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05-3951 (RPL)!f P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: UL SEP 14 1005 CITY OF LA QUINTA ,05-00003951 79700 CITRUS 772-170-012- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 28600 T419 4 4 Q" Architect or Engineer: BUILDING .& SAFETY DEPARTMENT BUILDING PERMIT LTJ ----------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bu 'rte and Professionals Code, and my License is in full force and effect. License Class: License No.: /Date;'r'�'i'� Contractor:- WNER-BUILDE CLARATION 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 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 (5500).: (_ 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.). (_ 1 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 _ 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: WHEELOCK 79-700 CITRUS LA QUINTA, CA 92253 ontractor: C CALLUM:POOLS CC: EXEMPT C: EXEMPT SLB: 818835 VOICE (760) 777-7012. FAX (760) 777-7011 INSPECTIONS (760) 777-7153 05/31/06 04/30/07 Date: 9/12/05 ----------------------------------------------- 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. 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 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 become subject to the workers' compensation laws of California, and agree that, if d become subject to the workers' com anon provisions of Section 3700 of the Labo Code*ORKES shall forth ith mply wi�h th c p ovist ns. �e: 1 'rJ Applicant: WARNING: FAILURE TO SECUENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CAND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDOF 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 county ordinances'and state laws relati to but g construction, and hereby authoriz resentativas of this.county to enter upon the above -mention d property i spect'o purposes. D e:��" Signature (Applicant or Agen -4 Application Number . . . . . 05-00003951 Permit BLDG POOL PERMIT Additional desc Permit Fee 278.00 Plan Check Fee 180:70 Issue Date . . . . Valuation . . . . 28600 Expiration Date 3/11/06 Qty Unit'Charge Per Extension I BASE FEE 252.00 rs 4.00 6.5000 THOU BLDG 25,001-50,000 ---------------------------------------------------------------------------- 26.00 Permit MECH POOL Additional desc Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 3/11/06 Qty Unit Charge Pet Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K --------------------------------- 11.00 . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 ' Expiration Date.. 3/11/06 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 . . ... 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/11/06 C� 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 ONLY. ALARMS/BARRIERS SHALL 0 LQPERMIT Application Number . . . 05-00003951 ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE_PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary- Charged _--Paid--- Credited ----Due--- -------------------------------_ --- Permit Fee Total 382.00 .00 .00 382.00 I Plan Check Total 206.70 .00 .00 206.70 Grand Total 588.70 .00 .00 588.70 Sep 12 05 09:40a Joseph McCallum 7607755685 N y p.l g a± m � poiN mo* �F- � X = UU o:• % x . I • x� (Y m y CID r M0 i' -n m N � \\ W 0 0 J �- �o\\ J rn Irj G rn \Q��' i O °r •- c \\oma\\�. CD CITY OF LA QUINT;,-\ BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE 4113 foS PY CS v r. ACITY OF LA QUINTA SUB -CONTRACTOR IST JOB ADDRESS �7 -?C206rllIW S PERMIT NUMBER p j OWNER BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each annlirahle trade. all information renuesteri hPlnw mi mt hp rmmnletPri by nnnlirant "On Pilo" is not an arrpntahln rncnnnea Trade / Classification Contractor77 State:Contractor's License WorkerrCom ensation Insurance City Business Licensee . Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund,(�CalComp) Policy Number (Format Varies) Exp. Date Ixx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) 'rte SIL Cts/ So I s so Iab S'}G2 S, CONCRETE (C -8)1p �` d > -�' iO �"��-`� ) •