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07-2089 (SOTB)P.O. BOX 1504 8-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002089 , Property Address: 78420 CLARKE CT APN: 643-170-999-14 -31348 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2200 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Business and Professionals Code, and my License is in full force and effect. License Class: 13 C27 C53 License No.: 810111 Date: - 'C-% Contractor: --gor� 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 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).: 1 _ 1 1, 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.). (_) I am exempt under Sec. , BAP.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: LQPERnfIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/17/07 Owner: ELLIS RESIDENCE 78-420 CLARKE CT LA QUINTA, CA 92253 i Contractor:W�3 Lr1 POOLS INC 78078SCOUNTTRY CLUB DR6 BERMUDA DUNES,CA 922 (760)345-4600 Lic. No.: 810111 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. 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 STATE FUND .Policy Number 290-0001790 1 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor„4hall forthwi h comply with those provisions. Date: • Applicant: 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. 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 relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property f tion purposes. Date: Signature (Applicant or Agent): Application Number . . . . . 07-00002089 Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date Valuation 2200 Expiration Date 1/13/08 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 . . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation 0 Expiration Date 1/13/08 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 ------------------------------- PER ELEC -------------------------------------------- DEVICE/FIXTURE 1ST 20 2.25 Permit . . . PLUMBING Additional desc . Permit Fee . . 18.00 Plan Check Fee 4.50 Issue Date . . . Valuation . . . . 0 Expiration Date 1/13/08 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 PER APPROVED PLAN ONLY Fee summary Charged ----------------- ---------- ---------- Paid Credited ---------- ---------- Due Permit Fee Total 89.25 .00 .00 89.25 Plan Check Total 43.91 .00 .00 43.91 Grand Total 133.16 .00 .00 133.16 LQPERMIT V, rn -..fry Of. La QUjn.t2 Bul7aing. az Safery, Division P.O. Boz 1504, 78 : F3. CaDe Tampico . La Qilinra, CA F=3 - (760) 77-70 12 Bulldin c Permit Application and Trackin Shpt• iPertnit n (Ip jPmj= :78'. o?-Dklplmes Nam= A-?. N=nb=r Address:- O (Lxpi.DsaipDan. Cin. ST. Zip: 9 . ��3 Cottmcorr: �� 1 cicphorzr. ' + Andre= �"1.�� 'Z.� Projc s LYsa iprio¢: . J5✓ •V . �002� 7 Cm . ST, up' ;I* Telepbon4/j S=it U__ R : El Q\ Citm Lie r: � ,AZC . �_ Adam= Cm. ST .T.to: Tei_ hone =--- - _-- -- Corstruaion T�:pc_ Start Lir =: F' ''=" - - —X-`= Pre e=T P (citric anc): Nc�s fidd'n .�it_r R�saa Detno f Name?of Cobra?error.: Sq. FL: r stories- N.I Units ri`f e 4 IOO® 02 0� Tci mac ai Contact Person: treated Value orproicc - APPLICANT: DO NOT WRr7E BELOW THIS LIME Sabsttitsai Rcq'd I Rr'd PER–MIT FEES Ptaa Sets + I Pian Check submitted I �� ttcm , :Amount iStrsernral Cates I I Reviewed. reads for corrections I Paan Check Deposer Trues Calc. Calied Contact Person. ' Plan Check Bztauct -Title _g C Im Plans picked up I Construction :Mood piais plan I I Ptans resubuurted I %Ieci:anical �. iGradmg pan '_" Review. ready for corrcctionsrissuc Electrical Snbcnat2ts3r List I Callcd Contact Prison ( Mumbing ' Maui Deet: Pians picked up S_tit_l. FLOA_AFproval I I Plans resubmincd Crading TN Hous_- I � '"'Review. readv for correctio ensue Devdoper Impact Fee Plassmin, Anprm•al I IIl on t—) n .Pnh.,i'ks.Apprati� & SQI= Schoof.FLs R O VR _� A• I I hIS RUCTION j DATE____RY Tool Pettait'Fees