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05-1945 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 'QO�50 0 0 0=1-94 5 Property Address: 57870 SOUTH VALLEY,LN APN: 762-250-019- - Application description: POOL -'RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8000 Applicant: T&!t 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer MAY 2 05 Fe 0.0 5 VOICE (760) 777-7012 FAX (760) 777-1011 INSPECTIONS (760) 777-7153 Owner: ,BILL FAUBION 57870 SOUTH VALLEY LANE LA Q0INTA, CA 92253 Contractor: DEI�ONIS & FAUBION CONSTRUCTION P.O. BOX 306 MT. BALDY, CA 91759 (909)223-2030 Lic. No.: -737479 Date: 5/20/05 -------—-------------------—-------------—------------------------------- LICENSED'CONTRACTOR's DECLARATION - 7 -------------- 7 ---------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided LicanseClass: B, C39 LicenseNo.: 737479 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ontractor: c5i 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify that,'in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that 6 or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. 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).: �ate� _R�cant�� FPP 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. 704.4, Business and Professions Code: The - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building & improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT 1, as'owner of the property, am exclusively.contracting with licensed contractors to construct the project (Sec. IMPORTANT -Application is hereby made to the Director of Building and Safety for a permit- subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects With'a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City Date: Owner: CONSTRUCTION LENDING AGENCY I 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: LQPERMff 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%ad 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 ihis county to enter upon the above-mentionedpri5perty fdr-Ris-pectiOn.pur o a 155 ia —�, Si V__;;�___ gnature,(6pplican or Agent): Application Number . . . . . 05-00001945 Permit .. . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 99.00 Plan Check Fee� 64.35 Issue Date . . . . Valuation . . . . 8000 Expiration Date 11/16/05 Qty- Unit Charge Per Extension BASE.FEE 45.00 6.00 9.0000 -------------------- 7 THOU BLDG 2,001-25,000 ------------------------------ -------------------- 54.00 Permit . ... . . . ELEC POOL PERMIT -RES Additional desc ' * : Permit Fee . . . . 15.00 Plan Check Fee 3'.75 Issue Date Valuation 0 Expiration Date 11/16/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---- ------------------ 7 ------------------------------------------------------ Specidl Notes and Comments REFLECTING POND(WATER..FEATURE 24-1) PER APPROVED PLAN. SUPPLEMENTAL TO P(ERMIT 05-0736 Fee summary I Charged ----------------- ---------- Paid ---------- Credited ---------- Due Permit Fee Total 114.00 .00 7 .00 --------- 114.00 Plan Check Total 68.10 .00 .00 -68.10 Grand Total 182.10 .00 .00 182.10 LQPERMIT A RE -INSPECTION FIE OF $30 WILL BE CHARGED IF THE OPROVED PLANS AND joB CARD AREVT ON THE SITE FOR A� SCHEDULE I D INSPECTION. NO EXCEPTIONS! 14 0 U SAL- ry CITY OF LA QUINTA SUB-CONTIRACTOR LkST LID JOBADDRIES PERMIT NUMBER OWNEkJLI 0_VN-,) BUILDER W n as In a 02MMISIMA11""Ift. this list or their employees are authorized to —ork .-This fam Shall be on3ted dn the Jnb ith the buaidl g inspection Card at All tim Only perso'ns appearing on C', A- �� n this job. Any change's to INS list must be approved by the Building Division pirlat to CY) -of building permit. Fo . each appli commencement of work. Failure to comply will result in a stoppage of work andlor ths vold'ance (D. cable trade, all inform Ion Mueste below must be compleled applicant. 'On File' Is ot an accepta CD ble response. 0 U-N—M.- 4 CD ompany Name :A" ciassincallan U40"Se Number Exp. Date Carrier Namc Policy.Num,ber Exp. [Late Ucwm Nwnb� Exp. Date C 41 (e.g. A. 5, C -S) (XXXXXXI 4xxtuxt") la-aj State Fumd, LqRK-- (xxjiwxx) LXXXXI L A ), ;L 611AA4.1 I L I�Jc I ro CS Z: ��SVV PfNN0 aizF- L oat 13 CG r,�4 to - nc rict Z: -36 J o? no I -0Lk V�14 Itx!: 'OL-b'k 4 a: f- i2qVR_- V11ke'Ll LN-Lb.13 L C11 04 Uk 4; AwD< OqL4q2- C, i7evy !P1 4. r�� M? Z: 0 YOQ V 6 U H �_Y%t 14, -)P .1 0S kk 1_2510/cd L -2- A al!i ?�m let 1 14- f(A `dime e��!j�qAft 0 C .i a,-),) .5 66 -_'*UV*N1.'t,i :4 W 0 ) 9 -T, * , & _7 1WE CNI'l 71 I