06-2452 (RPL)e, Is
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002452
Property Address: 79640 CORTEZ IN
APN: 649-063-002-71 -2180 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 24000
c&ht °F 4Qu&a
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: C53 license No.: 786814
Date:' Contractor:
A.
OWNER -BUILDER. DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law4orthe
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 7600) 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 applicent.for a permit Subj" the.aPPlieant to a civil penalty of not more than five hundred dollars (8600)•:
(_ 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, ausiness 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'improvemsnt;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:forthe projects with a contractor(s) licensed
pursuant to the. Contractors' State License Law.).
(_) I am exempt under Sec. , Bf&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. CJ.
Lender's Name:.
Lender's Address:
LQPERbUT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)777-7153
Date: 6/20/06.
Owner:
Ilv'I III
JUN 2 6 2006
Contractor: L___
A
DEVINE POOLS AND SPAS FINANCE
81113 AVE ROMERO
I_NDIO, CA 92201
(760)989-03.54
Lit. No.: 786814
WORKER'S. COMPENSATION.DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of oonsent 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 numberere:
Carrier STATE FUND Policy Number 1641733-2005
_ I oertifycthat, in the performance of the work for which this permh.is'iswed, I shall not employ any
person in any manner so as to become subject to the.woikers' compensation'laws of California,,
and agree that, if I should become subjec to the workers' compensation provisions of Section
3700 of the Labor Code,.I shall forthwith comply with those provisions.
Dsts: &-Z&66 Applicant: 303.i1J �'�AR onu L-roz
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN'EMPLOYER TO CRIMINAL PENALTIES,ANa:CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001: 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 fora permit subject to the
conditions: and restrictions set forth on this application.
t. Each'personupon whose behalf this application is made, each person at .whose request and for
whose benefit work is performed, underrorpursuantt to any permit Issued as &result of this application,
the owner; and the applicant, each agrees to, and shall:defend, indemnify and hold harmless the City
of La Quints, its officers, agents and employees forrany 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 f issuance of, such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that l have read this application and state that -the above information is correct. l,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: 6'26106. Signature (Applicant or Agent):
r
Application Number . . . 06•-00002452
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 243.00 P1an,Check Fee 157.95
Issue Date . . . Valuation . . . . 24000
Expiration Date 12/17/06
Qty Unit Charge Per Extension
BASE FEE 45.00
22.00 9.0000 THOU BLDG 2,00.1-25,000 198.00
Permit . . . MECH POOL
Additional desc .
Permit Fee . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation 0
Expiration Date . . 12/17/06
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 12/17/06
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 12/17/06
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
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Special Notes and Comments
POOL/SPA ONLY PERMIT DOES.NOT INCLUDE
LQPELmrr
f
Application Number . . . . .
06-0000.2452
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Special Notes. and Comments
--------------------
-
ANY EQUIPMENT BLOCK WALL
Fee summary Charged
-------
Paid
Credited
------ ---- --
Due
Permit Fee Total 347.00
.00
.00
347.00
Plan Check Total 183.9.5
.0.0
.00
183.95
Grand Total 530..95
LQPERMn'
.00
.00
530.95