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05-4581 (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: 05-00004581 81213 RED ROCK RD 764-270-999-61 -30023= POOL - RESIDENTIAL MEDIUM HIGH DENSITY'REE 15000 Architect or h'! Td�v 4 4& Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Code, and my License is in full force and effect. License Class: Licens No.: Date/fl` _CZS Contractor: OWN -B ILDER DECLARATION I hereby affirm under penalty of perjur at I am exem f m the Contractor's 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 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 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 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.). (_ 1 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.). (_ 1 I am exempt under Sec. , 6.&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 (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: GIZZI, MARION 81-213 RED ROCK ROAD LA QUINTA, CA 92253 Contractor: ALPINE SERVICES WCC: STATE FUND WC: 2290023236 CSLB: 786324 . VOICE (760) 777-7012 FAX (760) 777-7011- INSPECTIONS (760) 777-7153 01/01/06 10/31/06 Date: 10/12/05 WORKER'S 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. Y I have and will maintain workers' compensation insurance; as required by Section 3700 of the Labor 7' Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier C53 Policy Number - - - - - - - - - - - - - -- _ 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 e, I shall forthwith comply with t se provisions. aim Applicant: r WARNING: FAILURE TO SEC WORKERS' COMP SA ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO IMINAL PENALTIES ND IVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST NOD 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 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. 1 agree omply with all city and county ordinances and state laws relating to onstruction, and hereb authori presentatives of this count toenter upon the above-mentioned Merty for ins purposes. Da . �- •6i� Signature (Applicant or Agent): Application Number . . . . . 05-00004581 Permit . . BLDG POOL PERMIT_ Additional desc . Permit Fee 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date . . 4/10/06 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ----------------------------------------------------------------------------- THOU BLDG 2,001-25,000 117.00 Permit ME -CH POOL Additional desc.. Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0. Expiration Date 4/10/06 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 4/10/06 QtyUnit 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 4/10/06 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 ONLY. ALARMS/BARRIERS SHALL LQPERMIT Application Number 05-00004581 ---------------------------------------------------------------------------- ' Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION: EQUIPMENT ENCLOSURE NOT ` INCLUDED IN PERMIT. Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 266.00 .00 00 266.00 w. Plan Check Total 131.30 .00 .00 131.30 Grand Total 397.30 .00 .00 397.30 LQPERMIT Bin # City of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 0.5 Project Address: l , Q LK D Owner's Name: / , C� Z t CLI 6 h. A. P. Number: Address: 12) _ a I `- Legal Description: City, ST, Zip: .Z i s Contractor: ` Telephone: Y Address: ,_ S �1� �- Project Description: City, ST, Zip: rA Isehi UD Telephone: 116 - so City;Lic. #: State Lic. # : Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: .� �� r Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES 2 Plan Sets Plan Check submitted to Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance 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:- IN Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees --�--r777 , y. t n + v 3 �1 . 1r�r�aews NO. 186A k. 11X!4 , . - . .. :» .,. .".. � ...: -a:. - .: , � .. .. ,� • .. m .w. ,s .�,n. 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