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04-6210 (RPL)Tihf 4 4 Q" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . . .04-000 260 10� Date 4 87 6-8—B I G—HORN DR 658-140-999-15 -29436 - . . POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL . . . 16000 IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC 7979 IVANHOE AVE STE 550 LA JOLLA CA 92037 Contractor 9/09/04 CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA CA 92236 (760) 398-9222 WCC: STATE FUND WC: 04600061168 01/01/05 CSLB: 656128 10/31/04 CCC: C8 -C27 -C29-053 ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 171.00 Plan Check Fee 111.15 Issue Date . . . . Valuation . . . 15760 Qty Unit Charge Per Extension BASE FEE 45.00 14.00 9.0000 THOU BLDG 2,001-25,000 126.00 ---------------------------------------------------------------------------- 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 . . . . . . ELEC POOL PERMIT=RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuatio . - N --1 0 N Qty Unit Charge Per D _ a� Extension BASE FEE j 1-5,% 0 0 r, P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: 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 unde visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Lic a is f force and effect. /License Class— "DateFi ontractor 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 1 am exempt under Sec. , B.& P.C. for this reason Date 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 Dof the work for which this permit is issued. -1 have and will main09workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is is 'eco My wor compensation ins ce carrier olio n mbar a /� /farrier S1 ��f� icv Number c�l� _ I certify that, in the performance of the work for w this reit 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 t , if I sh Id become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pfpvisions. Z0. WARNING: FAILURE TO SECURE WORKERS' COMPENSY4TIBN 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 an 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 performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if ork is of 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 in ation is co ct. I a e to comply with all city and county ordinances and state laws relafing to building construction, and here y authorize�representatives of this county o nter up n t bov enboned property for inspection purposes. ate �� ig6 nature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006210 Date 9/09/04 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 ----------=------------------------------------------- ---------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 240 Qty Unit Charge Per Extension BASE FEE 15.00 -------------------------7-------------------------------------------------- Special Notes and Comments POOL/SPA, 15 L,F 4' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged --------------------------- Paid Credited ------------------------------ Due Permit Fee Total 288.00 .00 .00 288.00 Plan Check Total 136.65 .00 .00 136.65 Grand Total 424.65 .00 .00 424.65 it FIr Ko /,P e te •r ► it •E (IC-lr 9 a x.�►Tr�(I ce 1y• -.rr�� • ate.--��.}� r -� 'X 3 } an -:L- j 84 n 64 bw OP W* ' map 6pa JAL M-.F- roff vtw JL wwft DECKftG +G 1 1 IM■ jwn . t� �' � � ■fir, comom am lam am me 4im smallft lid lwE -- - 1 womdmmm► r_ . I" � - — -- - - qr mum - d.v+. y WY am — � opm *" G" .on 94k§W wM PLUMBAV • ' r - # q*o=$ WL-t 41orL AMPS _ avow AM ow aim OWL 60%M fx -.4 �` •.a Lon oft fto _ �~ mm KMMUM -�- O.!'l�'- ..A lllp� 20 r '.w Im 'M,I14' am MD ampow =L� MR mom * emw%mm v ►fiftDOW 10%Wn► e %K40 OftEMOFiW (z IV =w mmR 9116► at ww in* JAR* to Im #+f loft0vWMAD fdp mu SW Cklrr► Aft s"r onromj m go lodgm " an ro r I% a �m Bowes Una a ow � a v t am m In %-T fti mma wn Aw �w moo m• - 3ft% Mft ow i "K vm MM V fmrkWW mow"D + ■&mow►~+A'"m Mom N lm-- 0AR ou% 1mom �1 "W rrr : M"rM ON* ag a mma of .a mom M�m ftm MM. W .iv" an fto mw %F mw�w wwo low CONSTRUCTION AUTHORIZATION SAI -C I DIG 19"-.C:t 'Nrni Hl — - -- �- - IWLA o'R1 � -t'I � it131.E I, 5 BOULOM DICK ;mop 3AMY pW IM S DR Ai HA GE NOTE: _ A' RE -INSPECTION FEE OF S,.._ MUBECHARCEDIFTHEAPFROVE - - _ RD ARE Qnd p•ot% by 86 i _m