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06-3089 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00003089 Property Address: 58235 CARMONA APN: 764-200-006-1'4 -316811- Application description: POOL - RESIDENTIAL ' Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 100000 T4bt 4 4 Q" Applicant: Architect or Engineer: - BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -----------------------------------------------'-- . LICENSED CONTRACTOR'S DECLARATION 1 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 Cla C53 LicenseNo.: 238947 Date: Z Contractors— — OWNER -BUILDER DECLARATION I hereby affirm under penalty o perjury that I am exempt from the Contractor's State License Law for the - following reason ISec. 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, 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 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 Owner: JOHN DEAN 58-235 CARMONA LA QUINTA, CA 92253 ( VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/24/06 Contractor: D I'M MASTER POOLS AND SPAS AUG.73555 HIGHWAY 111 U 2 5 2006 PALM .DESERT, CA 92260 (760)346-6115 CITY OF IA QUINTA Lic. No.: 238947 eOuwunewelll - ----------------------------------------------— WORKER'S COMPENSATION DECLARATION 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 CLARENDON Policy Number 01KR0033017 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 700 of the Labor Code, I shall forthwith comply with those provisions. Date: Ws Applicant: WARNING: FAILURE TO ECU WORKERS' COMPENSATION COVERAG�1SUNLHAWFDURLi AND SHALL SUBJECT AN EMPLOYERTORIMINAL PENALTIES AND CIVIL FINES UP D 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 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 coun ordinances and state laws relating to building construction, and hereby authorize representatives of this coun to a ter upon the above-mentioned property for inspection purposes. Dater nature, (Applicant or Agent): Application Number . . . . . 0.6-00003089 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 639.50 Plan Check Fee,. 415.68 Issue Date . . . . Valuation 100000 - -Expiration Date 2/20/07 Qty Unit.Charge Per Extension BASE FEE 414.50 50.00 4.5000 THOU BLDG 50,001-100,000 225.00 Permit . . . MECH POOL Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue.Date Valuation . . . . 0 Expiration Date 2/20/07 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 2/20/07 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 . . . . 39.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 0 Expiration Date .2/20/0.7 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .6.0000 EA PLB FIXTURE' 18.00 1.00 3.0000 EAPLB 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 & WATER FEATURE. PERMIT DOES LQPERMIT 0 . Application Number . . . . . 06-00003089 ---------------------------------------------------------------------------- Special Notes and Comments NOT INCLUDE EQUIPMENT WALLS Fee summary Charged --------------------------- Paid ---------- Credited ---------- Due ---------- Permit Fee Total 749.50 .00 .00 749.50 Plan Check Total 443.18 .00 .00' 443.18 Grand Total 1192.68 .00 .00 1192.68 LQPERAIIT