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07-2853 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA,. CALIFORNIA 92253 Application Number:07,'00002853 Property Address: 61620 TULARE LN APN: 764-280-999-112 -300237-- 300237-Application Applicationdescription: POOL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 36000 Applicant: T4hf 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: ,I0'r 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 Business and Professionals Code, and my License is in full force and effect. License Class: C53,, ��ION N861430 Date:' / ontractor. I hereby affirm under penalty of perjury that 1 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 theprovisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3of ttie 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'apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ I 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 (Seca 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 1, as owner of the property, am exclusively contractingwith 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. , 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: PIK LQPERMIT Owner: DEBRA VERMOCH 860 MONUMENT PARK CIRCLE SALT LAKE CITY, UT 811JU U Contractor: f DIAMOND POOLS & SPA 77700 ENFIELD LANE, SU PALM DESERT, CA 922 1 (760)200-5888 Lic. No.: 861430 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/01/07 e� U ill. 206 OF LA QUIWTa- 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, STATE FUND Policy Number 1715177 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 I should become subject to the workers' compensation provisions of Section. 3700 of the Labor Code, 1 shall forth ith comply wit those visions.. Pere: 0 icant: r WARN( G: FAILURE TO 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 atwhose 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,;or inspe 'on purposes.' � c Pale: C Signa re (Applicant or Agent): Application Number . . . . . 07-00002853 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 323.50 Plan Check Fee 210.28 Issue Date . . . . Valuation . . . . 35760 Expiration Date 4/29/08 Qty Unit Charge Per Extension BASE FEE 252..00 11.00 6.5000 ------------- -------------------------------------------------------------- THOU BLDG 25,001-50,000 71.50 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/29/08 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 4/29/08 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 4/29/08 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 Permit . . . . . . WALL/FENCE PERMIT LQPERMIT Application Number . . . . . 07-00002853 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 240 Expiration Date 4/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special. Notes and Comments POOL/SPA,15 L.F. 4' SCREEN WALL, CITY STANDARD. ALARMS/BARRIERS.SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged ------------------------------------- Paid Credited ---------- ---------- Due Permit Fee Total 442.50 .00 .00 442.50 Plan Check Total 236.28 .00 .00 236.28 Grand Total 678.78 .00 .00 678.78 LQPERMIT (—:>i- _tr b W L 43 %_J 0 CITY OF LA WINTA SUB -'CONTRACTOR LIST JOS A D D 11 ESt_t C-4 PERMIT NUMBER 0 WNE'1RJtAdQi Er -. .d M -.BUILDER 0 US This form shall he hosted on the lob with -the Building Inspection Qprd.st all limes In a consnicu6us place. Only persons appearing on this list or their employees are'authorized to work - S4, an this job. Any changes to this list must be approved by the Building Division prior tocommenremint of -work.. Failure to comply will result In a stoppage of work and/or the voidance. 0 of building permit. For each applicable trade, all infor tion requested below must be-comnletdcl by applicant. 'On File" is not -an acceptable response, .q NU— Company NameC13381116ation, Ucense Number Exp. bate Carrier Name Policy Numbar Exp. Date 1.1censa Number, UP. b6te C (e.g. A -8) lxxxxixl (xx/xx/xil .(e.g. State Fund, CalComp)' (Format Varies). (xxlxx/xx) (xxxxY (xx/xx/xx) Mo M r CoC Z-0 oto 53: IA5 0 -.3 L [0 .10 7 W(6 21 _777-7777 IA 5 . . . . . . . . . . . . �40 - u -a, NAM AT +U3 M74 � 74 51-7>1 LL'WAY 6L; 6.1PMft WT T +4'r. 1 I 1 IblJ �:1 PS ,odt ..:I.ipM.f,� ..:s`p G CL.I~ l c 'T :I O N S. E�; FUN. 15. SIZE.D" r ' r' MI:tDT44.-�5!4MAX) SPA. is P 12'.25 ll PeCK:57q f f t AS Gp� .�'3'v,3 WV N0110f1UISN00 80- a3Aoldddd 'ldTl A-DAVS V ON101U18 ViNlno bel ao Allo ADDRE5 '' 61.00 7URLIP- LANE LA OI..�W*-TA.t.r, 7R1���-!4/+6`rt�'},�, C �g Y�*a:6.+ .A- Total Permit Fees a0o 35�a Bin./ f r , City io t a Quinta Building Or Safety Division Permit # (n � P.O. Box ' 1504,-78-49S.011e Tampico U Quints,, CSA 92253 - (760) 777.7012 Q` Building Permit APPli tionxand Tracking Sheet Project Address: _ (*'2_o "• '• Owner's Name . •: A. P. Number: .. OC Address: (0� Aw I C/ Legal Description: 'City,. S I', Zip:r ' Contractor: D( KC CI uT g (o? �% P Telephone:. o :<> -» <'::::':a Address: D Project Description: City, O C, ' r f `t �� Telephone: >•:;: G dRe - State Lic #: g614 Bo Citylic. Arch., Engr., Designer: Address: City, ST, Zip: phone:`<':: >i.:�:>< Tele>:s:::;>•:z.:;:.:::�>>ryw?:>:«<• ..:>::: ConstructionTYpe' F110(,, ... :' PA Occupancy: State Lic.#:.;;.r.::,,...;.,...,..,.;.,>;�.:<»>s�sr,�:,s — " '`Project type (circle. one): New Add'n Alter Repair'� Demo Name of Contact Person: J� M Sq. Ft.: 1. # Stories: # Units: • Telephone # of Contact Person: 0 O _g.-E'O o stimated Value of Project: • APPLICANT: DO NOT WRITE BELOW TNIS. LINE # Submittal`-Req'.d Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted . �© �® Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check $alance Title 24 Cales. Plans picked up.. Construction Floodplain plan Plans resubmitted Mechanical Grading plan 2'' Review, ready for correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.1. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for corrections/issue. , Developer Impact Fee Planning Approval Called Contact Person , A.1.P.1. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees a0o 35�a