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04-4841 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number . . . Property Address . . . . APN: Application description .Property Zoning . . . A Iication valuation BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT , r 04-00004-84-1 r + Date 54234 SHOAL CREEK .775-040-003-12 =27762 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 15000 6/09/04 Owner Contractor ------------------------- -------'----------- - NUNO KELLY DESERT PARADISE POOL & SPAS .54234 SHOAL CREEK 104 CALLE LOS HIBISCOS LA QUINTA CA 92253 PALM DESERT' CA -92260 (76,0) 836-0368 WCC: STATE FUND WC: 0614360 11/01/04 CSLB: 419309 12/31/04 CCC: C53 -C27 ----------------------------------------------------------------------------- Permit . . . . . . BLDG -POOL PERMIT Additional desc Permit Fee 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation ..15000 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU,- BLDG 2,-0,01-25,000 �>,` :-, ;. _.;, *_. 117.00 ----- - - - - - - - - - - - - - - - - - - - - - - - - - - -� - G - - --------------------------------------- Permit ----------------------------------- Permit . . . . . . MECH POOL Additional desc Permit Fee. 24.00 Plan'Check Fee `. 6.00 Issue Date 4 Valuation . . . . 0 Qty Unit Charge Per Extension BASE. FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 -----=---------------------------------------------------------------------- Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . 0 Qty Unit Charge Per BASE FEE 1.00 30.0000 EA... ELEC PRIVATE SWIMMING'POOL Extension 15.00 30.00 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Q Ll - ��q Applicant: t ) I Architect or Engineer:. Applicant's Mailing Address VOICE (760) 777.7,01. FAX (760) 7"_701 ; INSPECTIONS (760) 777-715: Date: 6• /0 - -a Q• rfcniteci or tnglneer'S Address: W -A Lic. No. BUILDING PERMIT DECLARATIONS I hereby affirm under penaltyof LICENSED CONTRACTOR'S DECLARATION pegury that I am licensed under provisions of Chapter 9 (commencing with Sefton 7000) of Division 3 of the Business and Professronals Code, and my License is in full force and effect. License Class [� —G •; ,� License No. LI � 7 1 O 1 hereby affirm under penaltyof OWNER -BUILDER DECLARATION perjury that I am exempt from the Contractors' 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 a civil penalty of not more than five hundred dollars ($500).): U 1, as ownet 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.). (--) 1, 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 canVactor(s) licensed pursuant to the Contractors' State License Law.). U 1 am exempt under Sec. . B.d P.C. for this reason Date • Owner I hereby affirm under penaltyof WORKERS' COMPENSATION DECLARATION 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 slue . M oro o pertfa ion ins tamer �(d p licy qumber a Carrier 41..�� i•ber CJ L / _ 1 cenity hat, to the performance of the work for which this permit is issue . I shall not employ an compensation laws of California, and agree that, if I should become subject to the workers' compensation nsason in any manner so ec io become subject to the workers' forthwith comply with those provisions. I pensation provisions of Section 3700 0} the Labor Code, I shell Qp rent t 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. I hereby affirm. under penally of perjury that there is a construction lending LENDING AGENCY RUCTION 9 agency for the Performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address IMPORTANT APPLICANT ACKNOWLEDGEMENT 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 perfomrod under or pursuent to any pemmit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmed the City u V Quints, 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 100 days from date of issuance of such permit a cessation of work for 180 days will subject permit to cancellation. I certify that I have read this applicatiori and state that the above information is correct I agree to comply with all city and county ordinances all state laws construction, and hereby authorize representatives of this county to enter upon the above rtmentoned property for inspection purposes. �mg to ��g /Dated d Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00004841 Date 6/0.9/04 ------------------------------ --------------------------------------------- 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 ----------------------------------------------------------- Special Notes and Comments ---------------- POOL/SPA, GAS LINES -FOR FUTURE BBQ & FIREPIT.ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECT ION. EQUIPMENT ENCLOSURE NOT INC LUDED Fee summary Charged Paid Credited ----------------- Due -------=---------------------- Permit Fee Total 264.00 .00. .00 ---------- 264.00 Plan Check Total 130.80 .00 .00 130.80 Grand Total 394.80 .00 .00- 394.80 ■ AG e6W)od6--t- Rf 1K° 4"J77� , 71,8��, . ,6 coo 4'Aa Le�oc �-Fr� fpc�a. A1fr for o. f - - - - ..c...-. n•rcz -tsvtin•X+".'r't�^-�r.A.^t•. .':r"� d+r.:�<1.:. °w �u7�?� 'a"t"��T� ..,....-.. „_.._ �, .,:_..«..�.l,..�. .. •� �r ..- tom•' �,�' s b ice`! -V 5 �3'� '-Aft/Aa- 4(..�?A.5'v19-11* �ri��"'..._._.. �f �/lq'/meq �y�/C /G• '�"�j ,D ��. �.rz.7a0e, /4WF2 z, fN > 2- j?" 77 06 6-V s7i up Zixeo (,�jAtL — 1= LA OUINTA 3)AFETY DEPT. �j QT,.,,IUCT;ON PO4 #W140 A)DdIL f#/Fi?m-f n `4?44ADB NUNO RESIDENCE PORME 17 T.6S. ,R.7E C I TY OF LA QUI NTA 121.80• 79. C2' 77.e0 Ilt� • a aMAON o i9 AAA COti4dOPt 9. .r M Zixeo (,�jAtL — 1= LA OUINTA 3)AFETY DEPT. �j QT,.,,IUCT;ON PO4 #W140 A)DdIL f#/Fi?m-f n `4?44ADB NUNO RESIDENCE PORME 17 T.6S. ,R.7E C I TY OF LA QUI NTA 121.80• 79. C2' 77.e0 a aMAON o i9 AAA COti4dOPt 9. i � /��'��H• ��r�'� �gyvaJ� .sem �aaL "svk-,i fAmW-0 M Qualify Award Winning Designs J�GOA$r ch' ~'..o � o ro p c� a GOASr �. AWANO a