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06-2063 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 I Application Number: 06-00002063 .Property Address: 80205 NORTH RESIDENCE APN: 775-380-999-20 -31627 Application description: STRUCTURES OTHER THAN Property Zoning: MEDIUM DENSITY RES Application valuation: 1500 4 44 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CLUB DR NADADOR, LLC - 78120 CALLE ESTADO, SUITE 203 BUILDINGS LA QUINTA, CA 92253 Contractor: Applicant: Architect or Engineer: CALIFORNIA POOLS & P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 ------------------ 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: C8 C27 C29 License No.: 656128 e�( Contiactor: Milli OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I m exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and rofessions 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 ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the - improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7644, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a comractor(s) licensed pursuant to the Contractors' State License Law.). . (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ISec. 3097, Civ. C.). ' Lender's Name: _ Lender's Address: LQPERMIT S N VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/16/06 PLAY 1$ 2006 CITY- OF Qco�TA ----------------------------------------------— 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. vl 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 SEABRIGHT ' 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 ecome subject to the workers' compensation laws of California, and agree that, if I should be subject to the workers' compensation provisions of Section / p. 3700 of the Labor Code, I a o with comply with those provisions. DatC� 6Id ApplicarSi: ~ WARNING: FAILURE TO SECURE WORKERS'OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES 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. 4'1 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 bove information is correct. I agree to comply with all city and county ordinances and state laws relating to b ' onstruction, and hereby authorize representatives of this count` to enter upon the above-mentioned pro for i pection purposes. Date. 6 Signature (Applicant or Agent . f) " Application Number . . 06-00002063 Permit BUILDING PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee .22.75 Issue Date . . . . Valuation 1500 Expiration Date 11/14/06 Qty. Unit Charge Per Extension BASE FEE 15.00 10.00 2.0000 HND BLDG.501-2,000 20.00 ------------------------------------------------ Special Notes and Comments FIREPIT (AGAL 496) ONLY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 2.28 Fee su:::mary Charged Paid Credits2. Due ------------------------------=----`-- ---------- ---------- t Permit Fee.Total 35.00 .00 .00 35.00 Plan Check Total 22.75 .00* .00 22.75 Other Fee Total 2.28 .00 .00 2.28 Grand Total 60.03 .00 .00 60.03 LQPERMIT LDATE_L_BY_\, t. a :•.:; B #A. .7777 0.6 t.::...:' i :...:.....:.,B�uildrng � ty-, uislon\;� Safe ;::D, I • 0.4. :,� ,; Rs 'P'errnit # B;gz 1::5Q4'78.:495:.Ca1(' e' Tampico a.Q . ta, .CA.922?53�:=:`•°760��`7�77:-7.0:1 Z 5�ii$5 .......... i 1s• :. /.- .63.cation 011 �...:...::P 'Nand°�:�- co ect Addre W et•�� s , F , S' N.�. � " ame• , ddre O ss: Z Le al Desert .. .... ... .. ..... .... ..... .. _..... ,..... ti: ...q��;;..... �.. U sC t f Zi , ......... NSuu3:,t,,.D �}a,dt-2:s _: ,:-:.. ;:.. .: '':::_'.:: ":;" qty>. ��•: _ • Ad r- e ..t. ss. ,t •;i'U �i ''t3',,. o .. ,�': LL • :ti: �'�"::�: stir::`.".::;;'v,\:',\!, •©. 2 . Cp . 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