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04-5029 (RPL)T4hf 4 4 4" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number Property Address . . . . APN: Application description Property Zoning . . . . . Application.valuation . . Owner ------------------------ BUHLER NED H 8.0712 BELLERIVE LA QUINTA CA 92253 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00005029 Date 80712 BELLERIVE 775-360-006-16 -28961 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 45000 6/11/04 Contractor ------------------------ ALPINE SERVICES P.O. BOX 4687 PALM DESERT CA 92261 WCC: STATE FUND WC: 229002323604 01/01/05 CSLB: 786324 10/31/04 CCC: C53 ---------------------------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date Valuation . . . . 0 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 . . . . 382.00 Plan Check Fee 248.30 Issue Date Valuation . . . . 45000 Qty Unit Charge Per Extension BASE FEE 252.00 20.00 6.5000 THOU BLDG 25,001-50,000 130.00 -----------------------=---------------------------------------------------- Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per 1.00 30.0000 EA BASE FEE ELEC PRIVATE SW4IMMING PO©L2004 Extension 15.00 30.00 P.O. Box 1504I4 CE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Li n is in full force and effect. License Class �` Lice No. Date t ( f Q IO ( Contractor OWNER -BUILDER 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: 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 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).): U 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 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.). U 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 Owner WORKERS' 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 �y��l d. My-werkers' compensation insurance carrier , cy �1q a(e: Carrier .)(�Y/ k f-�M Policy Number 04111 - oC S�e _ I certify that, the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date Applicant Applicant F-✓�r WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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. 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 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 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 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 county to enter upon the above-mentioned property for inspection purposes. Date—// 6 LO Signature (Applicant or Agent): Q Page 2 Application Number . . . . . 04-00005029 Date 6/17/04 ------------------------------------------------------------- Permit . . . . . . PLUMBING -------------- Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation. . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB 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 ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT .f. Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 80 - Qty Unit Charge Per Extension BASE FEE 15.00 Fee summary Charged --------------------------- ---------- Paid Credited ---------- Due ---------- Permit Fee Total 499.00 .00 .00 499.00 Plan Check Total 273.80 .00 .00 273.80 Grand Total 772.80 .00 .00 772.80 e+ Qum& V - Y q�mou�im� OF T 9 baa- 2'-0„ M�KiMUM U -TA I � 10 6-? WAL.L Il`} �� Naeiz Tip , e5" tox-p-,.C.M,0- A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND 10B CARD ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. NO EXCEPTIONS! VIOF LA QUINTA NG & SAFETY DEPT. APPROVED �;.�•'' r�.' �' mss'.. ® s FAIRWAYS ASSOCIA'T'ION June 15, 2004 Mr. & Mrs. Ned Buhler RE: 80-712 Bellerive Pool, Spa, Decking Dear Mr. & Mrs. Buhler: �oOp� At the June 14th, 2004, Architectural/Landscape Committee meeting the committee reviewed and approved the submitted plans with the following condition: the pool equipment must be enclosed for noise abatement. Please have your contractor stop by our office to make this change on the plans in our files. If you have any questions, please feel free to contact this office at any time. Sincerely, i } Nancy Dua , CACM, CCAM Association Manager ND/ncp CC: Alpine Services Post Office Box 1658 • La Quinta, California 92253 • Phone (760) 776-5100 • Fax (760) 776-5111 9 r �r- NUU. TOP 6F SU RFACL �' ��� Z � _ ' � � F—,r � �-- i L' TWAO V.C.T. 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