- Permit Fee Total 386.50 Plan Check Total 210.43 Grand Total 596.93 Paid Credited Due ---------- ---------- ---------- .00 .00 386.50 .00 .00 210.43 .00 .00 596.93 N cl- Ln Ln x U Cn 0 0 GOLF COURSE ......................... P/L ........................................ ........ umbrella sleeve quartzite spillway ------ ------- 510 ......... ....... P/A ............. V .................... +1811 sba ........................................................... .............bench ...................... pool lawn 43,0 f irepit 3$ A decking - .............................. ....................... ... . ..... ................... ................. ........... .... 14'0 mister system LOGGIA AREA —1516 — existing all CITY Oi LACWINT G )k BUILDINSAFETY DEPT. L G E light switch I AP OVED FOR CO _.O sTRuc 10 C . PON AND VICTORIA GRAY DIEJ0�� 11 - LOT 20 EAGLE SEND PLAN 1R, LA QUINTA, CA. 92253 P&A WEST 80-632 BELLRIVE 21'6 1 P/L 0 6' decking bbq ■ 7 G/E d.9 F H P EQUIP SCREENING WALL 4'H A RE -INSPECTION F E OF $30 WILLBECHAR DIFTH --'APPROVED PL AS AND JO 3 CARD kRE NOT ON TH SITE FIR A S HE11L11 p INSPECTION. S 1 May 13 04 03:14a CTX -USER 772-5572 p.2 FAIRWAYS ASSO)C. A r ION a r.s 6"32 Seile:tiVFr Qin ply. Pool, s AAF t., . = 1!i.� n p Leaf A At rile Aprii� ice'2004, !ii'C4' Recxuv-zv-.---- et— �ea:nn`es�iis@ ?'n;z?iiF1g the rm>7IEtCLe ,avzv,e¢ a;;a your so-gb ty",er9 plans with the following conditions: !,, we !•.- h 'a Urf n '— 6_-% f a [ tµ.nrdelineate V F��1 �� 1.7 �� p�i4' nb1f� :v Ci��v �! `i�!Y=5 ° y !'4 !F. ! Y aA! 6 1�1 q �.��ia�.i I L ?i�=: LJ with header board and give neduerS uu-a-i u �}+cwuoa.auv� w Ci Ff < g e si :roe% �-le Sld�3 n7-.-, `� Eii�' A aircas ►TiiA"s�( Equipment %Y-811 around the pool ec uiament to enclose and screen for noise ellbate n :Zen't nc_m�� c F... — �- -�:. ...�,.:...^�� the ia. s ' cur riibW w o -r ti.t310 ut "' ��:�P. �r:v !3i3i:� :Y °G� ��FD0.i�S!!I�i1a3'si1 u�a. 1�iucziiJ ar� vl,.� i:".J.pp..0 t- F?.��c 4�Y•� yr �.. Ste' 4).-l.�.Sji ami Cl,r a y��a itemr s. If You have any questions please do not nesitaie to conicac4 ihis u I e. 1 Y _r - \ � • AAY G4 i Ae----ol``iatt n Manager E 4°_V incP PUSS, 0--fice Boz 165%: - L; quint, Cati`or;a 43' 53 • e ens 7rn'}; 776-51.00 Fax '760)776-51111 Mar 03 05 03:37p CTk-USER 772-5572 p•1 RON AND VICTORIA GRAY 80-632 BELLE:RIVE LA QUINTA, CA. 92263 LA QUINTA BUILDING AND SAFETY ATTENTION: TO WHOM IT MAY CONCERN PLEASE ISSUE A NEW JOB CARD FOR THE COMPLETION OF OUR POOL CONSTRUCTION PROJECT AT 80.6:32 BELLERIVE. TO VICTORIA LANDSCAPES AND WATERFALLS. WE HAVE RETAINED THEM FOR THE PURPOSE OF FINISHING THE POOL AND SPA. THEY SHALL PROVIDE INSURANCE AND LICENSE CERTFICATES FOR THIS PURPOSE. MAR2 -73 0 '(1 � � Fe (c. e, ITPr 6ALTL)S(? tj p 15 � pD c o� o P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT ti� OFTY�� 78-495 CALLS TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX 760 777-7011 May 18, 2004 Ms. Esther Sanchez Riverside County Assessor's Office 3255 E Tahquitz Canyon Way, Ste 114 Palm Springs, CA 92262-6962 Dear Ms. Sanchez, Please be advised of an address change for the following structure. The structure formerly addressed as 80-632 Bellerive, permit # 0306-238, APN: 775-360-010, Lot 20, Tract 28961, is now addressed as: 56-043 Baltusrol Please note this change and contact me directly at (760) 777-7084 if I may be of further assistance. Sincerely, Kay Hensel Office Assistant 0 U