05-0192 (RPL)TAf °F.l'NQ"
504
:.LE TAMPICO
CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-701.1.
INSPECTION REQUESTS (760) 777-7153
' caLi'
er
. . 05�-000,00192 Date 1/'19/05
Property Address .
. . . . OUPLES CT
APN:
764-060-049- - -
Application description POOL- '- RESIDENTIAL
Property Zoning.
'LOW DENSITY RESIDENTIAL
Application valuation
6000
-
Owner
Contractor
BIRDIE HOMES
CALIFORNIA POOLS &
SPAS
5 E. CITRUS
P.O. BOX 128'0
REDLANDS
CA 92.373 COACHELLA
CA 92236
(760)..398-9222
WCC: SEABRI.GHT
INS
WC: BB1:050.510
01/01/06
CSLB - • 656128
10/31/06
CCC: C8 -C -27-C29-053
Permit . ... . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
8.1.00 Plan Check Fee
52.65
.Issue Date . . . .
Valuation . . .
. 6000
Qty Unit Charge
Per
Extension
BASE FEE
45.00
4.00 9.0000
THOU BLDG�2,001-2.5,000
36.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . .
24.00 Plan Check Fee
6.00
Issue Date
Valuation
0
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
Issuue Date
Valuation
0
Qty- Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
3.0.00
----------------------------------------------------------------------------------
Permit . . . . . .
PLUMBING
Additional-desc .
Permit Fee
27.00 Plan Check Fee
6.75
P.O. BOX 1504 VOICE (760) 777-7012.
79-495 CALLE TAMPICO FAX (760) 777-.7011
LA QUiNTA, CALIFORNIA 92253 INSPECTIONS (760) 777-71.5.3
BUILDING' & SAFETY DEPARTMENT
Application Number: 10- Date: �' O
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architector Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S. DECLARATION
1 hereby affirm under penalty of perjury that f am licensei] under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Co nd my Li II force and'effect.
Dense Class `— "✓ vie No. A6S61 Z
L/ OWNER43UILDER DECLARATION
I hereby affirm under penalty of pedury that I am exempt from the Contractors' 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
statementthat he or she is licensed pursuant to the provisions of the Contractors' ns
State Lioee Lew (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 violetkxh of Becton 7031.5 by any eppl'�cent fora permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500):):
( j 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;oroifered for sate (Sec. 7044,
Business an& Professions Code:; The Contractors' State. License Law does not apply to an owner of property who builds or improves thereon, end who does the work
himself or herself or through his or her own employees, provided, that the Improvements are not Intended or offered for sale., If, however, the building orimm
proveent is
sold within one.year of completion, the owner -builder will have the burden of proving tat 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 projed (Sea 7044, Business and Professions Code: The Contractors'
State License Law does not apply twan owner of property who builds or improves thereon, and who contracts for the protects with a contrector(s) lichened pursuant to
the Contractors' State UoenseLaw.).
U I am exempt under Sec. , B:8 P.C. for this reason
Date Owner
WORKERS' COMPENSATIOKDECLARATION
11%reby affirm under penalty of perjury one of the4ollowing declarations:
I. have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for bySection 3700 of the Labor Code, for the performance
of the work for which this -permit is'issued.
I have. nd will mainta' workers' compensator insurance, as requiredby Section 3700 of the Labor Code,;forthe perfortnance'of the work for whkth this pemhit.is
f work con enation nce:prier�(�d
_ 1 certifythat, in the performance of the work for wj9Q this,pennft Is issued, l shall not employanyperson in any manner so es,:to bebomwsubject to the workers'
compensation laws of.Califomia, and!agies t i ct tothe should become subjeworkers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
WARNING: FAILURE TOtiSECURE WORKERS' COMPENVXTiONiCOVERAGE 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 3708'0,F THE LABOR COLE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penaltyof perjury that there is,a construction lending agency for the,performance of the work for which this permit Is Issued (Sec. 3097, Ctv. C.).
Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby, made to the Director of Building and Safety for a permit subjecfto the conditions and restrictions set forth on this application.
1. Each person uponmhose behalf this application Irmade, each person at -whose request and for whose benefitwork is perfomad underor pursuant to any permit
Issued as a result of this application, the owner, and the applicant, each agressto, and shall, defend, Indemnify and hold harmless the City of La Quints, its -
officers,. agentsand. employees any actoromission related to the work being performed under or following issuance of this permit
2. Any permit issued.as`a result of this.applicetionbecomes null and void if work is not commenced within I io.days from date of issuance of such permit, or
cessation of work for 180 days will subjectpernitto cancellation.
I certify that I have: read this application and state that the above: information is agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize re ntatives of, this county Meru a tloned;property foninspedlan purposes:
ate �•ion leant or ant
g (APP1 Agent):
Page
Application Number . . . . . 05-00000192 Date 1/19/05
Issue Date . . . . Valuation . . . . 0.
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.0000 EA P.LB FIXTURE 6.00,
1.00 .3..0000 EA PLB WATER INST/ALT/REP 3.00
1.00 3.0000 .EA P,LB,GAS PIPE 1-4 OUTLETS 3.00
Special Notes and 'Comments
SPA. ALARMS/BARRIERS SHALL BE IN PLACE
AT PRE, -PLASTER INSPECTION. EQU.IPMEN_T
ENCLOSURE NOT INCLUDED
Fee summary .Charged Paid Credited Due
Permit Fee Total. 177.0.0 .00 .00 177.00
Plan Check.Total 76.65 ,00 .00 76.65
Grand Total 25'3.65 .00 .00 253.65