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05-2140 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: X05-00002140 Property Address: APN: 79360 BROOKVILLE Application description: 772 -040 -019 - Property Zoning: POOL - RESIDENTIA.L Application valuation: LOW DENSIT Applicant: Architect or T`t!t aF 4v Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 1UN 0 3 72nm -------------------------------------------7------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I amlic under provisions of Chapter 9 (commencing with Section 7000) of Di 'sign of the Business and Pr ssio Is Code, and cen - � or nd effect. LicensLicense Class: No.: /Date: 6SCOntractor: O NR!!5ILDER 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 _) 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.l. 1 _ 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 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: 6/03/05 Owner: --------------------------------- LA QUINTA ORCHARDS PARTNERS C/O LA QUINTA ORCHARD PARTNERS P 0 BOX 1716 Contractor: CALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: BS1050510 01/01/06 LiC. No.: --------------- ----------------------------------------------- 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. X_ 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 656128 10/31/06olicyNumber C8 C27 C29 C53 _ I certify that, in the performance oftor hich this permit is issued, I shall not employ any person in any manner so as to bec subject o the workers' compensation laws of California, and agree that, if I.shou become sp ' ct to a workers' compensation provisions of Section /7"000oof the Labor Co shall f rth it mply with those provisions. ate: .�ZApplicanv r WARNING: FAILURE TO SECURE W KERS' CO ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 vo 1 w ' not commenced within 180 days from date of issuance of such permit, or cessation/ work for 0 days will subject permit to cancellation. I I certify that I have read this application and state that the above informatio is cor ct. agre to comply with all city and county ordinances and state laws relating to buil ' g onstruction, no/ 'her y au ize representatives oftb(s coon ' to /ntterr upon the above-mentioned�pr/o/off for nspection rposes. Date: t. S,gnature (Applicant or A Application Number . . . . . 05-00002140 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date. Valuation . . . . 20000 Expiration Date 11/30/05 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2.,001-25,000 162.00 Permit . . . MECH POOL Additional desc . Permit Fee 37.00 Plan Check Fee 9.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/30/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 11.0000 ---------------------------------------------------------------------------- EA MECH FURNACE >100K 22.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee 135.00 Plan Check Fee 33.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/30/05 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 30.0000 ------------------ ---------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 120.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 42.00 Plan Check Fee 10.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/30/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 4.00 3.0000 EA PLB WATER INST/ALT/REP 12.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and,Comments POOL, SPA & WATERFEATURE ONLY. LQPERMIT Application Number . . . . . 05-00002140 ---------------------------------------------------------------------------- Special Notes and Comments 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 421.00 .00 .00 421.00 Plan Check Total 188.05 .00 .00 188.05 Grand Total 609.05 .00 .00 609.05 LQPERMIT L+ 1 Bin # ity of La Quinta Building 8L Safety Division ��Permit �}, p rrwwF/�_ S`�°" P.O. Box 1504 78-495 Calle Tam ico 47 La Quinta, CA 92253 - (760) 777-7012 Alk-. Building Permit Application and Tracking Sheet # 5 Project Address: D Owner's Name: A. P. Number: 'Address: Legal Description: City, ST, Zip: onr"t r.C // P C t ac o h one• dr c5 Tele Address: © Project Description: City, ST, zip:Cy" ZZ3 O A- 5 TeleP h0 ne: 2 Z State Lic. # : 5(p City Lic. #: s i Arch., Engr., Designer: Address City, ST, Zip: Telephone: .ConstructionT Type: Oc cu ancv: State Lic. #: ProJectn (circle one) Ne, Add n Alter Repairair Demo Name of Contact Person: D ��� Sq. Ft.: # Stories: J#Units: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted s Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 talcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2wd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up H.O.A. Approval Plans resubmitted Grading IN HOUSE:- I'd 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 Total Permit Fees L; f