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05-4323 (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: 05-00004323 77121 CASA. DEL SOL 773-360-012- - POOL = RESIDENTIAL MEDIUM DENSITY RES 30000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/26/05 Owner: CORRALES 77-121 CASA DEL SOL LA QUINTA, CA 92253 ------------------ I --------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed5!Z7�� mmencing with Section 7000) of Division 3 of the Business and Professioll force and effect.;� License'class: stet "oZ�i �� Contra r: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.6, Business and Professions Code: Any city or county that requires a parmit.to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the'applicard for the permit to file a signed statement that'he or she'is licensed pursuanrto 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 orshe1s exempt therefrom and the.basis foe 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 (8600).: 1 _ 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 ft work himself or herself through his or her owrremployees;,provided, that the ,improvements are not intended.or offered for sale. If, however, thwbuilding or improvement is sold within one year of'completion, the ownerzbuilder will have the burden of proving that he or she did-notbuild or improve for the purpose.of safe.). 1 1 1, as owner of the property, am'ezclusiveiy contracting, with licensed contractors to construct the project (Sec. 760, 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..forthis 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: r M: )MPLETE POOL EXEMPT EXEMPT 8'41981 SERVICE 09/30/0.5 07/31/06 WORKER'S COMPENSATION DECLARATION I hereby.affirm under penalty of°pedury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workeW compensation, as provided forby Section 3700 of the.Labor Code„for the performance of the work forwhich.this permit is issued. /k I have and will maintain workers' compensationinsurance, as required by Section 3700 of the:Labor J — Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and,.policy numbevare, Carrier C53 Policy Number --------------- _ I certify that, in the performance of the work,for which,this=permit is issued, 1 shall not employ any person in enymarmer so_as to beco subject to the workers' compensation laws of Celifornia, snd�agree that, if I should becom bject.to the coo era' compensation provisions of Section 370 the Le e, l shall ith ply those provisions. Date:Applicerrt. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES.ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($I 00,009)1 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 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, eachagrees to, and shall defend, indemnify 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 permk.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 that .1 have read this: application and state that the above” rmation Is correct. I agree to comply with, all city and courtly ordinances and state laws relating pb�ulldin'co coon, and hereby authorize representatives of this �o1yto emerupon the above-men[ioned'r npu mate: Signature (Applicant or, Agent Application Number . . . . . 05-000043.23 Permit . . . BLDG POOL PERMIT Additional desc . . Permit.Fee 284.50 Plan Check Fee 184.93 Issue Date . . . Valuation. . . . . 30000 Expiration Date .3/25./06 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG,25.,001-50,000 32.50 Permit MECH POOL Additional desc . Permit Fee . . . . .26.00 Plan Check Fee 6.50 .Issue Date . . . . Valuation . . 0 Expiration Date . . 3/25,/06 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 Additional desc .Permit Fee . . 45.0.0 Plan Check Fee 11.2.5 Issue Date . . . Valuation . . . . 0 Expiration Date 3/25/06 Qty Unit Charge Per Extension BASE' FEE 151.00 1..00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit PLUMBING Additional desc . . Permit Fee . . . . .33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 3/125/06 Qty Unit Charge Per Extension BASE FEE 15`.00 2.0.0 6.0000 EA PLB 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 ONLY. ALARMS/BARRIERS SHALL Application Number 05-00004323 ---------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Permit Fee Total 388.50 Plan Check Total 210.93 Grand Total 599.43 Paid Credited Due .00 .00 388.50 .00 .00 210.93 .00 .00 599.43 Bin # City Of La Quinta Buildings Safety Division P.O. Box 1.504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ac "— Project Address: -7-71J 1 04q5A hp Owner's.Name: %p JJr &leg-41-e-5 A. P. Number: Address: 77/a) Legal,Description: City, ST, Zip: GL . / Contractor: ¢ !s Address: �;�-Z City, ST, Zip: Liq inla, ra 9A0D$ Telephone.. Project Description: Me U) Dro 1 L10 4— Telepho ..K If 1- State Lic: # : -city Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone; `>> Construction Type: Occupancy: State Lic. #: Project type (circle one): ew dd'n Alter Repair Demo Name of Contact?erson:Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: % P "oi7a-%3y Estimated Valueof,Ptoject: %_�30 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'd TRACENG PERMIT FEES Plau.Sets Plan Checksubmitted 9 u Item Amount Structural Cala: Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked tip Construction Flood plain plan Plans resubmitted Mechanical Grading plan_ 2•' Review, ready for correctionslissue Electrical Subcontactor List i Called Contact Person Plumbing Grant Deed Plans picked up- S.K.I. H.O>A: Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees / I CITY OF LA QUINTA SUB-CONTRACTOR LIST �D JOB ADDRESS -7 7/a/ e�fwa.. , l / PERMIT NUMBER 0S- Y323 OWNER /omi- �� Ao -BUILDER A 4x 0861 0 This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of`work and/or the voidance