05-0824 (RPL)BUILDING &'SAFETY.DEPARTMENT
P.O. Box 45.04 .(760).777-7012
78-495 CALiE TAMPICO FAX (760) 777-7011
LA QUINTA, CntiIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING'PERMIT
Application Number
.. . . 0'50`0-00`0'8.24. Date
3/11/05
Property Address
. .: 432.77 PARKWAY.ESPLANADE W
APN:'
609-38'0-997-26 -293233-
Application description..
POOL-_i`RESIDENTIAL
'Property Zoning
..LOW DENSITY RESIDENTIAL
Application valuation
.. 17000
Owner.
Contractor
LENNAR HOMES OF CALIFORNIA
., CALIFORNIA.POOLS & SPAS
78401 HIGHWAY .111, STE-`'C.
P.O. BOX 1280
LA QU,INTACA,
COACHELLA CA
92236
LA QUINTA.
CA 92253 .�`. (760) 398-9222
WCC: SEA -BRIGHT INS
WC:' BB1`050510.
01/01/06
CSLB:. 6561128
10/31/06
CCC: C8 -C27 -C29-053
Permit
BLDG POOL PERMIT
Additional desc
Permit -Fee
180.00 Plan Check Fee
117.00
Issue Date
" Valuation
17000
Qty Unit Charge
Per Extension
;BASE, FEE-..
45.00
15.00 9.00-0.0
.THOU-. ,BLDG.- 2, 001-25, 000
135.00
Permit -MECH
POOL
Additional desc
Permit Fee
24.0.0 Plan'.CheQk Fee
6.00
Issue Date
Valuation
0
Qty Unit Charge
Per" Extension
BASE;; ,'FEE
15.00
1.00 9.00,00
EA MECH FORNACE <=100K
9.00
- - - - - - - - - - - - - - - - - - - - - -._ - - -
_ - --- - - - - -S- - - - - - -'- - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - -
Permit
ELEC.POOL PERMIT -RES
Additional desc
Permit Fee
'. 45.00. Plan CY
1.25
Issue Date
Valuat-i0
MAR 21 200jEx
Qty Unit .Charge
Per
e
sion
BASE FEE
aw OF LAGUINTA
15.00
1.00 30.00.00.
-EA ELEC PRIVATE SWIMMING
' ffiANCEONPT
J0.00
Permit . . . .
PLUMBING '
Additional desc
P.O. Box 1504 • ���
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153
BUILDING cit SAFETY DEPARTMENT
Application Number: Q Jam' .2Date: 3—Z I�O s'Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
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.
�de, and my Liceefe i rl force and effect.
License Class /lam is nse No. ✓/w O
DJ 0L [ 0 5 Contractor
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 I am exempt under Sec. , B.8 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.
no -6
had will manta* orkers' compensation insurance, as required by Section 3700 of th Labor Code, for the performance of the work for which this permit is
pensation insurance carri✓CarrierPolicy Numbee/
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 t a if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwi
th comply with those provisions.
D� <.pplicant
WARNING: FAILURE TO SECURE WORK RS' 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 q
y
Lender's Address
l 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.
1.1 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 rrect. I gree to comply with all city and county ordinances and state laws relating to building
/coons/tructionannd hereby authorize representatives of this county to terupona ab e -mentioned property for inspection purposes.
a� to W �� Signature (Applicant or Agent):
Page 2
Application Number . . . . 05-00000824 Date 3/11/05
Permit Fee . . . . 33.00 Plan Check Fee . . 8.25
Issue Date . . . . Valuation . . . . 0
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
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Special Notes and Comments
POOL & SPA. ALARMS/BARRIERS SHALL BE IN
PLACE PRIOR TO PRE -PLASTER -INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary Charged.
----------------- ----------
Permit Fee Total 282.00
Plan Check Total 142.50
Grand Total 424.50
Paid Credited Due
---------- ---------- ----------
.00 .00 282.00
.00 .00 142.50
.00 .00 424.50
r