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05-2579 (RPL)m P.O. BOX 1504 Tdif 78-495 CALLE TAMPICO .4 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: OS -00002579 Owner:.. Property Address: 585-65--QUARRY-RANCH RD QUARRY RANCH APN: 766-060-999-5 -30651 - 41865 BOARDWALK NO 214 Application description: POOL - RESIDENTIAL PALM DESERT, CA 92211 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 35000 Applicant: Architect or VOICE (760) 777-70.12 FAX (760) 777=7011 INSPECTIONS (760) 777-7153 Contractor: leer: C & G CONSTRUCTION COMPANY ID 0 WCC: STATE FUND WC: 1799267 10/01/05 CSLB: 692234 '07/31/06 rl JUN 28 2005 CITY OF LA QUINTA -- - - - - - - - - - - - - - - _ -- - - - - - - - -- 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 Cl s: _ License No.: ate: 6�'ontractor: C (> 4.:-J 3 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 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 improvesthereon, 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 impr9ye5 theregn, and whn nnntrarts fnr tho prnjertr mdrh ;, eontmatotlol lieenaad pursuant to the Contractors' State License Law.).. 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: LQPERIIIIT Date: 6/24/05 ----------------------------------------------.-- 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. - - x 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: -t '? b -L/ -, arner B Policy Number 1, ` L (!� . 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 3Rp 70 ff'the Labor Code, I shall forthwith comply with those provisions. te: plicarff: C WARNING: FAI URE 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 . Eauh peisun upuii wnuse uenalT Tr1I5 application ii: 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 Ouima, 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 d within 180 days from date of issuance of such permit, or cessation of work for 180 day ill subject permit to cancellation. certify that I have read this application and state that the above inf n is carr _ a to ply with city and co my ordinances and state laws relating to building con ct , and eby au rize resentative of t�h' o ty t .enter upon the above-mentioned pr erty for in cti purp ✓Date: C -J Signature (Applicant or Agent): =r . Application Number 05-00002579 Permit . . BLDG POOL PERMIT Additional desc . Permit Fee 317.00.. Plan Check Fee 206.05 Issue Date Valuation 34600 Expiration• Date 12/21/05 Qty, Unit Charge Per Extension BASE.FEE 252.00- 10.00 6.5000 THOU BLDG 25,001-50,000 65.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration'Date .. 12/21/05 ' 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 12/21/05 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 .. 12/21/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTVRE 12.00 1.00 3.000U EA PLB NATER INST./ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 Permit . . . .. WALL/FENCE•PERMIT' LQPERMTT Application Number . . . : 05-000025.79 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation 400 Expiration Date 12/21/05 Qty Unit Charge' Per .Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. 16, L.F. 6' BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER -INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 43.6.00 .00 .00 436.00 Pian Check Total 232.05 .00 00 232.05 Grand Total 668.05 .00 .00 668.05 r-boolz-4 00 S--f-o%J16, � �'Sep, In 01A SO4 l,iw/rt JE St�r��wa"/ E F LA QUINTA & SAFETY(D�EPT. ROVEDONSTRUCTION �