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05-4167 (RPL)(R P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Td4t 4 4 Q" Application Number: 0:5=00004167 Property Address: 56070 BALTUSROL APN: 775-360-015- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Applicant: Architect or Engineer: I 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. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION 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).: (_ 1 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 r 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 `1t 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. T� 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 f ate: �i � O;ifier: r U e ` r V V ! I&— 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: KUITNE 1515 EL CALIFORNIA BOULEVARD PASDENA, CA 91106 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/16/05 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. 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 Policy Number I certify that, in the performance of the work ar which this permit is issued, I shall not employ any person in any manner so as to become su ject to the workers' compensation laws of California, and agree that, if I should become subjec to the workers' compensation provisions of Section 37 0 o Labor o hall forthwith comply with t rovisions. �►13o c����;� y WARNING: FAILURE TO SECURE WORKERS' COMPEN TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANV 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 i work is not commenced within 180 days from date of issuance of such permit, or cessation of ork for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is cor ct. I agree to comply with all city and county ordinan sand state laws relating to building con ion, and r b authorize representatives of this county ter ion ve-mentioned property for i se Dat - gna�f�7r� (Aapbpolicant or Agent): Application Number . . . . . 05-00004167 Permit . . . BLDG POOL PERMIT Additional desc . Permit'Fee. 252.00 Plan Check Fee 163.80 Issue Date . . . . Valuation . . . . 25000 Expiration Date 3/15/06 Qty Unit Charge Per Extension BASE FEE 45.00 23.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 207.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 3/15/06 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 3/15/06 Qty Unit Charge Per Extension BASE .FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE.SWIMMING POOL 30.0.0 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/15/06 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA PLB FIXTURE 24.00 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; BARBECUE, SINK & 2 LQPERMIT Application Number . . . . 05-00004167 ---------------------------------------------------------------------------- Special Notes and Comments FIREPLACES. ALARMS/BARRIERS SHALL BE.IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. (TO REPLACE EXPIRED PERMIT #0402319) Fee summary Charged Paid Credited Due --------------------------------------------------------- •Permit Fee Total 368.00 .00 .00 368.00 Plan Check Total 192.80 .00 .00 192.80 Grand Total 560.80 .00 .00 560.80 LQPERMIT ����,� CITY OF LA QUINTA' SUB -CONTRACTOR LISTRZ _ JOB ADDRESS f PERMIT NUMBER OWNER NP� �,_�__ BUILDER This form shall be posIed on the job with he Building Inspection Card at all jimps in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of huildina permit. For each aoolicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade / Classification Contractor State::.Contractor's License Workeis Com emation Insurance City. Business License':::. Company Name Classification A, B, C-8) License Number (xxxxxx) Exp. Date (xxlxx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) pExp.-Date xx/xx) License Number (xxxx) Exp, Date(e.g. (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8) (�-,01 ^n CC,`--- P �•-�i Ql� / �o (© so1G ji \ Ct FRAMING (C-5) STRUCT. STEEL (C-51) MASONRY (C-29) F� — L �o G �E� ('01 3(0!� PLUMBING (C-36) C* LATH; PLASTER (C-35) s� QoaL— ( .�' `o ��o(� �O f3� ��b fpG ZS'? DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C=10) : L( � FL.'!,!y" s�� 5 Z u �} ''j P 3 i �� — S (07, C 'L-(I -Vo 04 r 3 ( N- 4(01�, ROOFING IC-39) SHEET METAL (C-43) FLOORING (C-15): GLAZING (C-17) INSULATION : (C-2) SEWAGE DISPk (G-42) PAINTING (C-'33) CERAMIC TILE (C-54) �ll.��� ��f✓- S ? 5T,�C Tv+ "04 <.70 CABINETS (C-6) FENCING (C-13) LANDSCAPING (C=27.) 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Q u O N J bn [ v a� o Cd b v [ v ,� " +r q U 1-4 � C� W [ fp (d •- a 0 V] Q V bpi /W, guy .� o° > 4 a E -0 a O O "0 El [ In v YO' i� Ov O +0V a� N O0 '° m c � v M +� C) O a O , 'AC A a� O O� cd u� E. Ly a L. 0.�� o� 0 °�� o 04 M 2OC G�°"� o� Q ME 1-4 ~ao W al i+ `.J o�o�� wY o.o �0 �� W c. n M��� - O [ ono a+ ti moo.° bA ^ i+ O cK �� o o°° o�� ��.a�� 4bo O [:i O c� a 0 0 0,I-a [ Q O O cd ° O O a� M� A ¢� wa0:� U1�a � a BMW) w O --U y Hti w>a eau �o.aaOk a� w d C7 cn -4 N O A d Qj r- P7 -. r w0V O in ^ El 'T VA°r°a�w' H O rn pA d a a P4 a Bin # ��� � � r� l� ° �� � � � • C f Permit # 05- 4161 Project Address: 5 A. P. Number: Legal Description; Contractor: x Address: City, ST, Zip: Y Telephone: K State Lic. # : x, Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic_ #: Name of Contact Person:�� Teiephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees rty o La Quinta Building W Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, G4 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheet tl/Y Owner's Name: X 49 �• (V C�,L� Address: y L City, ST, Zip: K Telephone: Project Description: )c City Lic. #: INW__ . Construction T e: YP Occupancy: Project type (circle one). - New Add'n Alter Repair Demo Sq. Ft.: #Stories: # Units: Estimated Value of Project: X p25Coo �— APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKING PERh11T FEES Plan Check submitted �� Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2"d Review, ready for correction ssur Electrical Called Contact Person �( Plumbing c:-.. Plans picked up S.111.1. Plans resubmitted Grading 1id Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. permit issue jDateof Lv17 1 Total Permit Fees