06-2451 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-dy 4 4 Qa&m
Application Number: 06-00002451
Property Address: 79640 CORTEZ IN
APN: 649-063-002-71 -2180 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW_ DENSITY RESIDENTIAL
Application valuation: 500
Applicant: Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
1 hereby affirm under penalty of perjury that Iam_ 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.
ucerrse Class: C53 License No.: 786814
Date:/, -:6 Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penaltyof perjury that I am exempt from the Contractor's State License Lew for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit.to
corrstruc4,alter, improve, demolish,,or repair any structure, prior to its issuance; also requires the applicant for -the;
permit to file a signed statemeM:that he'or she is licensed pursuanCto the.provisions of the Contractor's State
License Low (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.forthe alleged exemption. Any violation of Section 7031..5 by
any applicant for a permit subjects.the applicant toe civil penalty of not more than:five:hundred dollars. (4500).:
(_) I, as owner of the property, or. my employees with wages as their sole-Iwmpensation, will do the work; and.
the structure is not intended or offered'for sate (Sec. 7044, Business and Professions Code: The
Contractors' Stem License Law does not apply town 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:licansed contractors to construct the project (Sec.
7044, Business and, Professions Code: The Contractors' State License. Lew does not apply to an`owner, of
property who builds or Improves thereon, and;who contracts for the projects with a contract_orls) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under 'Sec. , B.&P.C..for this reason
Dote: Owner:
CONSTRUCTION LENDING. AGENCY
I hereby affirm under penalty of perjury that there Is:s 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:
LQPERI•IIT
Owner.
KUHNKE;RODGER L
IID
Contractor:
DEVINE POOLS AND SPAS
81113 AVE ROMERO
INDIO, CA 92201
(760)989-0354
Uc..No.: 786814
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/20/06
W u
6=20
:I T1f OF LA QUINTA
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of thekabor 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 STATE FUND Policy Number
_ I certify that, in the performance of the work for which this permt:is issued, I shall not employ any
pawn -in any manner so asto become subject to the workers' compensation laws of California,
and agree that, if 1 should become subject to the workers' compensation provisions of Section
3700 of ihe:LaoorCode, I shall forthwith comply with those provisions.
Dater Applicant: 4 I)L(0 I10&6
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER. TO CRIMINALPENALTIESAND CIVIL FINES.UP TO ONE HUNDREO'THOUSAND
DOLLARS (8100,000). IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR,IN
SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and, Safety fora 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 shell defend, indemnity and hold harmless the City
of La Quints, 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'end void if work is not,commenced.
within ISO 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 for inspection purposes.
Date: ,5.26-06 Signature (Applicant or Agent):.
Application Number . . . . . 06-00002.451
PermitBUILDING
PERMIT
Additional desc .
Permit Fee
15.00
Plan Check
Fee
9.75
Issue Date . . .
.
Valuation
. . .
. 500
Expiration Date
12/17/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
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Special Notes and
Comments
2-FIREPITS PER APPROVED PLAN
Fee summary
Charged Paid
-
Credited
-
Due
-----------------
Permit Fee Total
---------- -
15.00
.00
.00
.15..00
Plan Check Total
9:75
.00
.00
9.75
Grand Total.
24.75
.00
.00
.24.15