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07-0405 (CP)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 ' BUILDING & SAFETY DEPARTMENT - INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/06/07 Application Number:. � r-00000.4.Q5__ Owner: Property Address: 43100 PALM-ROYALE DR "DUTCH PARENT NV APN: 609;-051-010- - - 38 NEWBURY ST 6TH FL Application description: POOL COMMERCIAL. BOSTON, MA- 2116 Property Zoning: -HIGH DENSITY RESIDENTIAL A,pliratinn v?hrntinn l�npnrt _ e Contractor: Applicant: Architect or Engineer: PARZINSKY POOL, IN RICH P.O. BOX 897 ' . E FEB 0 6'200PALM SPRINGS, CA'9 (760) 324-5827 CITY OF LAQUINTA 1 I Lic. No.: 431055 FINANCE DEPT. ----------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed) under rovisions Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business and Profe i nals Code, d License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C8 C53 Lice a ,o.: 10 •5 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is • issued. ate .`;7 J _ ntractor: - - - I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor - - - - -- - - `-- Code, for the performance of the work for whichthis permit is issued.- My workers' compensation's OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0000328-2006 following reason (Sec. 7031 ;5, Business and Professions Code: Any city or county that requires a permit to _ 1 certify that, in the, performance of the work for which this permit is issued, I shall not,employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so -.b'e'cBMe­su 'ect to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I shoul ecome subject the workers' compensation provisions of Section License Law, (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor.Cod s II fortbwif omply with those provisions. ' 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).: Ap nt: r- ( 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 WARNING: FAILU E TO CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND , and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' one year of completion, the owner -builder will have the burden of proving that he or she did notbuild or improve for the purpose of sale.). - .APPLICANT ACKNOWLEDGEMENT i ( ) J; as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of - conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed i . Each person upon whose behalf this applicationis made, each person at whose request and for - pursuant to the Contractors' State License Law.). ` whose benefit work is performed under or pursuant to any permit issued as a result of this application, I am exempt under Sec. , B.&P:C. for this reason 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 anyact or omission related to the work being performed under of following issuance of this permit. Date:. Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I ve read this application and state that the ove information is corre I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.6 - - city and my ordinances and state laws relating to burl ' construction, an eby a thorize representatives' of th�t r to en r upon t above -mentioned prope or a ti rd' es. / Lender's Name: - ate ff ature (Applican _ Lender's Address: LQPERMIT 7 - - . I Application Number . . . . . 07-00000405 Permit MECH POOL Additional desc . Permit Fee 48.00 Plan Check Fee 14.75 - Issue Date Valuation. 0 Expiration Date 8/05/07 Qty Unit Charge Per Extension - -BASE FEE 15.00 3.00 11.0000 EA MECH FURNACE >100K 33.00 Permit ELEC-MISCELLANEOUS Additional desc . Permit Fee 97.75 Plan Check Fee 26.13 Issue -Date. . . . Valuation . . 0 Expiration Date 8/05/07 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 .7500 PER ELEC DEVICE/FIXTURE 1ST.20 8.25 5.00 7.5000 EA ELEC PWR APP >1 TO <=10 37.50 2.00 18.5000 EA ELEC SVC <=600V/<=200A .37.00 Permit PLUMBING Additional desc . Permit Fee . . . . 39.00 Plan Check Fee "13.50 Issue Date- -• - _ Valuation - Expiration Date 8/05/07 Qty Unit Charge Per Extension BASE FEE 15..00 3.00 6.0000 EA PLB FIXTURE 18.00 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 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . 709.50 Plan Check Fee .' 461.18 Issue Date . . . . Valuation 120000 Expiration Date 8/05/07 Qty Unit Charge Per Extension BASE FEE 639.50 20.00 3.5000.THOU BLDG 100,001-UP 70-.00 ----------------------------------------------------------------------------- Special Notes and Comments 2 POOLS & 1 SPA LOCATED NEAR CLUBHOUSE. LQPERMIT I q T o,a so o o cl 9114106 ® Oa o •_ m o to J I , �� r•. d m o .o U O PALM a W p. - - W - -" Mediterra Apartments I' 43-100 Palm Royale Drive `\ \\ \ Nam° La Quinta CA 92253 114/06 co w • I I I I � .SITE LEGEND: 6LkNDSCAK � 4 AODPE59 FM ACCESSIBLE RARE ➢pR pU SrfE. . N $ w uwr l � erm",vns Q ADDRESS PLAN II G '-,.— �J &` / Cf FO—FLACUiNTA .. % .Rio. .. - 03169.03 ca r�, r c� spirk.:,i+xZ?e.�mr9r ic�f..r� .�stt`y' o� COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH > ENVIRONMENTAL HEALTH SERVICES x SUPPLEMENTALREPORT TO SAN. FORM # i DATE 12 ! 21 I n-7 SUBJECT' 1 P ( i - r sir /`.1 �''� i� %ln I l_J PERMIT NO. t, -- n n - k • ` - ADDRESS 'I � ` I U 0 Fart X -,�nn Q_mL1 (a U 0 INSPECTOR REMARKS: t ,_ � j I lf7-P(11f l -SiJ Sr�()r dQ i 5 a PA 3 .. nn n . i n s ei i I tl 4-en Il P m �t /�---I'`-P p :C i" P� i 1 �P r^ -t W 20 - 5 h,�. tom'' 0 0 "7 -- , ft: - ik 4-T) hero-P,��A44 P -f hdAZ r) n-,O)o ro\A DA .5++lii/�%✓� pis ��'-•...:..` 1� ors ,ii, Ivy` ; ,� t .- � i - •. . - + DEHSAN118(RevWO2) + Distribution WHITE —Office; CANARY —Owner PINK —Office a i t L�. air;._. >-iT.F'n'�a,*ii?,}`.:1'y�c;'rn :'.e •r. °c. x.Y a�kst.:'��.�,. .,.d n...".Ys.�,�.�..:�:s.. !.1�.'x,_.r':.•:r .s?.,1� �*�rf,...•..- �r� -+v4� < SM�t. .fir.- �. .,. .. ,.a. ,a....�a .,�.. -.-. .. _... .r. � �r r �`, �: �. v,��,:-.y.-r�.�.t :m��,!-srw a•.u-•..,rf•�,,.�,._�miyK�.'�a�.+�,�y��AL..W`Tvt�:,�'4^;..r��..� ..✓��;,/t, x�F.,..YFT'+...�...-s�.F �i�*i°� ._�. r COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # DATE I /2-9 /O—% SUBJECT ( Y 1 Q_(/l/L/1 Q ,� i/� i 1 7—�%D l PERMIT NO. ADDRESS REMARKS: INSPECTOR ' M Nil' ,--ems 1-4 a 1, - a SO C14A OLJ n . A-0--r r\Q E ffig k2,,-ml fp d 7b) op p rmvr o S V DEH-SAN-118 (Rev 8i02) a Distribution: WHITE—)ffice; CANARY --Owner; PINK —Office "'r4'. i ` �R�"'.!`.?�""""`�Z"" F"ixs�yri,�r; our--�z-�. •:; ��°�•L.,,� ,s".`� .•-+.' #r�'�?. t'?�"�..i}��7 � ]k >-y� X os..�is��� �i �.`",� ; �"..91�'+i1� �• r�'�!.v.�n�,.."`ir•.��� i ��i � Yf<��<w,�•r . ^�v COUNTY OF RIVERSIDElCOMMUNITY HEALTH AGENCY r DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL ,1HEAU ;SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # DATE SUBJECT yr ►.o l /Ate As + r PERMIT NO. ADDRESS �� t�Gf44 lollLe r INSPECTORrum ' . REMARKS: {! a // - �.P 3 v ifs 4 , j, t^ Ji' 1 �1AA 41 W 10A)lr� - II <ti d 4. l ilk h' y DEH-SAN,l18 (Rev 8/02) 1, „ Distribution: WHITE - Offce;,CANARY-Owner PINK=Office y . ..e.' '`- ; s ....i .. _ .. y'� i Lis rut-,[kx..:..•.1 r.x, 9�Y:., r'�.. A:�:.. i,..:-..,��'+ �-ha T. Y. �"! -. _ 1 :..s.,. d" . 4..., ...� X COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH Pl. 'ENVIRONMENTAL HEALTH SERVICES aF SUPPLEMENTAL REPORT TO. SAN. FORM # DATE I SUBJECT C PERMIT NO. ADDRESS L4 -31 &,tli La • Nt,4APL,4 INSPECTOR REMARKS: -T r rov; 7,i (.4 ilu CA itY u ,4r i ( V)p pf o (o p eA J (%bp, 0�zf d o pvjn� o" U. crp&m .V Dis�tribytion....\tVHITE-!--h.,O.-T�p;,P�r9ARY—OWne'r; PINK —Office �4, -i; COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SERVICES 2,1:2s SUPPLEMENTALREPORTTO(S�AN. FORM # DATE . D SUBJECT PERMIT NO. ADDRESS C/ REMARKS:-*P© INSPECTOR-!"��rl I F - i� (�F-Cov; —f-u rnio� d AD? 4 PC? 0 s . (2 A d L2a r,4 Z 1) AZf-A'Cllad 'e-a(l 60 02x-�__ 0 0 i-y-) P\ in W) Lo 0,4- a� DEHSAN-116 (Rev 8/02) Distribution: WHITE —Office; CANARY —Owner; PINK —Office '; • � r . 7 -. r�i "i'rrh', �t k i,:f' �'f 3`.�� y { :. s 'c_� . 4 -;.. 3 ; COUNTY OF RIVERSIDE `COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # I, DATE. SUBJECT /VUU! /'lave /t D �'I PERMIT NO. :ADDRESS./UL !I INSPECTOR '/ J , (/lyi ✓ rY �1lUy/JGyr� REMARKS; G G l � s� 2 /'^ l� dl f%Ga a�'L'I . Gam- 6!r/ D✓ ,, / W / / 0 5�V eI7 %1!' l/lt/lGv.l.�r� 1i1��r�;v� �Xi� �� �-5V5 �v 6't^A, /9;,,,1 , u ��u�f��� .s✓�� ��, % ,�s ;� w w limos � ,.. ,c�f=:E3LU�.[f4�_F� '__-7/.,lI/•-7-1-f.�-^- U:GL/t 7/ ///� (/t/ U! �� • �C/�^'_f ,. ._ _ _ ...- � � -... _ _ .. .-. G� 1 5 ;a Der SAN 118 (Rev 8102) Distribution: WHITE f9ce CANARY —Owner PINK —Office ? .v 1 i .�•: d :. t+ 1 F � • t 4� f � . ! i N� w t3a .,,2•ra�°. fr,.K.,ey' w, fir,_,... :�::.4