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06-2459 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA .92253 Application Number: 06-00002459 Property Address: 56150 BALTUSROL APN: 775 -360 -020 - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1000 T4ht 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT PIX -------------------------------------------------- +alicensed ONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury thunder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businesionals Code, and my License is in full force and effect. LicenseClass: CS C27 C29 LicenseNo.: 656128 % 1Date: G Contractor:R-BUILDER DECLARATION I hereby affirm under penalty of perjury thpt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business ns 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 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 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 contractors) licensed pursuant to the Contractors' State License Law.). (_) 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: A&A LQPERDIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 /21A/06 Owner: KELLEY :o 0 56-150 BALTUSROL c=:?N LA QUINTA, CA 92253 a� a � Contractor: CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, CA 92236 D (760)398-9222 Lic. No.: 656128 ----------------------------------------------- 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 SEABRIGHT Policy Number BB1060510 _ 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 toecom bec me subject to the workers' compensation laws of California, and agree that, if I should bjsubject to the the compensation provisions of Section 37700�of the Labor'Code, I shall with comply with those provisions. AateAr��_�I' Applicant: WARNING: FAILURE TO SECURE WORKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO T E 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 fora 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 abov formation is correct. I agree to comply with all city and coup y ordinances and state laws relating to building ction, and hereby authorize representatives of tIrrun to ter upon the above-mentioned property r i ec on purposes. ignatu a (Applicant or Agent): Application Number . . '. . . 06-00002459 Permit PLUMBING Additional desc . - Permit Fee 18.00• Plan Check Fee 4.50, Issue Date . . . . Valuation . . . . 0 Expiration Date 12/18/06 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 GAS LINE ONLY FOR FUTURE FIREPIT. FIREPIT REQUIRES A SEPARATE PERMIT Fee summary Charged Paid Credited Due ----------------- Permit Fee Total -------------------- 18.00 ---------- .00 ---------- .00 18.00 Plan Check Total 4.50 .00 .00 4.50 Grand Total 22.50 .00 .00 22.50 LQPERAIIT B,R #Quanta . . Buli din S ,,a et Diuis, n gJ$L R:O''Box:15g4 7P8`=:4:95-'Gal(eTam ico Rerritit # La Qu►nta, Ck 92253 (760) 777.7012 `. Bu1[d�ng PermI,t pp[lcatiozn and Trac ng Sheet A Pro ect:Address. �� .S� G E1 mber: �. Address:. , ... L D cr hon. ............ . :. Ct T• �'C o 'tra to n �J ,T as - �..... Address:. . �P S, R66" , . roJect�Desccpt•►.on �; P Ci ST ZtVY 39�g2Z ff ty;Lic: �# Aich.; Engr.,"Designer: ... .�. Ci., ST" :.:... i�,Tele v. hon Occi `an ="Corisha►ctiod:T: e Er" e�`ne A dd-n Al circl o P.: n :. ......:::... #..Units: ame o C tact Pe o + _.; Tele h on o C ntachE rson: �. : ;B' `eet• � C7 stiinatedsValiie of:Ero T, .t).O�.:NOT WRITE,tiELOW�;THIS.;L-tN6:::' ,: yC:• ��`� F.. _.:. �., :"::, r .. ..: ., :.. .,}.' Submtittal;: t:Rec,d».. ':�1" �'�i�? .&fi r.;. h, =5;::'y`'^'Sis'�`�a�iai�. PER1Vi1T BEES.' :Re .d .:..:1.'-IauSets. �,}l'.Ianat�Geck�sadaiitted�' ';Item Amount - ' 'Stii►etural Calts. _ Reviewed `Xeady:for: corrections P:{an Ctieck Deposit "Tiuss`Calcs. *:Called Coutact'Persori ' Ylan Check Balance Energy ,Gales. P. awns plcked;upCinstiiiction." .:. Flood; la►n, an . ,:.. ;;#PtansresiStiinittid;:.:;.::::;.; : w14lgch , Gradingplan' e2""aeview;<readp for :corcections(ssue Electrical SulicoiitactorList ... . ;:,Called.Contact;Person;,.;.:..;Elariibirig Grant Deed A A ` , f6val � '`Plans Fesub� M. Gradin ` EIOUSEc-" / 11Review; ready.°torico rC ectionsrssue ;1)evelo'per Impact Fee. .;IN. Planning Approval ft- / Called Contact Per, s o^� PP f, 1, I)a e:of<.pe , }it;i ue. School Fees /OAt :..., , Total'Perinit Fees