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11-1103 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:. Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 11-0000.1103 77153 CASA DEL SOL 773-3'60-014– – POOL - RESIDENTIAL MEDIUM DENSITY RES 30000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ROGER ADAMS 77153 CASA LA QUINTA, VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ;U OCT 10 2011 `U Contractor: I PREMIER OUTDQOR INOITY OF LA QUINTA Date: 10/10/11 following reason (Sec. 7031.5, Business .Professions Cade: Any city or county that requires a permit to construct, cher, Improve, demolish, or re zany structure, prior to Its issuance, also requires the applicem for the permit to filer 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 Divisiom3 of the'Business and Professions Code) or that he or she Is exempttherefrom and the.basis for the alleged exemption. Any violation otSectlon 7031.5 try any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($560).: (_ 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 amended 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 improyes.thereon, and who.does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered forsale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that heofshe 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 Ucertsa Lew.). 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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 (Sect 3097, Civ. C:). Lender's Name: Lender's Address: �� 1 LQPERMIT person inany man and agre&that, if 1 3700 of the Labor ,01%;OU (I ant: WARNING: FAILURE TO'SECUI SUBJECT AN EMPLOYER TO C DOLLARS (8100,000). IN ADD SECTION 3708 OF THE LABOR to provisions of any TANSATION COVERAGE IS UNLAWFUL, AND SHALL ND CIVIL FINES UP TO ONE HUNDRED THOUSAND IST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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, indemnlfy.and hold harmless the City of La Quints, 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 cessation of work for 180 days will subject permit to cancellation. I certify thati have read this application and,state that he a e I mationis correct. I agree to comply with all city and county ordinances and state laws relating to aiding Ion, and hereby a orize representatives, of t�nity ter upon theabove mentioned pro rtYfov Ion puatS re;(Appllcamor.Agent): 77588 EL DI Ar6TTbT F!NJ'lxC6171M. I PALM DESERT, CA 92211 (760)34'5-9791 Lic. NO.: 963116 --------------------------------------------------------------------------------------------------- NSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION'DECLARATION I hereby affirm under pen I licensed:- nder provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Divisioa Profe ars Code, and y License is in full force, and effect. — I have and will maintain a certificate of consent to self-insurefor workers' compensation, as provided License Class: C53Licen 963116 for by Section 3700 of the Labor Cade, forthe performance of the work "forwhich this permit Is JBIness Ste: Irl II issued. �! have and will maintain workers' compensation Insurance, as requiredby Section 3700 of:the Labor Code, for the performance of'the work for which_this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penam exempt from the Contractor's State License Law for the Carrier CALIF INS- Policy Number 460030110307 following reason (Sec. 7031.5, Business .Professions Cade: Any city or county that requires a permit to construct, cher, Improve, demolish, or re zany structure, prior to Its issuance, also requires the applicem for the permit to filer 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 Divisiom3 of the'Business and Professions Code) or that he or she Is exempttherefrom and the.basis for the alleged exemption. Any violation otSectlon 7031.5 try any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($560).: (_ 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 amended 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 improyes.thereon, and who.does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered forsale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that heofshe 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 Ucertsa Lew.). 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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 (Sect 3097, Civ. C:). Lender's Name: Lender's Address: �� 1 LQPERMIT person inany man and agre&that, if 1 3700 of the Labor ,01%;OU (I ant: WARNING: FAILURE TO'SECUI SUBJECT AN EMPLOYER TO C DOLLARS (8100,000). IN ADD SECTION 3708 OF THE LABOR to provisions of any TANSATION COVERAGE IS UNLAWFUL, AND SHALL ND CIVIL FINES UP TO ONE HUNDRED THOUSAND IST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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, indemnlfy.and hold harmless the City of La Quints, 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 cessation of work for 180 days will subject permit to cancellation. I certify thati have read this application and,state that he a e I mationis correct. I agree to comply with all city and county ordinances and state laws relating to aiding Ion, and hereby a orize representatives, of t�nity ter upon theabove mentioned pro rtYfov Ion puatS re;(Appllcamor.Agent): Application Number . . . . . 11-00001103 Permit. . . . BLDG POOL PERMIT INV FEE Additional desc . Permit Fee . . . . 569.00 Plan Check Fee 184.93 Issue Date Valuation . . . . 30000 Expiration Date 4/03/12 Qty Unit Charge Per Extension BASE FEE 504.00 5.00 13.0000 THOU BLDG 25,001-50,000 ----------------------------------- 65.00 Permit... . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date 4/03/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >10.0K 11.00 Permit.ELEC POOL PERMIT -RES Additionaldesc . Permit Fee 45.00 Plan Check Fee . I$sue Date . . . Valuation Expi-ration Date 4/03/12 11-.25 0' Qty Unit Charge Per Extension BASE.FEE 15.00 1..00 30..0000 EA ELEC PRIVATE SWIMMING POOL 30.00 PermitPLUMBING Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8:25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/03/12 Qty Unit Charge Per Extension BASE FEE 15.00' 2.00 6.0000 EA PLS FIXTURE 12.00 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 POOL/SPA. ALARMS/BARRIERS SHALL BE IN -.-;a7. J7,1k� Application Number . . . . . 11-00001103 . ----------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. •EQUIPMENT ENCLOSURE NOT INCLUDED.2010 CODES.INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 673.00 .0'0 .00- 673.00 Plan Check Total 210.93 .00 .00 210.93 Grand Total 883.93 .00 .00 883.93 LQPERMIT 4JA CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DAWAL29:1f6Y klZ_ Bin- #:. pph # Projeex:Addtt ss: 11 - SPIL . Citi Of La Quints Bull gng 8[ Safety DMWm P.O. Box 1504,78-495 Cage Tampico La.Qu1nt4. CA 92253•• (760) 777.7012. Building Permit, Appifcation and Tracking Sheet o'a Name . 46 (l O rn A P. Number. Address:. I'°ga1 D coatractor. Ad&= -7)SX( , L OU T O O k O G I S r t r City. ST. Zip: Telephone: rro}ea Damiption: Sw S A City. sT. Zip: Telephone~ L4 — State UQ # : 3 It C Lie #: &J. ,5v,4 -GAILY/� , alAy5 Arcb.. Engr.,:D esigttest 7.. Address: City. ST. Zip. Telephone: Stdc Lie #: Name of Contsa Person: 6y ( Cm*ucftn Type:. Oocapanw: Ptojoot type (dude one): New Add'a Apex Rope"v Demo Sq. Ft.: # Storks: # Unto; Telephone # of Coined parson: EstimaW Vtdiue of Pmjact: APPLICANT: DO NOT WRITE BELOW THIS -UNE d Submittal Req -d -'Rei -. T8AC MG P1;8A4i'P IM. Pisa Sea Pfau Cheeef<oabmitled !� b Yhm Amew4t Iitractaeal Cales. fRevk%14 ready for correcoom 'Plan Check Deposit • . Trass Calex. Called coatael Pawn, Plan chectewance. lids U Cala. Pfaus Visken 1% P4 conairaetloa Plow plain plan l�laarrnnbatltted / fldacharikal Grading plan Y! Review, ready ft cur �� �Q Electrical Sobeontaetor List Called Coutad Person Plumbing Grant Dead Pians plelted up HOA. Approval Plans resubmitted Gnedlog WHO fReview, rea ft for eorrectiomAssae Developer lmpaet Fee Planning Approval Calleet.Contaet Penn A.LP.P. Pub. VU. Apps' - Date of permit lune Sehool Fea Total Permit Fees