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05-3128 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: '05 -00003128 - 79360 BROOKVILLE 772-040-019- - - STRUCTURES OTHER THAN BUILTF9 LOW DENSITY RESIDENTIAL II 3000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT u I Architect or Engin er: JUL 2 5 2005 -------------- --- ------------------ LICENSE ONT CTOR'S DECLARATION I hereby affirm under penalty of perjury that I am Ii en d un r provisions of Chapter 9 (commencing with Section 7000) of Div' n Busines nd P fess nal Code, and my LjpenAisan furor nd effect. License Class: icense No.: l // ate: c7s,`ontractor. NE - ER 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).: (_) 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.). (_) 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: 7/22/05 Owner: LA QUINTA ORCHARDS PARTNERS C/O LA QUINTA ORCHARD PARTNERS P 0 BOX 1716 LA QUINTA, CA 92253 Contractor: CALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: BE1050510 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. 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 C8 C27 C29 C53 Policy Number - ----------- I certify that, in the performance of the work for hi this per it is issued, I shall not employ any person in any manner so as to become subject th ork s' is laws of California, and agree that, if I should bec ubject to th work compensation provisions of Section 3700 of the Labor Code, I all fo wit comp h t ose provisions. q i te: (i �A�plicant: WARNING: FAILURE TO SECURE WORKE ' COMPENSATMON COVERAGE IS UNLAWFUL, AND SHALL j SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES 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. l 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 cessPher rk for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above informatioI agree to comply with all city and•cbunty ordinances and state laws relating to building struction, authorize representatives oft �co&� n r upon the above-mentioned prop r i pection pu Plate: 4�ture (Applicant or Agent): Application Number . . . . . 05-00003128 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . 3000 Expiration Date 1/18/06 Qty Unit Charge Per Extension ` BASE FEE 45.00 1.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 9.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 15.90 Plan Check Fee 3.98 Issue Date . . . . Valuation . . . 0 Expiration Date 1/18/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .4500 - ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 .90 Permit . . . PLUMBING Additional desc . . Permit Fee .. . . . 15.75 Plan Check Fee 3.94 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/18/06 Qty Unit Charge 'Per Extension BASE FEE 15.00 1.00 .7500 EA PLB GAS PIPE >=5 .75 ---------------------------------------------------------------------------- Special Notes and Comments BARBEQUE ONLY. ANSI #Z21-58-1995. -----------------------------7---------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 3.51 Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total ---------- 85.65 ---------- .00 ---------- .00 85.65 Plan Check Total 43.02 .00 .00 43.02 Other Fee Total 3.51 .00 .00 3.51 Grand Total 132.18 .00 .00 132.18 LQPERMIT Rin # City Of La Quints Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # F O Z fp d J Project Address: ._ 3 c,V ) 200 L LC Owner's Name:' iwr G S A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: o . o Telephone. /� IODLS 's ne Address: C) B®x I -zQ Project Description: City, ST, Zip: C W C1 2.9 3 40 Telephone: ...................................................... State Lic. # : �`,ase� City Lic. #; z tq Arch., Engr., Designer: Address: City, ST, Zip: xxx- Telephone: hone: c Construction Type: Occupancy: Y State Lic. #: Project type one): Alter Repair Demo Name of Contact Person: AJ �' �' ��j Sq. Ft.: # Stories: T# Units: Telephone # of Contact Person: ��, �' y?,5=,�� Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 721IOS Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit 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 correctionsitssue Electrical RJf ,2 /y�q•� �t Subcontactor List Called Contact Person Plumbing cc 04 6JZ�7 Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd 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 bra