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12-0869 (RPL)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-701.1 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: .__!/03/12 Application Number: 12-00000869 Owner: D 0 Property Address: 81219 CASPIAN CT NAVRATIL APN: 764-280-004,-32 -35996 - 81219 CASPIAN COURT Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 AUGC,� 2012 Property Zoning: LOOP DENSITY RESIDENTIAL Ll tiUO l! L Application valuation: 16000 CITY OF LA QUINTA Contractor: F04414CE UEPT Applicant: Architect or Engineer: FAMILY POOLS CONSTRUCTION P O BOX 283 LA QUINTA, CA 92247 PI n (760)564-3655 ,^ Lic. No.: 658996 ---- _--. ---------------- penalty of perjury that I sion 3 of the. Business i V'— — — — — — -- — — — — --- — — — — — —— — —- rRACTOR'S DECLARATION under provisions of Chapter 9 (commencing with ials Code, and my License is in full force and effect. Lice�658996 < NEA -BUILDER DECLARATION 1 hereby a rm oder penalty of perjury that,I a xempt from the Contractor's State License Law for the following reaso (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to'its Issuance, also requires the applicant for the permit to file a signed statement that he orshe 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 hefor 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 We 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 notapply to an.owner of propertywho builds or improves thereon, and who does.the work himself'orherself through his or her own employees; provided that the Improvements are not Intended or offered for sale. If; however, the building" orlmprovemeit.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 improvesthereon, and who contracts forthe projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. . B.&P.C.:.for this reason Date: Owner: CONSTRUCTION LENLNNG'AGENCY I hereby affirm under penalty of perjury'thatthere.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: LQPMMI'f ------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjuryone of the following declarations: _'I have and will maintain a certificate,of'oonsent to self -insure for workers' compensation, as provided for by Section 3.700 of the Labor Code, for the performance of the work for which this permit is Issued. 1 have and will maintain workers' compensation insurance; as required by Section 3700 of the Labor Code, for the performance of"thework:for which this permit Is issued. My workers' compensation insurance carrier,and. policy number are. Carrier STATE FUND Policy Number 13.44032-2012 _ I certify that; in the, 'o X.b-, a work for which•this permit is Issued, I, shall not employ any person'in any'manneme subject-to'the workers' compensation laws. of Califomta> and agree that, if I ssubject to the workers' compensation provisions of Section 3700 of the.Labor Crthwith comply with those provisions. WARNING: JAILURE TO SECURE WOR R ' COMPENSATION COVERAGE IS.UNLAWFUL, AND SHALL SUBJECT A EMPLOYER TO CRIMINAL ALTIES AND CIVIL FINES "UP'TO ONE HUNDRED THOUSAND DOLLARS 14100,000). IN ADDITION T� 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.pursuantto any permit Issued as a rasult of this application; the owner, and the _applicant, each agrees to„and shalLdefend, Indemnify and hold harmless the City of La Quints, its officers, agents and employees for any act oromission 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 oid If.work Is not commenced within 180 Nave from date of issuance of such permit, anon of work for 180 days will subject' permit to.cancellation. 1 th I have. read this application and state that t . e information.is,correct. I agree to comply with all C, my ordinances and state laws relating to t construction, and hereby authorize representatives f itq enyr upon a above-mentioned pro f spectlon purposes., IY/ Si at (Applicant or Agent) Application Number . . . . . 12-00000869 Permit. . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 171.00 Plan Check Fee 111.15 Issue Date . . . Valuation . . . . 16000 Expiration Date . 1/30/13 Qty Unit Charge Per Extension BASE FEE 45.00 14.00 9.0000 THOU BLDG 2,001-25,000 126.00 Permit. . . . MECH POOL Additional desc . . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/30/13 Qty Unit 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 1/30/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30..0000 EA ELEC.PRIVATE SWIMMING POOL 30.00 Permit. . . . Additional desc . Permit Pee . . . . Issue Date . . . . Expiration Date . . PLUMBING 27.00 Plan Check Fee . . 6.75 Valuation . . . . 0 1/30/13 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. ALARMS/BARRIERS SHALL BE IN PLACE I QPERMIT Application Number . . . . . 12-00000869 ------------------------------------- Special Notes and Comments ------------ -------------- ------------- AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010 CODES. ------------------.-------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1 1.00 Fee summary Charged ---------- Paid Credited Due ------ Permit Fee Total 269.00 ----- -_-- 00 -------.-- ------ 00 269.00 Plan Check -Total 135.65 .00 .00 135.65 Other Fee Total 1.00 ..00 .00 1.00 Grand Total 405.65 .00 .00 405.65 GQPBRMIT Eiftdng P/L Wall` Family Foo is Construction �7'60�56� 3655 Lie. NO. 658996 Front Ddveway Bin #City of La Quints Btd[ft Safety DlvE w P.O. Box 1504, 78-495 Calle Tampico la Qtdnta, CA 92253 - (760) 777-7012 Bcdlding Pern* Application and Tracbng Sheet Penne 8 IVA e� v Projed Address:ELI Owner's Name: �, eM46L -A. P. Number: Address: u l Legal Description: City, ST, Zap: Z Contractor MI\) Telephone: AddressIW e�ProjectDeswiption: City, sT. zip' La 77 Telephone: (� State Lic. # : City Lic. C. Arch, Engr., Designer. Address: City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. M Project type (c=le one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft: # Stories- # Units: Telephone # of Contact Perron: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal RWd Reed TRACMG PERMIT FEES Plan$eb Plan Check submitted S ,?j Item Amount $fractural Catm Revkwed, mady;for corrections PlanehDeposit Truss Cake. Called Contnet Person Plan Cbe& Balance Title U Coles. ftw picked up Gsffipuct[on Flood plain plan Plass rnabmltted Meebasled Grading plan' r! Review, ready for ewrxtloosium Eleetrkd $ubcontacbor Ind Called Contact Person Plumbing Grant Deed Phu pkkedap S.M.I. HAA. Approval Pbu rnubmNkd. Qmdbrg INHOUSE:- ''d Review, ready for eonvcdo%e Devdoper Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit inane &pool Fees Total Permit Fen