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11-0029 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11_00_000_629 Property Address: 54465 AVENIDA RAMIREZ APN: 774-243_023-12 -000000- Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL.,. Application valuation: 20,000.''• TA 4 :Y. BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DEGRANDMASON 54465-AVENIDA RAMIREZ LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/10/11 Contractor: -� Applicant: Architect or Engineer: WESTFALL PLASTER SRVCS , • K I J 74823• VELIE WAY PALM'DESERT, CA 92260' (760) 779-0639 Lic . No 664483 --- -- -- - ----- -,r J LICENSED CONTRACTOR'S DECLARATION r - WORKER'S COMPENSATION,,,.,. RATIO - I hereby affirm underJpenalty of perjury that I am licensed underprovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury_one ofthe following`declarations . i 'Section 7066)-ofpi3ision3 of the Business and Professionals Code, and my License is in full force and effect.' _ I have and will maintain a certificate,of;consent to self -insure for workers' om ';tion, as provided License Class: C3'5`�C53 - '+" ' License No.: 664483' - forby Se6ti6n:3700 of the LaoorCode, for.tne.performance of the work of�hich this permit -is' l�zl p_ . issued. ate 4 �bntractor:• ' - I, have and wilLmaintain workers' -compensation insurance; as requlred:by Sec"n 3700 of the Labor ' Code, for the performance ofthe.work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance' carrier and policy number.ares I hereby affirm under, penalty of perjury that I am exempt from the Contractor's State License Law for.the Carrier STATE FUND. _,. Policy Number -0009927-2009 following reason (Sec.'.7031.5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance;obthe.work for which this permit'is issued, I shall not employ'any construct, alter, improve, demolish; or repair any structure„prior to its issuance, also requires theappncant.for the person in any manner so as to become"..subject to the workers"compensation laws of California, permit to file:a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should become subject to the workers' compensation provisions of Section License Law;(Chapter 9 (commencing with. Section.7000).of; Division 3 of the Business arid. Professions Code) or :w 3700 of the Labor Code, I shall fo/rthhWiiy� comply with those' provisions. that he li she rsexemrn therefrom and PP basis for the l pepadyxempt'm An a'n fivuon d' ecI dollars ($50 by KWARNING: I ` p an applicant fora permit_ subjects thea licant to a civil penalt of not more _than hve�hundred dollars (5500)•: I Z �l A ant: (_) I, as owner of'the property,'or my employees�wiih wages'as their sole compensation will do. work, and - ` - the structure:is not intended or offered fo*rsale (Sec. 7044 Business'anC ProfessionsCbde: The FAILU TO SECURE WORKERS' COMPENSATION COVERAGE�IS UNLAWFUL, AND SHALL Contractors''State License Law`does not apply to an owner of property who builds orimproves thereon; AN EM LOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herselfthrough his,or her own employees; provided' that the S ($100;000). IN ADDITION TO THE COST OF COMPENSATION,. DAMAGES,ASPROVIDED FOR IN improJements'are' not intended or offered forsale.. If, however, the bwlduigor improvement is sold 'within SECTION 3706 OF THE LABOR CODE, INTEREST; AND ATTORNEY'S FEES: one year of completion, the owner -builder will have the burden of proving that he or shedid not build or " improve for the purpose4of sale.)..,.,» .w,t . -, ,;,, ,... •.« i - +r:r — > - • '• +�*� - -+AP,PLICANT,ACKNOWLEDGEMENT (_ 1 'I, as owner of'the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - 7044,•Business and Professions Code: The Contractors' State License taw does not apply to an owner'of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this 'application is made, each person at whose request and,for pursuant to the Contractors' State License Law:). 'whose benefit work is performed under or pursuant to any'permi{issued as a result of this application, (_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees.to, and shall defend, indemnify and hold harmless the City 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIIT 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 issuedas 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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this ou1nty go�enter upon eabove-mentioned property fo pe p oses.'nature (Applicant or Agent):+ 6'7'Y ki LQPERMIT - Application Number . . . . . 11-00000029 ' Permit BLDG POOL PERMIT - Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue.Dite Valuation 20060 Expiration Date . 7/09/11 Qty Unit.Charge Per Extension BASE FEE 45.-00 00 _ 9 .0000 THOU. •:-BLDG 2, 001-25, 000- ------------------------------------------------------------------- 162.00 Permit MECH POOL ". Additional dedc .. Permit. Feer 2.6.`00 Plan Check Fee -6.50 'Issuo-,-Date ` .. Valuation . . 0 Expiration Date 7/09/11 Qty .Unit.Charge Per Extension'.'. BASE FEE 15.60 1.00 11.0000 -EA MECH . FURNACE >100K 11=. 00 Pemi-t ELEC -POOL :,PERMIT -RES ,. Additional desc Permit_a„Fee 45.0'0' Plan 'Check. Fee 11.25 2 •. :is, ue: 'Date Valuation 0' Expiration Date7/09/11 `'. Qty Unit `Charge Per r Extension ' BASE FEE <. 1..00 3,0.0000 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 7/09/11 -.:. Qty.. -Unit Charge-. 'Per, _p —Extension— :Extension-.=BASE BASEFEE 15.00 2.00 6.0000,EAPLB 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 LQPERMIT LQPERMIT Bin_ # . " 0 4 - hta .YLa . Q. Bu Ialhg &T Safety dMv Ion P.O Boz' 1504, i& 495 61te Tampico La Q61061CA 92253----:(760J.777-'7012 9 Building Perm t.Appli6d6h and Tracking'Sheet Permit # Project Address:_ `�� E Owner.'s Name: (��• NQ .. q N A. P. Number: Address: E Legal Description: "City ST, Zip: Contractor: �'( ESI L l J�vlc Telephone:,. ,f'. f••.. Address:` 7y- g2 .VCc t -JA Project'Description:. pL-AN-Aoo SaA City, ST, ZiP: T' Telephone: , o632. State Lic. # : 41i City Lic. #I- Arch., ;Arch., Engr., Designer Address: City., ST, Zip: Telephone: 4 k'? .; , • State Lic. #: `� �b"' Name of Contact Person: Construction Type: Occupancy: Project; a circle one New Add'n Alter Repair Demo #.Stories: #Units: Telephone # of Contact Person: LQ i/X).. 7h 7 4 ;Estimated Value;of Project. r7 APPLICANT. DO NOT WRITE BELOWTHIS.:LINE ,• # Submittal Req'd Rec'd . TRACKING PERMIT FEES Plan Sets Plan Check.submitted Item Amount Structural Cake. Reviewed, ready for correctiods Plan Check Deposit Truss Coles. Called Contact Person PlanCheck Balance Tine 24 Coles. Plans picked up" Construction Flood plain plan Pians resubmitted ' Mechanical Grading plan 20° Review; ready,;for• corrections/issue Electrical Subcontactor List Called Contact Person Plumbing . Grant Deed .. Plans picked up S.M.I. H.O.A. Approval " Plans resubmitted Grading INHOUSE:- '' Reytew,aeady for:correctionsfissue D'eveloper-Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of"permit issue School Fees -77 Total Permit Fees •�.......p .., v � �.. ..,. ..�. ., r..�. ,.- ..e,a a'a+„vx.. -.; ti5 :u"v? i 'a""i N'. Y'+'v. �u 6? Fn o�,� = RO r cn cn i' c < m 1� A PP i i