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05-1021 (RPL)It X41 BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760).777-7012 78-495 CALLE TAMPICO + FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . .0.5-0000102.1 Date 3/22/05 Property Address . . . . . 79459_PASEO'DEL REY APN: 604-440-001-1 -275-9 - Application description POOL - RESIDENTIAL Property Zoning ...LOW DENSITY RESIDENTIAL Application valuation 205020 Owner Contractor ---------------------- ---------------------- I LOPEZ AZURE POOLS AND SPAS 79-459 PASEO LA QUINTA P.O.,BOX 10641 PALM DESERT CA 92255 .(760) 322-7665 WCC:- STATE FUND WC: 1705653-2005 03/01/06 CSLB": 802919 01/31/06 CCC• C53 Permit . . . . BLDG.POOL PERMIT Additional desc Permit.Fee. 216.00 Plan Check Fee 140.40 Issue Date Valuation 20500 Qty Unit Charge Per Extension BASE FEE. 45.00 19.00 9.0000 THOU BLDG 2,001-25,000 171.00 ------------------------------------------------------------------------- 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. Issue Date . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 30.0000 EA ELEC PRIVATE SWIMMING PCOL 30.00 Permit . . . PLUMBING Additional desc Permit Fee . . . 33:00 Plan Check Fee 8.25 P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT s� " VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Application Number:y s— / O Z / Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: o%/ Tle,4- C TD V2 Architect or Engineer's Address: Lic. No.: tSUILIANU PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I 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 and Professionals de, and ss Lice e ' in }-'II yfforce and effect. /^� icense Class �� `j License No, ---" o✓ � (, a- to Contractor—,---- OWNER-8 ER DECLARATION I hereby affirm under penalty of perjury 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 statement that he or she is licensed pursuant to the provisions of the Contractors' 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).): U 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 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 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.). U 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 contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I 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 ntain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is / 'issue y w �IceA compe sation insurance carrier d go�nn b�{ arner Policy Number 1 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwithcomplywith those provisions. Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION ERAGE 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 4/4 Lender's Address 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, 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 cons�tCon, and herebyauthorize representatives of this county toenter upon the above-mentioned property for inspection purposes. 7 Signature (Applicant or Agent C• Page 2 Application Number, 05-000.01021 Date .3/22/05 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE' 15.00 2.00 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. GAS STUB TO FUTURE APPROVED.' _ APPLIANCE. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER -INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED"IN PERMIT. Fee.summary Charged Paid Creditec Due Permit Fee Total 318.00 00 C0 318.00 Plan Check Total 165.90 .00 - C0 165.90 Grand Total .483.90 .00 C0 483.90 AZURE- POOLS & SPAS LIC# C-53, 802919 POOL SPECS POOL SIZE: 15'X 34' POOL AREA: 460 SF POOL PER: 93 FT POOL DEPTH: SPA SPECS SPA SIZ :7' SPA AREA: 38 SF SPA PER: 22 FT ` EQUIPMENT PUMP: FILTER: HEATER: POOL LIGHT: SPA LIGHT: FINISHES DECK AREA: 726 SF PLASTER: TILE: 1"=8' SCALE LOPEZ RESIDENCE ADDRESS: 6j S CITY: LOT #: L fi T c T