07-1918 (RPL)P.O. BOX 1504 414 a"
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00001918 r t Owner:
Property Address: 81658 RICOCHET WY FREDDIE DIAZ
APN: 767-200-999-22 -312021- 81685 RICOCHET WAY
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL Mr
760) 777-9920
Application valuation: 22000 D
ontractor:
Applicant: Architect or Engineer: ENRY' S ENGINEERING
JULIla .O. BOX 10290
Ik NDIO, CA 92202
�a�760)275-6956
11 IaMnic. No.: 859859
------------------
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 ie ionals Code, and my License is in full force and effect. '
License Class: A License No.: 859859
Date:Contractor:
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 .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 1, 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.). '
(_) 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 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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/02/07
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.
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 STATE FUND Policy Number 046001530607
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 b bject to the workers' compensation provisions of Section
3700 of the Labor C shall f with comply with those provisions.
Date: - �d-1 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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.
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 actor 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 statet e above information is correct. I agree to comply with all
city and county ordinances and state laws relatin .to buil 'ng construc ' n, and hereby *authorize representatives
of this county
to enter upon the abov - Toned pr�rinspecti purposes.
Date:_ ignature (Applican
Application Number
07-00001918
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . .
225.00 Plan Check Fee
146.25
Issue Date . . . .
Valuation
22000
Expiration Date
12/29/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20:00 9.0000
-----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
180.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/29/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
-----------------------7----------------------------------------------------
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
12/29/07
Qty Unit Charge
.Per
Extension
BASE FEE
15.00
1.00 30.0000
---------------------------------------------------------------7------------
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
12/29/07
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
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Special Notes and.Comments
--------------
POOL/SPA, WATERFALL. ALARMS/BARRIERS
LQPERA1IT
Application Number . . . . . 07-00001918
Special Notes and Comments
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED. BBQ & FIREPIT BY SEPARATE
PERMIT.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 329.00 .00 .00 329.00
Plan Check Total 172.25 .00 .00 172.25
Grand Total 501.25 .00 .00 501.25
LQPMIIT