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04-7490 (RPL)El i yuylrQ. I BUILDING & SAFETY DEPARTMENT ;""•"41 2�•504, it -7012 O0x a OF T1 ..�.--�`78`- 5 �CALLE TAMPICO M� 4 y y FAX (760) 777=7011 CI�INANCEQU A QUANTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT ,-A Application Number . . . . X04=00007490 'hD,ate 11/29/04 Property Address . . . . . 50460 VIA AMANTE APN: .772-400-051- - - Application description POOL -'RESIDENTIAL Property Zoning'. . . . . LOW DENSITY RESIDENTIAL Application valuation . . 15000 Owner Contractor ------------------------ ..'---------------------- R ----------------R J T'HOMES RJT HOMES LLC 1425 E UNIVERSITY DR 1425 E. UNIVERSITY DRIVE PHOENIX AZ 85034 PHOENIX AZ"85034 WCC: STATE FUND WC: 1583906 10/.01/05 CSLB: 690645 06/30/06 11 CCC: A -B -------------------------------------------------------------------=-------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date Valuation . . . . 15000 Qty Unit Charge- Per- Extension BASE {.� FEE 1'3. 00 9.0000 THOU BLDG 2,,001-25, 000`--. 117 r00 - - - - - - - - - - - - - - - - - - - - Permit . . . - - - - - - - - - - - - - - - - ---------------------------------------- ---------------------------------------Permit MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fe -e- . 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 . . . -------------------------------------------- . . 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 -------------------- Permit . . . . ----------------- . . PLUMBING ------_------------------- ------ - - - - - -- Additional desc Permit Fee 33.00 Plan Check Fee 8.25 P.O. Box 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: - %4q0 I D t Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: tfUILUINU PERMIT DECLARATIONS a e. 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 C de, and my License is in ull force and effect. C� / /, �•� icense Class &4 —!4u cense No. I,;,/0 b y /Date - O- Oractor l a T— �k'I,-•e -5- OWNER-BUILDER OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt frotr 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 provisiois 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 fora 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' S -.ate 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.) (, 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 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 ceclarations: I have and will maintain a certificate of consent t:) 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 workgrs' compensation ' rance carrier and olic 4 er re: arner �� QJ,iJ c1 olicy Numoer � certify tha , 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 — 50 -d pplicant 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 A 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 iE 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 ro cancellation. I certify that I have read this application and state that the abcve 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 en er up the above-mentioned property for inspection purposes. Datefl 3 r — Signature (Applicant or Agent): i,• Page 2 Application Number 04-00007490 Date 11/29/04 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB'FIXTURE 12.00 1-.0.0 3.0000 EA PLB WATER INST/ALT/REP 3.0.0 1..001 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, BBQ (UL # ETL302091.4) ALARMS/BARRIERS_ SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited 'Due Permit Fee Total. 264.00 .00 .00 264.00 Plan Check Total 130.80 .00 .00 130.80 Grand Total 394.80 .00 '.00 394.80 i vm "�`'i�•;':' ':3_ 1.. r-+�'�. �•e�z,`<=art.- pm � MR, I TY �C -CCS C - ......:.:. BUILDING SAF E'S^ PP CTION t0- _� �~� • �` '- _ . 4/0 S=O...� m LO GB �. . • � 'Sp=4:60 �1`� .00�.;�� : . %440 VfA LAMANTE MANTE 3.50 PAD tSA 2A I PAD=33;0.. L°fi# 3-A. 5,ff FF=34:50: :PAD=34.0 =34 .50 �a PAD=34.4 r 3.- 17 o