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04-6125 (RPL)fa f1Cv SEP BUILDING & SAFETY DEPARTMENT ..0. B O y -1-50;,4 9� jaCl�uyTA(760).777-7012 78.F.9S��C �L�iLTETA=M`P'rC0 FAX (760) 777-7011 �A QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 . BUILDING PERMIT Application`Number Property Address APN: Application description . . Property Zoning Application valuation . . 04-00006.1-25 Date 9/01/04 52865 AVENIDA VALLEJO 773-323-019-6 -000000- POOL - RESIDENTIAL COVE RESIDENTIAL 23000 Owner Contractor JAMISON MOORE PICAZO POOLS & SPAS 52865 AVENIDA VALLEJO 82365 HIGHWAY 111, SUITE #101 LA QUINTA CA: 922S3 INDIO CA 92201. (760). 347-5855 WCC:. EXEMPT WC: EXEMPT 05/31/05 CSLB: 836900 04/30/06 CCC: C53 ---------------------------------------------------------------------------- Permit. . . 7 . . . BLDG POOL PERMIT Additional desc .-Permit Fee" 189.00 Plan Check Fee 122.85 Issue Date . . . . Valuation . . . . 17330 Qty Unit..Charge Per Extension BASE FEE 45.00 16.00 9.0000 THOU BLDG.2,001-25,000 144.00 ----------------------------------------------------------------- Permit ._ . . . ELEC POOL PERMIT -RES ----------- \ Additional desc Permit Fee 45.00 Plan Check Fee 1.1'.25 Issue Date Valuation 0 _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 27.00. Plan Check Fee 6.75 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB'"FIXTURE, 6.00' P.O. BOX 1504 78-495 CALLS TAMPICO VOICE (760) 777-7012FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04-- (o/Cl)15 Applicant: Applicant's Mailing Address: I Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'§ 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 Cods, and ss License i�j ull force and effect. � cense Class % - � ense No. (� 7 1--Hlte r1 Tactor % CA L O Cd S 4-6 It S PA S OWNER -BUILDER DECLARATION I hereby affirm under penalty of 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 exempttherefrom 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 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 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.). U 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 proje:ts with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. . BA P.C. for this reason Date-* Owner. WORKERS' 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 in�ance carrier and policy number are: ,Eamer _-13`61icy Number _ 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 Labor Code, I shall forthwith comply with those provisions. /a -ate_ WARNING: FAILURE TO SECURE WORK?RS' 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. 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 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. I. 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 this county to enter upon the above-mentioned property for inspection purposes. Date d�gnature (Applicant or Agent): /!/�� Page 2 Application Number 04-'00006125 Date 9/01/04 Qty: Unit Charge 'Per Extension 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 Additional desc Permit Fee 81.00 Plan Check Fee '. .00 Issue Date.,.. Valuation 5670 Qty Unit Charge Per Extension. BASE FEE. 45.00, 4.00 9.0000 THOU BLDG 2,00,1-25,000. 36.00 ` Special Notes.and Comments POOL,�;ONLY, 256.L.F.5' GARDEN WALL' 8 L.F. 4' GARDEN WALL, CITY STANDARD. ALARMS/BARRIERS SHALL .BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee.Total 342.00' .00 00 34.2.00 Plan -Check Total 140.85 00� .00 140.85'' Grand Total 482..85 .00 .00 482.85`. 09/01/2004 08:38 7603475834 PICAZO CUSTOM POOLS PAGE 02 U 1':p."T E1Attle:4 r-oi, boor -be L L. /is-EM4T� w ir��OM S�fS'T'EM a a bkrS MUST bF- sE fr-. GL JO:5040 til owt� 0 IL0 U' 0 rooL- eV l r- WW CL CITY OF LA QUINTA BUILDING' AFET`, DEFT. AP F(9ROVE D FOR CO S I UC -I N DATE BY g"1'lJGG4 R,EA� l`I'��� a DEtZ'� PAS. 4¢ KwLI �i'u�.co �sP. jgt,tl►jD WATEf[. p.Oo� jtSGlA WADI.-- 3 '-� - o A -r wT -LoR oG �� ' PtAi�lT 4-leTtAtSI✓ yu1l5�IN�D� GA1`�TILEV�-�=- i �i► Ga►PIT 1l.�i FA.I�� 1aejZ�d Ci1i6ST4J+h G/lSC1ADF 1STtSLGO l�>EA.�C - }�" �CA.l� l✓ w�t5`� GAP�T'! Li✓i t=�� S-1 LJ(AA-) FAG4^0-- 7it,� i�►Gf� ,e,llr-To �t�' W/�Wff To MAIgTArr1 � S� LiE1bL1't Awr' Wb.Lt► oPR�sIT'� FRDAh gip.. �' �' pootr SIDt Lco o MMOL 2� Lo sz St�S co M 00 m Q m 04 MIU& (A AM CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS 5 4.88A' AQV. 41A,- )O PERMIT NUMBER OWNER DO jZ� BUILDER C"'T�n ��,c5(_s This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to wo)', on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Fa ly a to comply will resultinastoppage of work and/or the voidance of building permit. _ For each applicable trade, all information requested below must be completed by applicant. ,,"On File" is not an acceptable reSDonsed Trade / Classification Contractor State Contractor's LicenseY� 1�lorkers Com ensation Insurance �'' City Business License Company Name Classification . (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) ��® CSI L-j'L. A'Ci®c erg ?. (3 O-5 3 S CONCRETE (C-8) LS S"r n ro Z3 6.13 / FRAMING (C-5) ' STRUCT. STEEL (C-51) 0CATC, C,)we L 9c0ub e_' t �� �- MASONRY (C-29) Cm14s-rw_: CMe>A1 PLUMBING (C-36)Pte-A yp. L5 C-53 4090C., ©iv ec t�A�LPrr -71 AD5 LATH, PLASTER (C-35) ILE L eo� > A Z -C_ i+lL.I°i:l^lye ps DRYWALL (C-9) HVAC (C-20) ELECTRICAL (C-10) J i® LES 13so --, , ky- "'— ? �p'I i v Ir ROOFING (C-39) SHEET METAL (C-43) I i FLOORING (C-15) GLAZING (C-17). INSULATION (C-2) SEWAGE DISj?. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) x POOL (C-53) e, C_ • .� i C^ `� '� �.� 2 �' 1:��� i✓