05-5355 (RPL)sm
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00005355
Property Address: 54530, AVENIDA VALLEJO
AM 774-282-002-23 -000000-
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 12000
Applicant:
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/08/05
Owner:
CORONEL ENTERPRISES INC
D d P 0 BOX 389
A QUINTA, CA 92253
JAN 0 510D�`
u .nntrartor,
Architect or Engineer: —" SOF CORONEL CONSTRUCTION
F�qN Eptq P.O. 'Box 389
LA QUINTA, CA 92247
(760) 564-4604 .
Lic. No.: 634981
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjur hat I am licensed under pr 'ions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu in ss an Profes" als C e, nd my License is in full force and effect.
License Class: B - C13 Lice a o.: 634981
"Date: X 26 Contracto .
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 1, 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.).
(_ 1 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 projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) 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
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
t� issued. -
/t 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 STATE FUND Policy Number 174445305
_ I certify that, in the performance of the work for whit ermit is issued, I shall not employ any
person in any m r so as to becwo kers' compensation laws of California,
and agree that2:�tt?!y if I s uld comeke ' compensation provisions of Section
�� 3700 of the Lt those provisions.
"Date: t_.s"d1* Applican
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 IN '
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 tha t e above informatio is corre I a ree to comply with all
city and county ordinances and state laws relating to b i ing co truction and here out rize representatives
2e.:
' county to enter upon the above-mentioned prop r ..for in ection urposes.
%S -4 � Signature (Applicant or Agent).
Application Number
05-00005355
Permit
BLDG POOL PERMIT
Additional.desc .
Permit Fee
135.00 Plan Check
Fee
87.75
Issue Date
Valuation
. . .
. 12000
Expiration Date
6/06/06
,Qty Unit Charge'
Per
Extension
BASE FEE
45.00
10.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001725,000
90.00
Permit . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee`.
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
6/06/06
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
-6/06/06 .
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
6/06/06
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 ONLY.. ALARMS/BARRIERS SHALL
LQPERMIT
Application
Number . . . 05-00005355
----------------------------------------------------------------------------
Special Notes
and Comments
BE IN PLACE
PRIOR TO PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT
INCLUDED IN
PERMIT.
Fee summary
Charged Paid
Credited
Due
Permit Fee
Total 239.00 .00
.00
239.00
Plan Check
Total 113.75 .00
.00
113.75
Grand Total
352.75' .00
.00
352.75
LQPERMIT
's
CITY 1TY OF LA
1
BUILDING & SAFETY DEPT. '
APPROVED
FOR CONSTRUCTION
DATE �1� °� `� BY
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