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05-3855 (RPL)::A a 1. yV� 4 P.O. BOX 1504- 78-495 50478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: /%05-00003855✓' Property Address: 54965—AVENIDA VALLEJO APN: 774-301-023-12 -000000- Application description: POOL.- RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 18000 Applicant: Architect or En k// T -40 iht 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ----------------- UCENSED 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. License Class:yye Date:"/•- I S Contractor. F - .� T_ 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, alsorequiresthe 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).: (_) 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.). (_ 1 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 VOICE (760) 777-7012 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/31/05 Owner: WISMAN JOHN 54-965 AVENIDA VALLEJO LA QUINTA, CA 92253 Contractor: LEAK DETECTORS WCC: VIRGINIA INC WC: 005-.00022797 CSLB: 618116 01/01/06 04/30/07 ------------------ 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 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 C36 C53 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 wor s' compensation provisions of Section 3700 of the Labor Code, I sh for thwi c ply it those provisions. Data! ApplicarK �� 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. ' 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 Ouinta, 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 constru tion, a reby thorize representatives of t1ounty to enter upon the above-mentioned prope for i io Signature (Applicant or Agentl"/ r '— Application Number . . . . . 05-00003855 Permit . . . ... . BLDG POOL PERMIT Additional deoo . . ' Permit Fee . . . . ' 189.00 Plan Check Fee . . 122.85 issue Date Valuation . . . . 18000 ` Expiration Date . . 2/27/06 ' Qty Unitrez - Extension BASE FEE 45'00 ' I6.00 9-0000 -=---------------------- --'__---___---_----,--` THOU BLDG 2.001-25,000 ------------------ 144.00 ------- ' Permit . MECH POOL ' . . . . . Additional deao \ Permit Fee ' . . . 26.00 eIao Check Fee ' . 6.50 Issue Date . . . '' Valuation . . . . O Expiration Date . ' 2/27/06 - Qty Unit Charge Per Extension BASE FEE15.00 1.00 ----_-_--_-_---__-----------_---_-'--_-_----_---_- oa MoCH FURNACE�>1O0K 11.00 ' ( . . Permit . ' ' . . . ELoC POOL PERMIT -RES Additional deao Permit Fee . . . ' 45'00 Plan Check Fee.. . 11.25 Ioone'Date . . . . Valuation O. Expiratimooate . ' ' 2./27/06 Qty Unit Charge Per Extension ` ' oAoo FEE . 15.00 _ I.00 30.00001 --_-------------------------------- EA ELEC PoznazE SWzMmImG'eOOL _-------'_--_-___-__-------__- 30.00 ~ ' eezmdt . . ' . ` . eLoomBzmG ` Additional deoc Permit nee . . . ' 27.00 eIao Check nee ' . 6'75 �oo Date . . ` . Valuation . . . . O ` Expiration Date . . 2/2,7/06 � ' Qty Charge Per Extension BASE FEE rEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA gLB WATER zmST/ALT/R8P 3.00 ' 1.00 a.00OoEA gLB cAS.gzPo 1-4 OUTLETS � 3.00 -------------------------------------------------------------- Special Notes and Comments ADozrzom or GPA To EXISTING POOL. ' LQPEmNM Application,Number . . . . . 05-00003855 ---------------------------------------------------------------------------- Special Notes and Comments ALARMS/BARRIERS SHALL BE -IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 287.00 .00 .00 287:`00 . Plan Check Total 147.35 .00 .00 147.35. Grand.Total 434.35 00 .00 434.35 CITY OF'.L��,G��a v BUILDINfG & .FOR CONSTRUCTION DATES/23 IOSBY lC �' Bin # Permit # ps- - 3t�S� Projbct Address:- NJumber: t7z_ Contractor: 1( — Address: City, ST, Zip: vT Telephone: State Lic. # Arch.. Engr.. Designer: Address: 112 D City, ST. Zip: Telephone: z State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Z Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building 8T Safety Division . P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ' Owner's.Name: X ( 1 V )X4N Address: X City, ST, Zip: X Telephone: Project Description: Lic. #: d Ale.,l�t�47tn � ALX L�} r�i✓ .Total Permit Fees Construction Type: Occupancy Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:,X, Stories: # Units: Estimated Value ofProiect: X APPLICANT: DO NOT WRITE BELOW THIS LINE 'd Rec'd TRACKING PERMIT FEES Plan Check submitted �7i3 Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical ' 2nd Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.111.1. Plans resubmitted Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P p Date of permit issue .Total Permit Fees