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04-4888 (RPL)Tihf 4 4 Q" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT"' Application Number . . . 04-00004888 Date 6/11/04 Property Address . . . . 52760 DEL GATO DR APN: ..770-330-016- - - Application description . . . POOL - RESIDENTIAL .Property Zoning.. . . . . . . LOW DENSITY RESIDENTIAL .Application valuation . . . . 22000 Owner Contractor ------------------------ --- ----------------------- MORLEY EARL p WESTERN POOLS -44850 LAS PALMAS H P.O. BOX 1047 PALM DESERT C1�312�� (12004 INDIO CA '92201 JJUU (760) 200-1110 clugcltiA WCC: STATE FUND CIFNpPICEp��' WC: 12709962004 02/01/05 CSLB: 348768 12/31/05 CCC: B-053 ---------------------------------------------------------------------------- Permit . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . 225.00 Plan Check Fee 146.25 Issue Date Valuation 22000 Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 THOU BLDG 2;'001-25,000 180.100 ---------------------------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge -Per Extension BASE -FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------------------------------------- Permit . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA.. ELEC PRIVATE SWIMMING'POOL. 30.00 Is P.O. BOX 1504__. • VOICE (760) 78-495 CALLE TAMPICO FAX (760) 7 i'.'• %Ol i LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-71511 BUILDING & SAFETY DEPARTMENT Application Number: 07- Date: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of pegury that 1 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 G 5.3 License No. .3f J? Ale 0- Date (0 -(5_ -f%01 --Contractor 11�� OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that i am exempt from the Contractors' 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 ne or she is licensed pursuant to the provisions of the Contractors' 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).): U I, as own& 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 wort himself or herself.or 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.). U 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.). U I am exempt under Sec. , 8.8 P.C. for this reason Date - Owner. WORKERS' 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 Vof 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 pemdl is issued. M workers' compensation nce carrier and policy number are: ,aFrier $5rXrg- 7U/1!7 Number _ f 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, it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall `` forthwithcomply with those provisio�ns�. ! si &4Z.— WARNING: FAILURE 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. 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 Lenders Address 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, indemnity and hold harmless the City of L& Ouints, its officers, agents and employees for any act or omission related to the work being perforned under or following issuance of this permit. 2. Any permit issued as a result bf this application becomes null and void if work is not commenced within 180 doyi from date of issuance of such peffr4 or cessation of work for 180 days will subject permit to cancellation. 1. certify that I have read this applicatiori and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above4lentioned property for inspection purposes. .4D5,_(0," �Signwrepplicant or Agent): N s Page 2 Application Number . . . . . 04-00004888 Date 6/11/04 N Page 2 Application Number . . . . . 04-00004888 Date 6/11/04 -------------------------------7-------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 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 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN' PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary. Charged Paid Credited ----------------- Due ------------------------------- Permit Fee Total 327..00 .00 .00 ---------- 327.00 Plan Check Total '171.75 .00 .00 171.75 Grand Total 498.75 .00 .00 498.75 N I V �'RN MAN Er. NOWN ► �' VAj i PIP® ..