05-3901 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application.Number. 05 00003901
Property Address: 473245 PARKWAY ESPLANADE W
APN: 609-380-997-25 -293233-
Application description: POOL - RESIDENTIAL
Property Zoning: ' LOW DENSITY RESIDENTIAL
Application valuation: 35000
• _ ..� .
Applicant:
Architect or Engineer:
UCENSED,CONTz90R'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/09/05
Owner:
"EGET
43-245 PARKWAY ESPLANADE
W
an)
7�i
LA QUINTA, CA
Q�
LA QUINTA,. CA 92253
Contractor:
o
CHAMPION CONSTRUCTION
WCC: STATE FUND
WC: 229040028780
09/01/06
_^
CSLB: 836472
04/30/06
hereby affirm under penalty of perjury, that I a licensed er provisions of Chapter 9 (commencing with. ,
Section 7000) of Division"3 of the'Business Professi s Code, and'my License is in'fujl force and effect:,
License CI ss: -License No.: -
Date: Contray r - -
`• NER-BUILD - CLARATION
I hereby affirm under penalty of perjury, that I exempt fr,t .Contractor's State License Law for the
following. reason (Sec. 7031.5, Business and Professio Any city or county that requires permit to.
construct,. alter, improve,, demolish, or repair any stru " e; 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 fora permit subjects._the applicant to a civil penalty'of not more than.five hundred dollars 1$5001.:
(_ 1
1, as owner of the property, or my employees with -wages as their sole compensation, will do the work, and
the structure isnot intended or offered for sale (Sec. 7044, Business and'ProfessionsCode: 'The
Contractors' State,License Law does not apply to are 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 imended 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 thathe or she did not build or
improve for the purpose of sale.). "
1 _ 1 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.).
I—) I am exempt under Sec. , B.&P.C. for this reason.
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty ofperjury 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 onii. ofthe 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, forthe performance of ihe.work for which this permit is
issued. '
/7( I have.and,will maintain workers' compensation insurance, a fquired by Section 3700*of the Labor
Code, for the performance of the work for which this `p rrlrt is issued. My workers' compensation
jinsurance carrier and policy number are:
Carrier B Policy Number - _ - - - - - - - - - -
_ I certify that, in the performance of a work for wh' �nis permit is issued, -1 shall not employ any
person in any. manner so as to com subject t• t workers' compensation laws of California,
and agree that, if 1 should be a bjact to t orkers' compensation provisions of Section
3700 of the Labor C/ode, I • I -f rth'.co plywith th tf provisions:
t 10�5Applicant:v _
WARNIN :. FAILURE TO WORKERS'.COM NSATIO CO RAGE IS UNLAWFUL, AND. SHALL
SUBJECT AN EMPLOYER .TO CRIMINAL PENALTI -AND.0 I ' ES UP TO ONE HUNDRED THOUSAND
DOLLARS'($100,000). IN ADDITION TO THE COST OFC PENSATION, 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 ha ss the City
of La Quinta, its.officers; agents and -employees for any act or omission related to t 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 i not commenced
within 180 days from date of issuance of such permit, or cess tion of work r.180 days will subject
permit to cancellation. -
I certify that I have read this application and state that the above inform io corre I gree to comply with all
city and coun .o inances and state laws relating to building constru ion her uthorize representatives
of this/(c%o n t enter upon the above-mentioned property for insp io rose
Dam ��Signature (Applicant or Agent): x,/
Application Number .
. . . . 05-00003901
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
317.00 Plan Check
Fee
206.05
Issue Date . . . .
Valuation
35.000
Expiration Date
3/08/06
Qty Unit Charge.
Per
Extension
BASE FEE
252.00
10.00 6.5000
THOU BLDG 25001-50,000
65.00
Permit . . .
MECH POOL
Additional.desc .
Permit
26.00 Plan Check
Fee
6.50,.
-Fee.
Issue :Date
Valuation
0
Expiration Date. .
3/08/.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 Cheek
Fee
11.25
Issu'e-Date
Valuation
0
Expirati'oiLDate,..
3/08/06
`.Qty. Unit.Charge.•.Per
"
Extension
BASE FEE
15:00
1.00 30.0000`EA
---------------------------------------------------------
ELEC PRIVATE'SWIMMING
POOL,
3.0.00
Permit
PLUMBING.
Additional desc .
Permit Fee
45.00 Plan.Check
Fee
11.25
Issue Date . . . .
Valuation
0
-. Expiration Date
3/08/06
Qty Unit Charge
Per.:
Extension
..BASE FEE'
15.00
4.00 6:0000
EA PLB FIXTURE
24.00
1.00 3.0000
EA PLB `WATER'IWST /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
LQPERMTT