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04-2177 (RPL)M,o d •r' BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (766)-7,77-7153 .BUILDING PERMIT - Application Number 04=00002177 ;% Date •4/23/04• Property Address . . . . . C44575---PALA -CIR APN: 604-262-006-50 -23913 - Application description POOL —.RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL .Application valuation.. . . 2000000 Owner Contractor BOB BATES OWNER 44-575 PALA CIRCLE LA QUINTA. CA 92253 ---�-- Structure .Information- ''POOL -=--- ---- ----------------- ------,--.--.= =---;w,---------------------------------------- Permit . . . . . . BLDG POOL.PERMIT. Additional desc CCHANGE OF CONTRACTOR TO .O/ -B Permit Fee 4:50 Plan Check Fee .00 Issue Date Valuation . . 0. Qty Unit Charge Per Extension BASE FEE 4.50 Special Notes and Comments EFFECTIVE 4/23/04,.CONTRACTOR OF RECORD y WITHDRAWN FROM JOB, REISSUED PERMIT AS a OWNER/BUILDER (GB) Fee summary Charged Paid Credited Due Permit Fee Total 4.50 00 .00 4..50 Plan.Check Total ..00 .00 .00 .00 Grand Total 4.50 .00 .00 4:..50 I I U APR 2 7.2004 CITYOV ak 21UNTA M P.O. Box 1504 s i 78-495 CALLE TAMPICO 9&cu VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 4Q INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 01_ 3) 1 7 Date: Of-Zd- 00 Appiicant: D y 3l�-7 Applicant's Mail* Address: �- cQ vh ,✓r�- �9 9 2z s3 Architect or Engineer. Archdect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS 1 hereby affirm under LICENSED CONTRACTOR'S DECLARATION fir d perjury and ghat I am licensed under prmisions d Chapter 9 (Mmwn=V with Section 7000) d Divesion 3 d the Business and P+olessionais Code. and my License 18 in fu/ face nd eAeet License pass License No. Oafs Contractor 1 hereby alum under PONNY Of perjury that I am OWNE,R•BUILDER DECLARATION city «County Chat M- grow a penrt b construct Germ from w Condactors' Stale License Law f« the toNowkV reason (Sec. 7031.5. Business and Prolehslons Coda: Any improve, demoish « repair any Muclum Prior b Its ksu XX4 ahso requires the appiani f r 9a permit b tie a siprad � � Code) b the pvvtsions a 9a Contracbrs' State License Law (Chapter 9 (commencing with Section 7000) d Division 3 of 9a Business the sapient b a civil r that he or she is e700fro n � the tmis for ths aNsped exon Pkm Any violation d Section 7031.5 by any applicant for a permit subjsets U I. applicant t d rine penalty d not more than in hundred doflsrs (t500)_r prmessio s Code: The a with waees as their 5018 Compensation, will do the work, and the structure is not intended «of18red for sale (Sec, 7044, Business and Professions Code: The Contractors' State Lioernse Law does not appy b an owner d property who builds « improves thereon and who doss the work whimseor herself or through itis or her own anpbyees, lxovided that f mprovements are not intended or offered f« sale. If. however. the iwi ft or improvement is sold U I. as owner in am the rex dP*Pwt�D1eth. f Oww-builder will have the burden d proving that h e ore did not build or improve f« the purpose d sale.). state owner of t Leu coma Wnnotappcantractig with licensed aantracbrs b Construct the pn�jed (Sec. 7044. Business and Professions Code: The Contractors' an vwnar of prop"propwho bolds or improves thereon. and and who contractscontractster the projects with a oontracior(s) fioensed pun wntb the Contracbre State License Law.) U 1 am exempt under Sec . B.3 P.C. for this reason 1 hereby strum under penally d WORKERS' COMPENSATION DECLARATION I have and will mainta a cer mate d consenthemb sedgy for workers• d the work tot which this permit is issued. - hPensa4an, as provided for by Section 3700 of the Latwr Code, for the pefomranoe _ 1 have and will maintain eaih workompes' tion insurance cankm as required by Section 3700 d the Labor Code. for ft perfomhance d the work ter which this peg., Is issued. MY workers' compensation insurance Cartier and Policy number aro: Cartier _Policy Number _ I oerti(y that, in the peAorrrnarrca of the work for which this Pei.. i is is — I shah not employ any person in any manner so as to becor, subject b 9a workes• c0n forthwith comply that, Y I should become th became subject e worfeers•Com;s; pensation provau of Section 3700 of She labor Code. I shat Date (4Zi Applicant WARNING: FAILURE TO SECURE WORKERS DD COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SL 3JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (3100.000). IN ADDITION TO THE COST OF COMPENSATION. OAMAGF SECTION 3705 OF THE LABOR CODE. INTEREST. AND ATTORNEY'S FEES. S AS PROVIDED FOR IN . 11w.eby alum under CONSTRUCTION LENDING AGENCY penalty d perjury that there it a construction W'*V agency for the Performance d the work f« which this pemhit is issued (Sec 3097, Civ. C.). Lendefs Name Lender's Address_w�/. IMPORTANT Application is hereby made b tla Dirocbr dAPPLICANT ACKNOWLEDGEMENT ane and Safety for a pewit subject 10 the conditions and restrictions set brth on this application. 1. Each person upon whose behalf this Issued as a result d this application• owner and "We, each pesos at wfhose reguest and for wfnose benefd work is petomad under «pursuant b any permit 0flices, agents and employees for any ac «omission relaate to C e hwo agrees ck to. and that. defend. indemnify and hold harmless the City d Le Oukhh. Its 2 Any Permit issued as • result d this application becoeas null and void If work is not loom eno�ed within l jp� issuance d Ws pemhil 1 oertiy that I haw 80tion of w � 180 days will subject pal.. b Cancellation. dabs nom dated issuance d such penriL « application and state that the above information is correct 189 b comply with all city and County ordinances and state laws rotating b building construciN% and hereby authorize representatives of this county to ewer upon the obove-nentioned property for inspection pins. - Date 'L Signature (Applicant or Aeenti W �Q .JOB CITY OF LA• QUINTA SUB=CONTRA TOR LIST 4 �'l ADDRESS - �7� l � 2C PERMIT NUMBER d�I- 21 = OWNER ' G- (JAS BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a,conspieuous place. Only persons appearing on this list. or their employees -are authorized to work , ' onAhis' job: • Any changes -to -this -list -must-be-approved-by-the-Building-Division-`prior. -commencement of work. ' Failure to comply will result in a stoppage of work and/or the' voidance of building permit: For each applicable trade, all information requested below must be completed by applicant..."On File" is not an acceptable response. x ::::: LQ : . . . .. ..0 ........................................-..................... ... ... ..... ...... .1k ... ...::::::: tY ..........S.. .... ....�... .5....... .. Company Name ClassificationLicense L'ce e Number EP Date - Carrier Name.. Policy.Num ber EP . Date L'icense Number E . Date , ABC -81 z xx xx1(e.9• le. .State Fund CalComP1' Format Varies1 xX/XX/Xx1 (XXXX1 (XX/xx xx 1xxxxxx1 4 =: �+� • .. 1: t ........................ _ :..... 3 .......... (x:91 .::::::..:.......::::: r= A . MEIN # HEf j'``11111 TA..:A..:::.M: ...:::: �. . -01 .>>"' ....:..... PX1 eST �CLST�(L I C - 3 �3 5 I P�� � ��� N 6`8 7 F 0 8'- Y 0 >_ o' Or 0 - p4=Z6 09. OWNER/BUILDER INFORMATION 1. Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law" to put their license number on all permits for which .they apply If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and suchpersons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the -State and Federal Government as an employer "and you are subject to "several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service.(and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under. Stare Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed, to perform their work personally or through their own employees, without a licensed contractor or subcontractor, onlyunder limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be 'signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please"complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY -78-495 Calle Tampico La Quinta, CA 92253 (760)777-7012 FAX: (760) 77-7011 <OWNER S--SIGNATURE/DATE PROP_ ERTY ADDRESS p -f -Z12? PERMIT NUMBER(s)