The URL can be used to link to this page

04-6023 (RPL)0 ciry or - F CEDEPT. BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-701'2 19 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINfA, CALIFORNIA 92253 'INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04-0000.6023 Date 8/2.4/D4 Property Address 80470 TORREON WY APN: 772-'250-997-114 -31349 Application -description . . . POOL - RESIDENTIAL property Zoning .. . . . . ... LOW DENSITY RESIDENTIAL Appl.iQation.valuation 1.6000 Owner Contractor ------------------------ TOLL CA V -------------- --------- CALIFORNIA POOLS & SPAS C/O KEVIN D DUERMIT P * '0 BOX 1280 8901 E MOUNTAIN VIEW 200 COACHELLA CA 92236 SCOTTSDALE. AZ 85258 (760) 398-9222 WCC: STATE FUND WC:' 04600061168 01/02/05 CSLB: .656128 10/30_/04 CCC: C8 -C2.7 -C29-053 - ------------------------------------------------------------------ Permit 7 ------------ MECH POOL Additional desc- Permit Fee . . . . .24.00 Plan Check Feb 6.00 Issue Date . . . . Valuation 0 Qty Unit Charge Per ExtensLon. BASEFEE15.00 1 :-00 9.0000 EA MECH FURNACE <=100K - 9.00 Permit - ----------- I -------- BLDG POOL PERMIT 7 -- Additional desc. Permit Fee 171.00 Plan Check Fee 111.15 Issue.Date . . . . Valuation, 16000 Qty Unit Charge Per Extension BASE FEE 45.00 ..-14.00. 9.-0000 THOU BLDG -2,001-25,000 126.00 -7 ------------------------- Permit . . . . . . -------------------------------------------------- ELEC POOL PERMIT -RES. Additional desc Permit. Fee . . . . -45.00 Plan'Check .Fee 11-25 .:Issue Date Valuation .0 Qty:Unit'Charge' Per Extension BASE FEE .15.00 P.O. BOX 1504 '�� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: :,2l•D�{ Applicant: I Architect or En ineer' Applicant's Mailing Address: to BUILDING PERMIT DECLARATIONS LIC NSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under pros of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licey, a is in II force and effect. License Class Date Z T ( C2 7 Contractor L�oWNER-BUILDER DECLARATION 1 hereby arm under penalty of perjury that f am exempt from�ie"Contract affirm ors' 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 Contractors' 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 Q civil penalty of not more than five hundred dollars ($500).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 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 maintainmi orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issed. orkers' ompensation insurance carrier a d licy nu ber re: Camer Policy Number certity trial, in the performance of the work fo2that, h thi ernit is i ued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I ould beco a subject to the workers'. compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p sions. Date v( , �[ j Appli �(/ cant �z.,f WARNING: FAILURE TO SECURE WORFFERS' COMPESONOVE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10kADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN EES. 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 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, indemnity and hold harmless the City of La Ouinta, 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' menced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above information is correct gree to mply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county t nter upon the bo ntio ed property for inspection purposes. Date �( I ( Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006023 Date 8/24/D4 Qty Unit Charge Per Extension 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 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 Additional desc Permit-.Fee . . . 15.00 Plan Check Fee.. _00 Issue Date Valuation 240 Qty -Unit Chargee Per Extension BASE FEE 15_00 Special Notes and Comments POOL & SPA. 15 LR 41BLOCK WALL CITY STND. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER,INSPECTION. Fee summary Charged Paid Credited Due Permit'Fee.Total 288.00 .00 .00 288.00 Plan Check Total 136.65 ,00 00 136.65 Grand Total 424.65 .00 .00 424.65