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05-2190 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 05-00002190 54825 AVENIDA JUAREZ 774-265-016-5 -000000 POOL - RESIDENTIAL COVE RESIDENTIAL 29000 Architect or Ti-tyl 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ---------------------' ---- ----------------------- LICENSED ONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lice sed under provisions of C pter 9 (commencing with Sey.`!on 7000) of Divisi 3 he _Business and Profe sionals Code, and my gys' ff rc�p6'nd effect. Llaense Cl ss: ��5 License No.: - T Date: I Contractor: 0 NER UII ER DECLARATION I hereby affirm under penalty of perjury that a mp from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions ode: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, rior 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).: ( _) 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 _ 1 1, 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—) 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: RINGGOLD WILLIAM 54-825 AVENIDA JUAREZ LA QUINTA, CA 92253 Contractor: MORIN POOLS INC WCC: EXEMPT WC: EXEMPT CSLB: 753964 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 05/31/06 09/30/06 Date: 6/07/05 ----------------------------------------------- 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 performancof the work for which this permit is issued. My workers' compensation insurance carrier and polic number are: Carrier C53 C61 D35 Policy Number - - - - - - - - - - - - - - - I certify that, in the performancof the work for which this permit is issued, I shall not employ any person in any manner so as t become subject to the workers' compensation laws of California, nd agree that, if I should eco a subject to the workers' compensation provisions of Section 70P of the Labor Code, I hal orthw' h comply with those provisions. I�' to J Applicant: WARNING: FAILURE TO SECURE WORKERS' M ENSATION 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 foray' 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 beco s 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 info ation is correct. I agree to comply with all city and c unt ordinances and state laws relating to building nstru ion, and hereby authorize representatives of this co o en r upon the above-mentioned prop y for spectj purposes. Date - 1 " ��Signature (Applicant or Agent). Application Number . . . . 05-00002190 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 278.00 Plan Check Fee 180.70 Issue Date Valuation 29000 Expiration Date. 12/04/05 Qty Unit Charge Per Extension BASE FEE 252.00 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 12/04/05 V Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 ------=------------------•--------------------------------------------------- Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation 0 ` Expiration Date 12/04/05 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 12/04/05 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 ADDITION TO EXISTING SWIMMING POOL & LQPERHIIT Application Number . . . . . 05-00002190 --------------------------------------------------------------------=------- Special Notes and Comments NEW SPA. ALARMS/BARRIERS SHALL 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 Plan Check Total 206.70 .00 .00 206.70 Grand Total 588.70 .00 .00 588.70 r Orn 7o Z D N ZZ A POOL ADDITION TO: Mr.WILLIAM RINGGOLD 54-825 AVENIDA JUAREZ La Quinta, Ca. 92253 > cn 3>°z� 8-0 n No> �Cm0 5m�c z�M� �O OD v O. 7- O Z Z_ Z N m 1 m Z m S m RA 2 70 z n r 0 70 y 2 _ Z 5P� z N n O c r C O O � n z r0i O z 1 N 0 S s T]E 4 � =O Q Z—_ C V _ � � a V V F3 - 0 oc '00 :L m S v N 1 Ntp aM r s W N w y N P O c; m N D 0 O z4 T 01 N mm N CA _m -1 O A POOL ADDITION TO: Mr.WILLIAM RINGGOLD 54-825 AVENIDA JUAREZ La Quinta, Ca. 92253 > cn 3>°z� 8-0 n No> �Cm0 5m�c z�M� �O OD v O. 7- O Z Z_ Z N m 1 m Z m S m RA 2 70 z n r 0 70 y 2 _ Z 5P� z N n O c r C O O � n z r0i O z 1 N 0 S s T]E 4 � =O Q Z—_ C V _ � � a V V F3 - 0 oc '00 :L m S v N 1 Ntp aM r s W N w y N P O c; m N D 0 O z4 T 01 _CITY OF LA QUINTA SUB-CONTRACTOR LIST �O Q ,I JOB ADDRESS 5 �� G��1410ZMIT NUMBER Q S - -Z 4d OWNER BUILDER = This form shall be posted on the job with the BL ilding inspection Card at all times in a conspicuous place. Only persob'ffs 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 f, of-building permit. For each applicable trade, all information requested below must be combleted byapplicant. "On File" is not an acceptable response. Trade /Classification Contractor State;Gontractor.s:License; Workers.CompensatUonansurance......::: Gity Business License. - 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 (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-1.21. IQ A A'V)dS C i $ O(¢ Dl 0 ' CONCRETE (C 8) Tvc v-n� 16 I-Z.COn� 7cC 5t '-'Te n q� �� 'J �� Z a� 3ba�N94 FRAMING. (C-5) ---aW STRUCT. STEEL (C-51) i J iC'i� �\� 1�RM ei �+ 1 �S 3 MASONRY (C-29) PLUMBING (C-36) �O — 9u �1 ���f '�pp yyqq,���p^�I ,,�A ojT l�lrVt�Y' Q '" 3� aoo`�q� LATH, PLASTER (C-35) .` DRYWALL (C-9) f , HVAC (C-20)" '' ELECTRICAL (C'10)!M QQA M f7 �/ ROOFING (C-39Y..'"'.. SHEET METAL (C-43): FLOORING '(C 151: GLAZING (C=17) INSULATION (C SEWAGE D1SP (C42) PAINTING (C 33) CERAMIC TILE (C:54) . ; CA.OINETS.IC.61._ FENCING (C-131 LANDSCAPING (C=27) M1 POOL (C-'53). v!)I \ V (LJD(�OAA65CC\ I C.