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11-1134 (SOTB)P.O. BOX 1504 78-495 CALLE..TAMPICO LA.QUINTA, CALIFORNIA 92253 c&ht 4 a(P " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: .11-000.01134_,1 Property Address: 53472 VIA BELLAGIO APN: 777-170-025- - - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7500 Applicant: Architect or. Engineer: 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. Lic nse Class: C53 / cense No.: 348768 Date: 7 ntractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 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 00 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 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.). 1 _ 1 I am exempt under Sec. BAP.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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/11 Owner:. EZRALOW MARSHALL a 23622•CALABASAS ROAD #200 CALABA SAS, CA 91302 r� 2011 Contractor: I - WESTERN POOLS cffy Of! A P.O. BOX 5328 LA QUINTA, CA 92248 (760)200-4777 Lic. No.: 348768 --------------- - - - 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. Y�1I 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 1270996-2011 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, f rth i h ply with those provisions. ,-'6_ate:ld'/- PIK,licant: WARNING: FAILURE TO SECURE 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 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 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 construc i , and hereby authorize representatives of this county to enter upon the above-mentioned property for i pur s ,Date: //gnature (Applicant or Agent): Application Number . . ll' -00001134 Permit BUILDING PERMIT Additional desc . Permit Fee 99.00 Plan Check Fee .- 64.35 Issue Date . . . . Valuation . . . . 7500 Expiration Date 4/11/12, Qty Unit Charge Per Extension BASE FEE 45.00. 6.00 9.0000 THOU .BLDG 2,001-25,000 54.00 -------------------------=---------- Special Notes and ----------------------------------------- Comments 7' X 11'.FOUNTAIN & WATER FEATURE USING EXISTING PUMP•& FILTER..2010 CODES. ----------------------------- Other Fees . . . ----------------------------------------------- . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 6.44 Fee summary ----------------- Charged Paid Credited -----=---------------------------------- Due Permit Fee•Total 99..00 .00 .00 99.00 Plan•Check.Total 64.35 .00 .00 64.35 Other Fee Total 7.44 .00 .00 7.44 Grand Total 170.79 .00 .00 170.79 LQPERMIT marrA /ow ..F � i ' I' - .53 y72 l�ia BeI/alio I ENTRY i I I ';I � La.. Qv�K�a Gid • TOWER � I e p'�wr 1 M. pWftl `> •�� uaem - r CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE/ 'l ' BY S'? NEW _ - - -- WATER - it ji BATH -'----- �---------------•--- _ -- -_-_.- -: FEATURE j 1 Ste. /i ' r f + y2_ Ind fount, IDOSR, rIIfiG� E ui . _ 'Pre- cast .� I FOUN-rAIvt ti siflE p/ WERE JD®O 4 (• r - 78409 DARBY RD. BERMUDA DUNES. CA PH. 760-200-4777 FAX 760-989-4708 CA Lic. # 348768 4Y, tg Ise ENTRY LQ r NEW LTRAV TO N ♦ q h `kw1. f £ a ...................... marrA /ow ..F � i ' I' - .53 y72 l�ia BeI/alio I ENTRY i I I ';I � La.. Qv�K�a Gid • TOWER � I e p'�wr 1 M. pWftl `> •�� uaem - r CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE/ 'l ' BY S'? NEW _ - - -- WATER - it ji BATH -'----- �---------------•--- _ -- -_-_.- -: FEATURE j 1 Ste. /i ' r f + y2_ Ind fount, IDOSR, rIIfiG� E ui . _ 'Pre- cast .� I FOUN-rAIvt ti siflE p/ WERE JD®O 4 (• r - 78409 DARBY RD. BERMUDA DUNES. CA PH. 760-200-4777 FAX 760-989-4708 CA Lic. # 348768 City of La Quina Building 8t Safety Div[sion Permit # P.O. Box 1504,78-495 Calle Tampico LR.Qutnta, CA 92253 - (760) 777-7012 Building Permit Application: and Tracking Sheet Project Address: J J? 72 V4 8 e-// Name: A. P. Number. Address: 6--31/7-, VIA Ee- %la %D Legal Description: Contractor. (,e>e s teres p / / OD[ City, ST, Zip: Telephone: Address:�aQ Project Description: City, ST, Zip: �Q v/K CrI10X I FOtJN fG!/K Telephone: 7'(00 2©D x1777 State Lic. #: ZZ 4 l �O :s /.JGi 7`e r Fe4 to re - City Arch., Engr., Designer Address: City., ST. Zip: Telephone: State Lic. #: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Coo= Person: l ie K K S9 7 % a # Stories: # Utut; Telephone # of Contact Person: 7(p0 .27.5 29 S Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Cheek Submitted Item Amount structural Calcs Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs• Called Contact Person Plan Check Balance. Tithe 24 Cala Pian picked up Construction Flood plain plan Pians resubmitted'. Mecharilcal Grading plea 2" Revlew, ready for correctious/issue Electrical Subeontactor List Called Contact Person plumbing Grant Deed Plans picked up SMI, H.O.A. Approval Plans resubmitted Grading IN HOUSE;- Review; ready for correctionsftuc Developer Impact Fee. Planning Approval. Called Contact Person Ad.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees