07-2180 (RPL). J 012TAh
P.O. BOX 1504 ;44.Q"'
VOICE (760) 777-7IS
78-495 CALLE TAMPICO FAX (760).777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 '
BUILDING PERMIT
-.Date: 7/25/07
Application Number: =07-00002180 Owner:
Property Address: 61763 TOPAZ DR REDLINE -
APN:" 764-280-999-27 -300237- 61763 TOPAZ DRIVE _
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY_ RES
Application'valuation: 32000 "
Contractor:
Applicant: Architect or Engineer: PLATINUM POOLS & SPA v
` -77564 COUNTRY CLUB D #108.
PALM DESERT, CA 9221 •til 1r 0 ? 20U7
' (760)772-4274 "
1I� Lic. No.: 890670, CITY OF LAC4uJNT
N l I�iNAN gJ!pt
CXr
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury th I am I' ensed 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 Busine and r fessio s 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 _
License Class: C53 icense No.: 890670 for by Section 3700 of the Labor Code, for the performance of the;work for which this permit is .. _
••� issued'.
Date •�• Xntractor:—Z—lF -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 natty of perjury th I am exempt from the Contractor's State License Law for the Carrier•STATE -FUND - Policy Number 1863573-2007
.. following reason (Sec. 031.5, Business d 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, improv demolish, or r air any structure, prior to its issuance, also requires the applicant for th person in any manner so as to become subject to the workers' compensation laws of California, +
permit to file a signed 'E.tate or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I shou ome ject t0.th 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 La or Cod C0117- II f rt with com y. 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).: V +�•V� tLAB
'
( 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, Business and Professions Code: The WARNING:. FAILUREiINTEREST,
RS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner ofproperty who tiuilds or improves thereon, . SUBJECT ANEMPLOENALTIES 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'IS100,000THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INimprovements are not intended or offered for sale.. If, however, the building or improvement is sold within SECTION 3706 OF TAND 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 _) I, 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 contractors) 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,
(_ 1*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
- 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.
Date_ Owner: • 2. Any permit issued as aresult 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
CONSTRUCTION LENDING AGENCY permit to cancellation. - - -
I hereby affirm under,penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above informa ' is correct. I agree to comply with all
work for, which this permit is issued (Sec. 3097, Civ. C.). -_ city and county ordinances and state laws relating to buildin c structi nd here 'authorize representatives -- - _
• < . • • • • - - - + x • ` ' - - - _ of this county to enter upon th ove-mentioned property f i pecti p rposes. ,.
Lender's Name: - + -
' •O 1. S' ature (Applicant or Agent):
is Lender's Address: - -
LQPERMIT • - -
—Application Number. 07-00002180
1 .
Permit . . BLDG,POOL PERMIT
Additional desc -- -
_
Permit. Fee. 297.50 Plan Check Fee
193.38
'Issue Date Valuation
32000 �.
Expiration Date 1/21/08
-Qty, Unit Charge Per
Extension
BASE FEE
252.00,
7.00 6.5000`THOU BLDG 25,001-50,000
45.50.
Permit . . MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check Fee
6.50
Issue Date Valuation
0 E
Expiration Date 1/21/08.
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 .. 1/21/08
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 ..--.- 1/21/08 -
Qty Unit Charge. Per-..-
Extension.*
BASE,
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
Jul 24 07.08:09p p.l
a
Bin City of La Quints
Buifdift a Safety DIvhion
Permit M �P.O. Box 1504, 78.495 Calle Tampico
La QUinta, CA 92253 - (760) 777-7012
-Building-permit Application and Tracking Sheet
N= Address:' / 'Z Owner's Name Ix -1
A P. Numbs: Address:1 -7 Z.
Legal A�aiption city. ST. Zip:
Contractor: (�� v Telephone (,o•.
Add=: 7 7 iD 0,g-AIINraj ( , cfi3 ProJed Desaipti=
aux s't, P= fl ! CA `�? II -
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Tdcphkme: C=M-ManTypr. �� Occupancy:
State Lis, 0. Pte+jecttype (d:cla ): New Add's Alta Repair Dmo
Name of Coatrrt Pelson: �C 5Q FL: d Stories # Utut r
Telcphnne 0 of Contact Person (9pa�j'�7 j�� Enimated Value: of sojoet: t �7
APPLICANT: DQ NOT WInTE BELOW Ms LINE
f Sabaittal Rcq'd Itte'd TRACIaNG • Pi°.R>~IIT FEQS
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TrM Carta. Caw Coated Person Plss CAakHalasee
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FloodPLWa Plea Phar resabaWtted Medtaaical '
Or�r!Gp�' ?� Rtview. ready [as corrsclisathraae Etedrieal •
Sabcauftdor Lut Called Cosset Pemn plum blag
Grast Dwd Phar tdtlotd cup • &Nil'
H.OA_ Approval Pram resubmitted Gra"
IN i[OI1$R: A Rgiew, ready for earreetlotsliwe Dtvebyer Impact Fa
Plassisy Approval Caped Coubd Pascua A.LP.P.
Psb. Wlkv. Appr Date of permlt Rase
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Toul ?trmit Fee
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