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09-1023 (RPL),-P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: ,_ 09-00001023,_ - Property Address: 79340 TORONJA APN: 772-340-015- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW. DENSITY RESIDENTIAL Application valuation: 34000. Applicant: ____________ _51 I hereby affirm under penalty of perjury t at I am Section 7000) of Division 3.of the Busi and P License Class: C53 i C actor: Architect or Engineer: CONTRACTOR'S DECLARATION ` ensed under provisions of Chapter 9 (commencing with ifessionals Code, and my License is in full force and effect. License No.: 875547 01I�fNER-BUILDER DECLARATION I hereby affirm under penalty of pVineand am exempt from the Contractor's State License Law. for the following reason (Sec. 7031.5, BProfessions Code:. Any city or county that requires a permit to construct, alter, improve, demolisany structure, prior to its issuance, also requires the applicant for the permit to,file a signed statement te 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, 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 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: SCHMIDT 79340 TORONJA' LA QUINTA, CA 92253 Contractor: INTERNATIONAL GUNITE IN, 45561 OASIS STREET, #10 INDIO,'r CA 92201 (760)863-1600 LiC. No.: 875547 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/22/09 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 workeis' 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 DELOS INS • Policy Number OISKEM22004057 I certify that, in the perfo mance f the work for which this permit is issued, I shall not employ any person in any mannjle o as to ecome subject to the workers' compensation laws of California, and agree that, if I s11 beco a subject to the workers' compensation provisions of Section OO3 00 of the Labor C I shall orthwith comply with those provisions. . ate: © v pplicant:. WARNING: FAIL RE TO SECURE ORK S' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI NA ENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ' DOLLARS ($100,000)• IN ADDITI N O THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR C D , 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 ermit. 2. Any permit issued as a result of this app becomes ull and void if work is not commenced within 180 days from date of issuance ibuiln permit, o cessation of work for 180 days will subject permit to cancellation. I certify that I have read this. application and state thove infor ation is correct. I agree to comply with all city and county ordinances and st to laws relating toconstruc ion, and hereby authorize representaiives of thi oun top n�r upon th bove-mentioned-prrinspecti n purposes.•ate: Q Si azure (Applicant or Agent):/ • r J Application Number . . 09-00001023 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 3.10.50 Plan Check Fee 201.83 Issue Date . . . . Valuation 34000 Expiration Date 3/21/10. Qty "Unit Charge Per Extension BASE FEE252.00 9.00 6.5000 THOU BLDG 25,001-50,000 58.50. Permit MECH POOL.. Additional desc . Permit Fee` 26.00 Plan Check Fee .. 6.50 _ Issue Date — Valuation 0 Expiration Date 3/21/10 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 ". 3/21/10 Qty Unit. -Charge Per Extension BASE FEE 15.00 1.00 30.0000 E. 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 .. 3/21/10 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 Permit . . WALL/FENCE PERMIT •LQPERNIIT Application Number . . . . 09-00001023 Permit WALL/FENCE"PERMIT Additional de`sc . Permit 15.00 Plan Check Fee .00 -Fee Issue Date - Valuation. 160 ,Expiration Date 3/21/10 Qty Unit Charge Per _'. Extension BASE FEE .15.00 -----Special Notes and Comments POOL/SPA,,,10 L:F. 4' EQUIPMENT ENCLOSURE, CITY STANDARD, 125 L. -F. -GAS RUN -FOR FUTURE•BBQ..ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. 2007 CODES.-" - -_---'Other. Fees= -.-.-.-.-.-.-.-.-.--BLDG STDS ADMIN (SB1473)------------------------ 2.00.,---- + Fee summary Charged •••. Paid Credited Due Permit Fee Total 429.50 .00 .00 429.5Q Plan Check Total 227.83 00 ,.00 227.83 " Other Fee'Total 2:00 .00 .00 2.00 Grand -Total 659.33 .00 .00 659.33' t LQPERMIT s pool Plan Ilill Bin # City of La Quinta Building &r Safety Division Box 1504, 78-495 Calle Tampico• La Quints,. CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. n , 1p� "1 Project Address: _ ?� (� l'q (f ✓j ` f} IV .Owner's Name:. M ,2 A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: I V 1}'1 lV I tom• 1 h Telephone: P one: .....�..•,•... `... �1 Address: \ OM dQ �� Project Description: �� 01 City, ST, Zip: vo `a) �r z2�0ti — Telephone: �O 3 .•..... n f h State Lic. # ,0 p City Lic. #: l (i) Arch., Engr., Designer: Address: City, ST, Zip: Telephone: a e Lic. #: S t t L ': Construction T Occupancy: Type: e: Project Pe (circle one): New Add' Alter Repairair n Demo Name of Contact Person: Sq. Ft.:#Stories: # Units: Telephone # of Contact Person: ��,Q j — Estimated Value of Project: 3 Gc* APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted as Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Jnd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees