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04-4682 (RPL)t O�p: BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760),777.;7.01.2. 78-495 CALLS TAMPICo FAX (760) 777=7011 " Ln QurxTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153.-- 214 760)777-7153.214 BUILDING PERMIT Ap'p1= 777777, 1orr Number . . . 04-00004682 Date 6/01/04 Property Address . . . . 80760 BELLERIVE APN.: 77573.60.-004-14 -28961 - Application description ._ .. P.00L."- RESIDENTIAL Property Zoning .. . . LOW DENSITY RESIDENTIAL Ap' licat.ion -valuation 19000 Owner. Contractor. CRV LA .QUINTA 70 LP CALIFORNIP; POOLS & SPAS :. C/O CAPSTONE.ADVISORS P.O. BOX 1280 `9255` TOWNE' CENTER. DR 520 '.. " j: COACHELLA CA'. 9223.6 SAN. DIEGO, CA' 92121 (760) .398.-9222. . . WCC.: STATE FUND. - . .600Q-61168'. t ...WC:04:01./01/05 10/31/04C91,13.: 65.612.8° - -i229'-053 _ - CCi C8 C27. Permmit .. . MECH POOL ..Additional desc , :Permit . Fee .24.00 Plari. 'Check' `Fee :.. 6.00 Issue Date ..Valuation' .0 Qty. Unit .Charge Per ;.Extension BASE. FEE '15.00: 1.00 9.0000 EA MECH FURNACE <=:1.00)t 9..00 Permit .. BLDG POOL.PERMIT .Additional desc.. Permit Fee., 198.00. Plan .Check Fee 128.70 Issue Date .'-Valuation. .19.000 Qty'Unit Charge Per. Extension BASE.FEE 45.00 57.00 9:0000 THOU:- BLDG 2,'001•-25;000 153:.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 Extension BASE FEE 15.00 P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT VOICE (7 60) 7.77-7012 : FAX (760) 777-7011 INSPECTIONS (760) 777-7153- Application 77-7153 Application Number. Date:. CO , 42 - 0 y . Applicant: Architect or Engineer Applicant's Mailing Address: Architect or Engineer's Addr1 Uc. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (oomrhendng with Section 7000) of Division 3 0f the Business and PMfesslonals Code, and my Licen_' is in fun force and effect.. �� /z License Class L-'-. 53 License No. Dale L Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt iron time Contractors' State Lioense Law for the following reason (Sec. 7031 A Business and Professions Code: Any city or county that requires a per -it to construct, alter. Improve, demolish, or repair any structure, pew 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 Coitractoce State License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professions Co0e) or that he or she is exempt therefrom and the bests for the alleged exemptiom. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a dvil 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 sfructrrre 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 properly who builds or Improves thereon, and who does the work himself or herself or through his or her own employees, provided that the kmprovemants are not intended or offered for sate. If. however, the building or impraven►br►t Is sold within one year of completion, the owner4wiider willhave the burden of proving that he or she did not build or improve for the purpose of sale.). as owner of the property, am exclusively contracting with loaned 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.). (..) I am exempt under Sea . BA PTC. for this reason Date Owner._•. WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations:. —I have and will maintain a certificate of consent to selfansirre for workers' compensation, as provided for by Section 3700 of the Labor Code. for -ft performance . of the work for which this permit is issued. 11have 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 ��sue� My Von. Insurance carrier and pol'u�p ter are: Canter _'S�F,Ci P �{–r t.� 1 Policy Number b _ 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 to become subject to the workers' compensation laws of California. and agree that. 91 should became subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with torose provtAns. _ MnRrant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL. PENALTIES AND CML 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 ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there Is a construction lending agency far the performance of the work for which this permit Is Issued (Sea 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 tluinta, 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 wok Is not commenced within .180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellati I certify that I have read this application and state that timeabove info on correct I agree to comply with all city and county ordinances and state taws relating to bulWing construction, and hereby authorize representatives of this county to r u atxnre me property for inspection purposes. Date Z`� �Signature (Applicant o<Agent): Page 2 Application Number 04-00004682 Date 6/01/04. Qty Unit Charge Per Extension. 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 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 --------------------------------------------=------------------------------- Special Notes and Comments POOL & SPA. BBQ ANSI Z21-58-1995 FIREPIT 496AGAL ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee Total 300.00 ...00 .00 300.00 Plan Check Total 154.20 .00 .00 154.20 Grand Total 454.20 .00 .00 454.20 l 1 ►I -L r t ll A7 +' I " lip 'le k4l-Tr rAWrt-r CASE t7 0aHGFr -rr- 4^F ` '4(o AG^L 64" ...oce v%rlT pr-G Arl-p I F- z 14.%6. 1 Tf or C.:�`i tET� L11 TUa Fe . -_- OL r , r Jf F 1 - flriAIS 1, -zAr^ l " 1rJ1T1# TAN14 ,v p t ECK, -S' !-kS AND 7 — - s j { QA6r WILL M� C. %Amer AKJL co ow or - _ MAX VA two do" W7M low am 9r AM ax am —�— gUAOM ■ouA — ----- -• •-- R a amso !A AT Aj VLLN47 Tl" El�� - - - pECKINr. ic Ei�ti E XC A d tvm n.g+ atm low Ermemm Awn � EJ.E'Y+�T�1 c�rr�trae , amp oa uw o�s U74 WA' go= DRAM 0o"caR M W 14 L arc We _ ��yy��/�� MF � --_��. __ - � 4Y'�1* slom TM 101CRAL fT irim rin FJV.%T1dY FL o0wo R e e IL .or rw .or RJL&- 2-. 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