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07-2550 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 a Applicant: c -t�t . 44Q Architect or Engineer: Q k BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: B License No.: 780713 Date -2-0' fContractor:JJ/6) CA y 0(,%QT-4 ILJG 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).: f _') 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 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, 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.). (_ I 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: LQPERMIT Owner: LAURENO RESIDENCE 787745 CALLE TAMPICO LA QUINTA, CA '92253 a Contractor: WEW CONSTRUCTION INC P.O. BOX 444 THOUSAND PALMS, CA 922 6 (760)343-5102 Lic. No.: 780713 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date OCT 03 "L 'l OF LA 9/19/07 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 229-0039583 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 37700 of the Labor Code, I shall forthwith comply with those provisions. ov Date: 14�� ! t Applicant �J CoA✓s� (/ c-, �G LQ1ti% 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 ab - ,e information,is correct. I agree to comply with all city and county ordinances and state laws relating to building c nstruction, and hereby authorize representatives of this county to enter upon the above-mentioned proppAy for nsyecjion purgoses. /„ Signature (Applicant or Ulf— Application Number: 141 07-00002550_) f Property Address: 78745 CALLE TAMPICO 1.' , APN: 770-144-005-127 -000000- Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Applicant: c -t�t . 44Q Architect or Engineer: Q k BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: B License No.: 780713 Date -2-0' fContractor:JJ/6) CA y 0(,%QT-4 ILJG 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).: f _') 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 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, 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.). (_ I 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: LQPERMIT Owner: LAURENO RESIDENCE 787745 CALLE TAMPICO LA QUINTA, CA '92253 a Contractor: WEW CONSTRUCTION INC P.O. BOX 444 THOUSAND PALMS, CA 922 6 (760)343-5102 Lic. No.: 780713 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date OCT 03 "L 'l OF LA 9/19/07 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 229-0039583 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 37700 of the Labor Code, I shall forthwith comply with those provisions. ov Date: 14�� ! t Applicant �J CoA✓s� (/ c-, �G LQ1ti% 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 ab - ,e information,is correct. I agree to comply with all city and county ordinances and state laws relating to building c nstruction, and hereby authorize representatives of this county to enter upon the above-mentioned proppAy for nsyecjion purgoses. /„ Signature (Applicant or In Application Number . . . . . 07-00002550 Permit .. . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 252.00 Plan Check Fee 163.80 Issue Date . . . . Valuation . . . . 25000 Expiration Date 3/17/08 Qty. Unit Charge Per Extension BASE FEE 45.00 23.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 207.00 Permit MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . 3/17/08 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 3/17/08 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 3/17/08 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 -------- -- -------- - ----------------- Special Notes. and Comments POOL, SPA, ALARMS/BARRIERS SHALL BE IN LQPERMIT - . Application Number . . . . . 07-00002550 ----------------------------------- ----------------------------------------- Special Notes.and Comments PLACE AT PRE -PLASTER -INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED.. Fee summary Charged Paid. Credited Due ----------------- --------- ---------- ---------- ---------- Permit Fee Total 356.00 .00 .00 356.00 Plan Check Total 189.80 .00 .00 189.80 Grand Total-- 545.80 .00 .00 545.80 Bin # City of La Quinta. Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253.- (760) 777-7012 ..Building Permit Application and Tracking pp ng Sheet Permit.# ' 1 Project Addrgss: _ S -r A. P. Numbei:w _ 4 _ � � Legal Description: (� Z .. ITi CLViS Owner's Name: Address:'-7 8 -754_5' (�L-4F_ I-A kz7 LLD City, ST, Zip: Contractor: wgi-i s T CTIO)J I v e . Telephone: , . Address: J T" Project Description: C. City, ST, Zipri Telephone:. "CityLic'.: State Lic. # ) Arch., Engr.,Designer: Address: /N IsovE City, ST, Zip: ' Telephone: , 2f 15 State Lic. #: f Construction Type:. Occupancy:, P cy: Project type (circle one): New . Add'n Alter Repair Demo . Name of Contact Person:( Sq. FL: #Stories: #Units: Telephone # o Contact Person:2 �. Estimated Value of project: b�� — APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Se Plan Check submitted Item Amount Structur 1 Calcs. Reviewed, ready for corrections Plan Check Deposit Truss a Ics. Called Contact Person Plan Check Balance Energy Calcs.. Plans picked up Construction h Flood pl in plan Plans resubmitted Mechanical Grading, plan' 2'' Review, ready for correctionsfissue Electrical Subcont ctor List Called Contact Person Plumbing Grant Deed. Plans picked up S.M.I. ILO.A. Approval Plans resubmitted Grading j IN HOU �E:- Review, ready forcorrections/issue, Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wia. Appr Date of permit issue . School Fees Total Permit Fees