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06-0483 (RPL)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 06-00000483 79575 BLAZING STAR TR 604-092-011-49 -22982 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 30000 Architect or ------------------ LICENSED CONTRACTOR'S DECLARATION T,&t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: MUSASHI MASARU D e 79-575 BLAZING STAR TR LA QUINTA, CA 92253 FF3 02 2006 Contractor: CiTYOFIAQUINTA AMERICAN POOL CONSTRUCTION INC FINANCE DEPT. P.O. BOX 11996 PALM DESERT, CA 92255 (760)340-2588 Lic. No.: 518742 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 Busines and Professionals Code, and my License is in full force and effect. License Class: IC53 / License No.: 518742 Oate-7�Contract] 771i , OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 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.). 1 _ 1 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: LQPERMIT Date: 1/31/06 ----------------------------------------------- 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 STATE FUND Policy Number 0001188-2005 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, nd agree that, if I should beco a subject to the workers' compensation provisions of Section 700 of the Labor Code, I s I or�wiEFrcdFipfy with those provisions. Da Applica WARNING: FAILURE TO SECURE W PIKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C NAL 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. 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 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building co struction, and hereby authorize representatives of this cou y toef nter upon the above-mentioned grope o inspectio��Auro'oses. Date: V ignature (Applicant or Agen �—(/ V �— Application Number . . . . . 06-00000483 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 30000 Expiration Date 7/30/06 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 32.50 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/30/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ---------------------------------------------------------------------------- EA MECH FURNACE >100K 11.00 Permit . . ELEC POOL PERMIT -RES Additional desc . . Permit Fee' 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/30/06 Qty Unit Charge -.Per - Extension BASE FEE 15.00 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 Expiration Date 7/30/06 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 ONLY. ALARMS/BARRIERS SHALL LQPERMIT R Application Number 06-00000483 --------------- - ------------.----------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER. INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. s Fee summary Charged Paid ----------------- ---------- ---------- Credited Due Pe rmit Fee Total 388.50 .00 ---------- ---------- .00 388.50 Plan Check Total 210.93• .00 .00 210.93 Grand Total 599.43 .00 .00 599.43 LQPERMIT H o,>> 5g0E- LL 6 cc Z OzcLo 00 j LL v m Cii O NOFTES: E '.a. J ,. .`mi 1WAR [: S o E AREA MAP Q ., c 5 aim - w '�CACT Li u R LIC. si8,742 F Aoot� �4-5�� Etavui 'fir .Sar � . LAra�jf,ii-A g2zS E ,CA- Y.1 _- EASEMWT ® UMAT POU (� ELM RANFX J=MN N wx � � 0 WE ob -- FlL LW � 9MEA i MM -� U3a ® ANA DRAW � Lw TE Ea.-El O&AMMICAN U'TIU" FOCE 043WTrM WS SEIM O WMM LEVEW © FLYER -+ DRRETUW rye PkC MAN �;(�L17p1�.TlON OW. -i--E— U IDEWi ROLPID ELMC. 1 wwc RE3�CTE W.Vf p MATER -+ TMVJ V .�.}. ~1 RMS, P o• 8a 1996 '�-�- (;VEAIF-AO TELE. TALf> = SwnnCH P TRAP C> PUuP 0) 340.2588 H QFC: PEDESTAL AmESSC:�> O RECEPTACLE -1 S" t! CLP SSE fOT6 Permit # Project Address''��— A. P. Number: Contractor 0UN Address: City, ST. Zip: ,�CfL•T�'�— ,S=cz•T Tclephona��� !{ Stories: State Lio. # : i�- Arch., Engr., Address: a DO NOT WWTE BELOW THIS UNE City, ST, Zip: Reed Telephone: rERMT FELTS State Lic. #: Plan Check subtaitted Name of Contact son: Telephone iV of C tact Person:w,1,(/ # Submittal Ilan Sets Structural < Truss Cake Energy Cal Flood plain Grading pli Grant Deed H.O.A. App al IN HOUSE:- Planning APPvat Pub. Wks. Ap r School Fees City of La Quinta Building 8L Safety Division P.Q. Box.1504, 78.495 Calle Tampico l.a Quinta, CA 92253 -.(760) 777-7012 Building Permit Application and Tracking Sheet �r� ( Owner's Name: 2kV<C c (/ -VS41 Address: 7• City, ST, zip: •6;bm 14, CA`! 5, DI?,S'J,�pch& _74c Telephone: Project Description:. -� City Lic_ C. Permlt Fees Construction Type. Occupancy: Project type (circle one): New Add'n Alter Repair Demo ; Sq. Ft_: !{ Stories: ff Units; 3 Z S PAiwgod Value of project: APPUGANT: DO NOT WWTE BELOW THIS UNE Reed TRACIMG . rERMT FELTS Plan Check subtaitted 1 ( Item Amount Reviewed, ready for correctloas Plan Check Deposit Called Contact Person Plan Check Balance Plans,oicked up Construction Plans resubmitted . Mechanical 2" Review, ready ter corrmtlonsruuue Meetrical Called Contact Person Plumbing Plans picked up S.M.I Pians resubmitted Gradiag Review, ready for correclionVissue Developer Impact Fee Called Contact Person A.I.P.Y. Date of permit Issue Permlt Fees