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04-6014 (RPL)I%L.. - ..v---------- ✓v.a -- — .J 11..-. . ✓- AIS.MI- P.4.:�B.ox r35,94�c��AT - (760).777-7012 78-495 GALLE TAMPICO - FAX (760)777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 B UILDING PERMIT Application Number :._04 0000.6014 -~ -�, Date 8/24/04 Property Address 52885 AVENIDA VALLEJO APN.: 773-3.23-020-7. -000000- Application description . . . POOL - RESIDENTIAL -Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . . . 20000 Owner Contractor BEN & JESSICA MEND' PICAZO POOLS & SPAS 52885 VALLEJO 82365 HIGHWAY-111,,SUITE #101 LA QUINTA CA 92253 INDI.O CA 92201 (760).347-5855 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB: 836900 04/30/06 CCC: C53 ------------------------------------------------ Permit. . . . . . . ---------------------------- MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee*. 6.00 Issue Date . . . . Valuation 0 Qty Unit.Charge Per Extension BASE FEE 15.00 1.00 9.0000 ----------------------------------.------------------------------------------- EA MECH•FURNACE <=100K. 9.00 Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee 207.00 Plan Check Fee 134.55 Issue Date Valuation',. . . . 20,000 . \Qty Unit'.Charge -Per Extension BASE FEE 45.00 18.00 9.0000 --- THOU BLDG -2,001-25,00.0 162.00 ----,------------------- Permit -------------------------------------- ELEC POOL PERMIT -RES ------------ Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-701 1 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: — Date: Applicant: Architect or Engineer: Applicant's Mailing Address: 464&V& Architect or Engi a dress: Lic. No.: BUILDING PERMIT DECLARATIONS 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. r� ov License Class S� License No. R-71. 7G DO Date_ Contractor PI * C,12-0 C v S Td A 700 g SQA 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 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 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 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.). U 1 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 insurance carrier and policy number are: ` Carrier Policy 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. Date—16Z400 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 ($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. 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. 1 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 Me 7 6 Signature (Applicant or Agent): Page 2 Application Number 04-00006014 Date 8/24/04 Permit . . PLUMBING Additional desc Permit Fee27.00 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 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 . . 45.00 Plan Check Fee .00 Issue Date Valuation . . 1903 Qty Unit,Charge Per Extension BASE. FEE 15.00 15:00 2.0000 HND BLDG 501-2,000 30.00 ----------------------------------- 7---------------------------------------- Special.Notes and Comments . POOL ONLY. 82 LF 5' BLOCK WALL AND 8 LF 4' BLOCK WALL CITY STND. ALARMS BARRIERS, SHALL BE IN PLACE PRIOR TO PREPLASTER IN PECTION. Fee summary Charged Paid Credited- Due. Permit Fee Total 348.00 .00 .00 348.00 Plan Check Total 158.55 .00 .00 158.55 Grand Total 506.55 .00 .00 506.55 eo."fg. To op" AWXj MONI 10oot, D & P! A• A& ''1 d v Ott 44 A le"m Ak• t legA isr, w! 4) t I r f T 0 1tAilr�b .� is'. W-FAK TOO MAST. A RE-INSUQWdg+ . OF 3 1 WILL BE CHARGED IF THE APPR V� ..PLAN ARD ARE• N' THE SITE FOR A SCHED INSPECTION. NO EXCEPTIONS! •' CITY OF LA C�1:MNTA BUILDING & SAFETY DEPT. APPROVE® 52:885 VALLe-LC FO -1STRUCTION. DATE pZ Y Z0 39dd S-lOOd WO1S119 OZd9Id a t Ml �J6 ' n V v 6 VEHLVE09L 9Z:EZ b00Z/17Z/80 bRWa� &A. -Te. To OMA AWA*i F90K poo4 � AIJA �'✓-MX*1M& Al4b 66 X- • • V �^T Y A RE -INSPECTION FEE F WI ED IFTHE--A ED PLANS AND JOB CARD AR ` THE SITE FOR A SCH ULED " INSPECTION. •' NO EXCEPTIONS! P.w. CITY OF LPA QUINT A :5►lt.44(AEo BUILDING; & SAFETY DEPT. ��VED FOR CONSTRUCTION DATE y//OBY TO 39dd S -100d W01910 OZdOId t'le g lec, w/ VmAx To MAT. M+ 59 U 17E890609L 9T:ET b00Z/bZ/80 A* 1 &,'L -S-30 CITY OFLA QUINTA SUB -CONTRACTOR LISTJOB ADDRESS 2' S SS &JD. PERMIT NUMBER OWNER 1AekS O BUILD 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 t on this job. Any changes to this list must be approved by the Building Division prior to commencement of work.F� a ly a to com ly will result in a of building permit... For. each applicable .trade, all. information requested below must be completed by applicant. 4 "On File" is not an acceptableres Trade /Classification Contractor State Contractor's License F ^ f�lllorkers Compensation Insurance Company Name Classification , (e.g. A, B, C-8) License Number (xxxxxx) Exp..Date (xz/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) EARTHWORK (C-12)�� 23 CONCRETE (C-8) V-2-LS9 'IA. FQ I 3 FRAMING (C-5) ' STRUCT. STEEL (C-51) 1GaZc� �� :••� P�O�S �. 3 9� MASONRY (C-29)AGD PLUMBING (C-36)Pte-A L `> 5 90a 6, e -,c LATH, PLASTER (C-35) KPLA-,_-,T.SO-� r r DRYWALL -(C-9) . - .Y HVAC (C-20) ELECTRICAL (C-10) 3 -Ak, e4-ec-- t 9:::? - .— ROOFING (C-39) . SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17). i INSULATION (C-2) SEWAGE DISP. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) i LANDSCAPING (C-27) POOL (C-53) C, e= 4 21�2-