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06-2250 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00002250 Property'Address: J47820 STILLWATER DR APN: 658-140-999-59 -29436 - Application description: POOL - RESIDENTIAL - Property Zoning: LOW DENSITY - RESIDENTIAL Application valuation: 1 30000 Applicant: Architect or Engineer: 4 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: C53 License No.: 778703 - ate:�� ontractor: _�B 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).: 1—) 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, BusinessandProfessions 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 of 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 _ 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.). 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: RICHARD BULLOCK 47820 STILLWATER LA QUINTA, CA 92253 Contractor: R W & S WATERSHAPES 1342 PARK AVENUE SAN JACINTO, CA 92583 (951)712-6121 LiC. No.:.778703 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/07/06 ------------------ 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 piovided 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 performanceofthe work for which this permit is issued. My workers' compensation insurance -carrier and policy number are: - Carrier STATE FUND Policy Number 2292206306 _ 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 abor Code, I shall forthwith comply with those provisions. D�A Applicant: 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 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR ft 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 construction, and hereby authorize representatives of thjsj ounty to enter upon the above-mentioned property for inspection purposes. Dale: v —� Signature (Applicant or Agent): Application Number 06-00002250 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . Valuation. 30000 Expiration Date 12/04/06 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-$0,000. 32.50 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/04/06 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 12/04/06 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.. .12/04/06 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 06-00002250 Special Notes and Comments- 'PLACE omments'PLACE AT PRE -PLASTER INSPECTION. - EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due -- ------------------------ -- ------ ---------- Permit Fee Total' 388.50 .00 .00 388.50 Plan Check Total 210.93 00 .00 210.93 Grand Total 599.43. .00 .00 599.43 4- ...... ... VIAI i :d wamm gomp RE -Asw .900/6000 & SAFETY 1% APPROVED7 FOR CONSTRUCTION MA-rr7601,012 mv_ T 6/, -- - snld 10d30 IIVH HIM �m V-1md rQl-WW WMU V8699UL96- XVJ 9V:VL 900Z/Zo/90 �A O e— V-1md rQl-WW WMU V8699UL96- XVJ 9V:VL 900Z/Zo/90 06%02/2006 14:44 FAX 9519256984 06/02/2006 FR1 14:41 FAX l3ir1# 0 of La Qu inta Building a Safety Division , P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777.7012 r • Building Permit pplicatiorl and Tracking -Sheet Owner's Natnc: ✓ \ (�� &/Z 417 City, FrT, Zip: / /') al l /�.-> MAIL DEPOT PLUS Permit # 50 as Project Address:' 7 A. P. Numb": Legal Deserlption: Contractor Az Addn ss: 3 l City, ST, zip; G Tclepheno: 'l State Lie- # 1 Arch., Engr., Designer: Address: Z, City, ST, Zip; ana 'i't:lcphonc: Stats; L-tc. 9: Name of Contact Person: Telephone #1 of Contact Per. i! Submittal Plan Sets Structural Cities. Truss Calcs. Bacrgy Cake, Flood plain plan Grading, pian Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: rlannittg Approval Pub, Wks. A,ppr School )F•ecs 1 C.V:::�' I 2Is F3 � PM___ � Ili City Lic. #:' >ltt: -, r- bemiption: .li'e t�19 YPc= Projcot type (circle one; i Sq. FL: Estimated Value 4Pro' APPLICANT: DO NOT WRITE BELOW THUS Lll 'd i "_.1A — ee. TRA 3 Plan Checkottbmlued Reviewed, rea4y for torr ed ` Called Corwt1w Person Plaus ticked up ' Plans resubrnitted 2" Review, rcady.for'cor eat Called contact Parson Plans picked up Plans resubmitted Revlew, ready fhrcior4 ecti Called Contact Person Daitc o[ per6ult Issue (.will I� o' L3Uisr> 002/005 @1001 !001 .v I 04cupancy: ow Ad&n Altar Repair Dinno Sttitics: � Units; PERMIT FEES Item Amount Plan Checkbepoylt Plan Ch" Balance Con,gty�otioa . • Mcchanity] Electrical PlunLbing S.M.L Grading Deyeloper Impact Fee Total Fermit