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05-2809 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tit tt 4 XP Q" Application Number: -05-00002809 ., Property Address: 78890 CITRUS APN: 772-101-007- - - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3000 Applicant: Architect or Engineer: CO3 (V / )�I\ C /�/� BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------kdun�5 ----------------------- LICR'S DECLARATION I hereby affirm under penalty of perjury th I ovisions of Chapter 9 (commencing with Section 7000) of ' on Busi s a, and CZrZJ[� ipfuVor(Vnd effect. License CI� No.: � � ✓Da e: 6 Contractor: 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 Cade) 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 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 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/08/05 Owner: CAPITAL PACIFIC HOLDINGS 4100 MACARTHUR BLV STE 200 NEWPORT BEACH, CA 92660 Contractor: CALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: BB1050510 01/01/06 CSLB: 656128 10/31/06 ----------------------------------------------- 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. Y I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor T' Code, for the performance of the work for which this permit is issued. (/ Carrier C8 C27 C29 C53 Policy Number _ 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 beco subject to the workers' compensation laws of California, and agree that, if I shout ecome s b ct the workers' compensation provisions of Section %37 off the La �Co shall fo wi mply with those provisions. 1pde: L//��(/IIdI,Applicant: WARNING: FAILURE TO SECURERKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 cessa ' n of work for 180 days will subject permit to cancellation. . I certify that I have read this application and state that the above informatio i correc . I agree to comply with all city and county ordinances and state laws relating to building ruction, n here authorize representatives oft ounty /e/n(�r upon the above-mentioned prop r i pen p rpos Date:C nature (Applicant or Agent): I... Application Number . . . . . 05-00002809 Permit . . . BUILDING PERMIT Additional desc . Permit Fee. 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . . 3000 Expiration Date 1/04/06 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2;'001-25,000 9.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 16.35 Plan Check Fee 4.09 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .4500 ------------------------------------------------------------'---------------- EA ELEC DEVICE/FIXTURE >20. 1.35 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/04/06 -Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments BBQ ANSI Z21-58-1995 ---------------------------------------------------------------------------- ` Other Fees. . . . . . . . . . ENERGY REVIEW FEE 3.51 Fee summary Charged --------------------------- ---------- Paid CreditedDue -------------------- Permit Fee Total 88.35 .00 .00. 88.35 Plan Check Total 43.69 .00 .00 43.69 Other Fee Total 3.51 .00 .00 3.51 Grand Total 135.55 .00 .00 135.55 LQPERDIIT Bin # ' Permit # Project Address: A. P. Number: Legal Description: Contractor: CaLiC32 Address: N C) Box i zq o City, ST, Zip;.0 oct6t el Lei Telephone: State Lic. # : 65 61 a 2f Arch., Engr., Designer: Address: City, ST, Zip: City of La Quints Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet S Owner's Name: Address: City, ST, Zip: Lic. #: M .I Project Description: Telephone: Construction Type: Occupancy: P YP : P Y State Lic. #' ProJect type one): Addn AlterRepair Demo Name of Contact Person: DAA J , Sq. FL: # Stories: # Units: - Telephone # of Contact Person: 2?9''"11WZ-75 "0, 7 Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted % 7 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up o Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing 6�5 - JL) -rzer Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 'rd Review, ready for correctionsliissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees - -- -- -- -• — . . -. . . Total Permit Fees FOR CONSTRUCTION DATE 7' _f'0!5 BY n