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05-2535 (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: CoNiKACi0f2 05-00002535 43352 BORDEAUX DR 609-380-997-61 -293233- POOL - RESIDENTIAL Tit!t 4 XP Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LOW DENSITY RESIDULJA35000�1Arch 2 0 2005 CITY OF LA (QUINTA FINANCE DEPT. Owner: AIREY DEREK 43-352 BORDEAUX DRIVE LA QUINTA, CA 92253 Contractor: TOPMAN BUILDERS WCC: CLARENDON WC: 01KR-0030-842 CSLB: 455121 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 03/23/06 06/30/06 Date: 6/23/05 ----------------------------------------------------------------------------------•--------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of ivision 3 of the Business and Professionals Code, and�W i n is in full force and effect. icense Class: License Nei!S 1 2� _ 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 �1 .✓ate:(e-Z1 •1�Co r: issued. 1 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: ��`�/� ^�j?_ t��Z I hereby affirm under penalty o�ury I am exempt'from the Contractor's State License Law for the - Carrier B C2 9 C53 Policy Number - - ��i— J. following reason (Sec. 7031.5, d Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the 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 the applicant 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 ome su ject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or ' 3700 of the Labor Code, ha fo ith co ply with those provisions. 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).: q�aw:&2 ) -1--15 Applicant: (_) 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 WARNING: FAILURE TO SECUR WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRI AL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITIO COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or 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 she did not build or improve for the purpose of sale.). (_) 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 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: LQPERA11T 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 1 have read this application and state that th ve information is correct. I agree to comply with all city and county ordinances and state laws relating to bu ding c str tion, and hereby authorize representatives of this county to enter upon the above-mentioned prope y for ' spe ti n purposes. Dat '+Iignature (Applicant or Agent) Application Number . . . . . 05-00002535 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 317.00 Plan Check Fee 206.05• Issue Date .. . . . Valuation . . 35000 Expiration Date 12/20/05 Qty Unit Charge Per Extension BASE FEE 252.00 10.00 6.5000 ----------------------------------------------------------------------------- THOU BLDG 25,001-50,000 65.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . 0 Expiration Date 12/20/05 Qty 'Uni.t 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 12/20/05 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 12/20/05 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 Application Number . . . . . 05-00002535 Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary -----=----------- Charged Paid ---------- --- L ------ Credited ---------- Due Permit Fee Total 421.00 .00 ---------- .00 421.00 Plan Check Total 232.05 .00 .00 232.05 Grand Total 653.05 .00 .00 653.05 LQPERA11T Ain #City: of La Quint Building 81• Safety. Division Perrttit # P.O. Box 1504, 78-49S Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet 74 Project Address: 2- . 2 —PL te-oc A:7 x, Owner's Name: rknz,, e , umber: Address: v Description: r.Legal City, ST, Zip: L_A4 Tefe hone: P ` Address: 2San a Project Description: City, ST, Zip: CSA , . 2� l Telephone: o S-" 13 5 q 2. City Lic. #: StateLic.#-. yS51\� ` Arch., Engr., Designer: 7 P M1 k Address: City, ST, Zip: (I Telephone: State Gc. #: Name of Contact Person: - Construction Type:c' OcruPan t: New Add'nAlter Repair tr}P (circle one):Demo Sq. Ft.: #Stories: #Units; Telephone # of Contact Person: 15- -7 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted 6 �/� Item Amount Structural Calcs. Reviewed, reads for corrections Plan Check Deposit Truss*Calcs. Called Contact Person Plan Check Balance Title 14 Cala.. Plans picked upConst ruction Flood plain plan Plans resubmitted hLechanical Grading plan 2"' Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.l•I.1. II.O.A.Approval Plans. resubmitted Grading IN IIOUSE:- '' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Li Total Permit Fees RA.15W 5PA AT t95" AI T'm CZN6RE-r! AP ANP 5 7 N'_—ACV STONE 5P1LKAY RENiGrVE A11V REFI-ACE EX1571N& AA_ FOR DO A"' ACCESS &A M TC M Sir GL.O511 SELF LATCHINS RA;.5= BG\Z. A"-' AT #4:2" AI TF CITE OAP ANF S'70NE VENEER FAGS r M l ACCESS I I I 3'-6• '•l/ FOOL �!A �K �mr ■�� CiCahi�r.R�`� PAS DE�GII�IEs Pam. ADO Z>OOR A �_ ARM T0 ALLL FOOL AREA A Z�C ESS— :7COR5 h#6 M ROOM 1 �frG PLAN 4 &ARA&E SITE PLAN �1....1..tAL)om 03OHdd ViNinovi_�(-) A 1 PATIO COVER H1' SEPARATE PERMIT qr SPt,Ctr I, ,'s 7 ON5 own WrIm L�L.rTILri - - _ 1{.if- h�.AtCY •'7 - fa+' - k.RO L . 1•' _Rr _�4k ...wH J.�3 J� i -.+- - _ .—&' 1 ++4 A¢,A &44 i ELZ-eL'V - EX -RA S^TG` `C% rdk 1: — — 9^5m JAPA _ A4- CXCAVATION ==" •+yob. — - — G -710145 d TU� — c MASrG Fooms STEEL _TePy Tyfe f iJa'a`i 'i. A ' ri r -El �111R�y�:fltiL . 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