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05-3186 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00003186 Property Address: 79300 BRIARWOOD APN: 772-020-010- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 Applicant: T4t(t 4 4 Q" Architect or Engineer BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------- ------------------- - - - - -- LICENN'nal TOR'S DECLARATION I hereby affirm under penalty of perjury that I amprovisions of Chapter 9 (commencing with Section 7000) of D' Sion 3 o the Busine and ode, and my Li�en�S9�siin fy�J'�orCg and effect. License Class:— nse No.: /COL/X Date: Z'f0 D�ontractor: _ OW R-BUI ER DECLARATION I hereby affirm under penalty of perjury that I am exe= m 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 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 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 1, 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/26/05 Owner: CUMMINS KENNETH J 79-300 BRIARWOOD LA-QUINTA, CA 92253 Contractor: CALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: BB1050510 01/01/06 CSLB: 656128 10/31/06 ----------------------------------------------- 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. K 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: T// Carrier CS C27 C29 C53 Policy Number (eL'�" _ I certify that, in the performance o ork for which this permit is issued, I shall not employ any person in any manner so as to b ome ubject to the workers' compensation laws of California, and agree that, if I sh Id beco bj ct to the workers' compensation provisions of Section 3770001 of�the Labor o , I shall f rth ith co ply with those provisions. atm e: / �C�tO( �4pplic WARNING: FAILURE TO SECURE ORKERS' 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. 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, o cessa of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above infor a 'on is orrect. I agree to comply with all city and cou ty ordinances and state laws relating to buil ' g constru ion, nd/hereby authorize representatives of this c ty to ent upon the above-mentioned pro rty r inspecti n pur ses. Date. �ature (Applicant or Agent): Application Number . . . . . 05-00003186 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 117.00 Plan Check Fee 76.05 Issue Date . . . . Valuation . . . . 10000 Expiration Date 1/22/06 Qty Unit .Charge Per Extension BASE FEE 45.00 8.00 9.0000 ---------------------------------------------•------------------------------- THOU BLDG 2,001-25,000 72.00 Permit . . . MECH POOL Additional desc . Permit•Fee 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/22/06 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 . . . . Valuation . . . . 0 Expiration Date . . 1/22/06 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 . . . . 27.00 Plan Check Fee 6.75 Issue Date Valuation . . . . 0 Expiration Date 1/22/06 Qty Unit Charge Per. Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 SPA & TANNING SHELF ADDITION TO LQPERMIT Application Number . . . . . 05-00003186 ----------7----•------------------------------------------------------------- Special Notes and Comments EXISTING POOL. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ------ --- Paid ---------- Credited ---------- ---------- Due ----------------- - Permit Fee Total 213.00 .00 .00 213.00 Plan Check Total 100.05 .00 .00 .100.05 Grand Total 313.05 .00 .00 313.05 LQPERMIT Bin # City Of La Quints Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: - 0 1Owner's Name: tLt "Ji A. P. Number: Address: Legal Description: City, ST, Zip: ntractor:C L F� 0Ls � � Telephone: hon e:C Address: C) Called Contact Person Project Description: A. Plan Check Balance City, ST, Zip: �, � 7 S 2 phone: h ne: Tel0 P p Plans picked up .................................................. ...AXrr Construction State Lic. # Flood plain plan City Lic. #; Plans resubmitted Arch., Engr., Designer: Mechanical Address: 2"" Review, ready for corrections/issue City, ST, Zip: Electrical PON - Tele hone: c : Construction Type: Occupancy: State Lic. #: ProjectJ cttyP (circle one . Add'n Alter Repair r Demo Name of Contact Person: y '�� = Sq. Ft.: # Stories: # Units: - Telephone # of Contact Person: 2 S-7- /J/,a Z/j-7�0�� Estimated Value of Project:. S.M.I. APPLICANT: DO NOT WRITE BELOW THIS LINE H O.A. Approval # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Developer Impact Fce .: Item Amount Planning Approval Structural Calcs. Called Contact Person Reviewed, ready for corrections A.I.P.P. Plan Check Deposit _ i `. f. j' Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact.Person Plumbing Grant Deed Plans picked up S.M.I. H O.A. Approval Plans resubmitted Grading IN HORSE:- ''" Review, ready for corrections/issue Developer Impact Fce .: Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Totzn Permi:',P'ees _ i `. f. j'