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06-0083 (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: 66-00000083 49895 PATTI CT 649-520-998=6 -290533- POOL - RESIDENTIAL LOW DENSITY RESIDENTIA 23000 1 Architect o BUILDING & SAFETY DEPARTMENT BUILDING PERMIT. LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - Section 7000) of Division 3 of the Business d Professionals Code, and my License is in full force and effect. �LicenseClass: C8 C27 C29 License No.: 656128 ,--Date: Date: Contractgl� 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 ISec. 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).: 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 ISec. 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 _ ) 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 contractsfor the projects with a -contractors) licensed - pursuant to the Contractors' State License Law.). (_) 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: _ LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/09/06 Owner: WOODWARD 49-895 PATTI COURT LA QUINTA, CA 92253 Contractor: CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222. Lic. No..: 656128 ------------------ WORKER'S COMPENSATION DECLARATION 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 HRH INS Policy Number BB1060510 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I shout become subject to the workers' compensation provisions of Section 3700 of the Labor Co hall forthwith complywith those provisions. e:�ItApplicant: . WARNING: FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER I CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION T 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 a permit subject to the conditions and restrictions set forth on this application. - 1.... Each person upon whosebehalfthis application is made, each person at whoserequest 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 cessation of work for 180 days will subject permit to cancellation. - I certify that I have read this application and state that the above information is correct. I agree to comply with all, city and county -ordinances and state laws relating to building c rtc� tion, and hereby authorize representatives of this cou ty to enter upon the above-mentioned grope �fo mspe purposes. Da —� Signature (Applicant or Agent): LQPERMIT Application Number .. . . . . 06-00000083 _ Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee 234.00 Plan Check Fee 152.10 Issue Date Valuation 22675 Expiration Date 7/08/06 Qty Unit Charge Per Extension. BASE FEE 45.00 21.00 9.0000 THOU BLDG 2,001-25,000 189.00 Permit . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . . • Valuation 0 Expiration Date 7/08/06 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 .. 7/08/06• Qty Unit Charge Per Extension BASE FEE 15.00 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 7/08/06 . Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000. EA PLB FIXTURE 12.00 1 .UU 3 . UUUU EA PLB WA'i'ER 1N5'1'/Ai,,ijREP UU 3_00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 Permit . ... . . . WALL/FENCE PERMIT Application Number 06-00000083 _ Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00' Plan Check Fee .00. Issue Date . . . . Valuation . . . 325 -.. Expiration Date 7/08/06 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------ ----------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. 15 L.F. 6- EQUIPMENT BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due - ------ ---------- Permit Fee Total 353..00 .00 .00 ---------- 353.00 ..Plan Check Total -178.1-10 .00 .00 178.10 Grand Total 53110• .00 .00 531.10 Total Permit Fees Bin # _ City ®f La Quinta Building & Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico 0Of,3 La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:Q �/" Cis Owner's Name: - A. P. Number: Address: 09 City, ST, Zip: � Legal Description: Contractors. ce, ` Telephone: �� 7 .om _ Address: Project Description: City, ST, Zip: 9' - 2 Telephone: ��� 17 p 7�d �T�S7�22 ,. r _a Pte, State Lie. # .2— City Lie. #: Arch., Engr., Designer:. Address: City, ST, Zip: " Telephone: State Lie. #: r r Name.of Contact Person: �G�� Je Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo S Ft.: 4 # Stories: # Units: Estimated Value of Project: Telephone # of Contact Person:,26-0--7 V 2. 2 / APPLICANT: DO NOT WRITE BELOW THIS LINE # SubmittalReq'd Recd . TRACEING 6 ERM1T FEES Plan Sets Plan Check submitted /A6 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Babnce Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr School Fees Date of permit issue Total Permit Fees CITY OF LA QUINTA MIM I NG-cx 3 8 N r i FOR CONSTRUCTION DATE t 06 BY