05-1430 (RPL)1
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BUILDING &SAFETY DEPARTMENT
P.O,.-.-Box -1-504
(760).777-7012
OFTt�94�
178-495-'CALLE TAMPIFO µ FAX (760).7.77-7011
4 UINTA, CALIFORNIA 92233 _ INSPECTION. REQUESTS (360) 777-7153
- - --"�J
BUILDING PERMIT-
yrs`
pl cr 1t�ion
e . . . . . -Q05 000014L3=0 Date
4/15/05
per
V AR, 43-292 PARKWAY ESPLANADE W
P
609 ,3,80 5_7-:t .2
`=66 -93233-
APPI, '
n description POOL'`RESIDENTIAL
rty Zoning
,LOW DENSITY RESIDENTIAL.
Application
Val uation 1700`0 `
Owner
Contractor
— — — — — — — —
— — — — — — — — — — — — —
LENNAR HOMES
OF CALIFORNIA 'CALIFORNIA POOLS &
SPAS
78401 HIGHWAY:
111,_ STE C P.`O. BOX 1280
LA QUINT.A';
CA `CO`ACHELLA
CA 92236
LA QUINTA
CA 92.253 (760`) 398•-92.22
.WCC:: SEABRIGHT
INS
WC,::. BB•1',05.0510
01/01/06
CSLB: 65612=8
10/31/06
CCC: C8 'C27 C29
C53
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Permit- .
. . . BLDG POOL :PERMIT
Additional
desc
Permit Fee
. . . 180.0:0 Plan Check Fee
117.00
Issue Date
Valuation
17000
Qty
Unit Charge Per
Extension
`,r BASE�FEE,
t 45.00
15.00,
9.0000,`THOU'". BLDG 2,`001-25,•000
135.00
------------,---
-.------------------- ------ +- ;;----- - - - - - - - - - -
- - - - - - --- -----
Permit
• MECH POOL r
Additional
desc.
>J
Permit,: Fee
. . . . 24:00 '°Plan` Check Feb
6.00
Issue.Date
_-Val_uatiori
0
Qty
Unit Charge Per
Extension
BASE F,EE
15.00
1.00
9'OO,O0.EA MECH FURNACE <=100K
9.00
Permit
ELEC POOL PERMIT --RES
Additional
desc
Permit Fee.
. 45, 0.0 .:,EPl.an:_.Check Fee
11.25
Issue Date
Valuation
0
Qty
Unit Charge Per-,
Extension
BASE.FEE
15.00
-1.00
30.OD00:'EA /ELEC PRIVATE SWIMMING POOL
.30.00
-- - - - - - - - - - - - - -
- - - - - - -- - - - - - - - -- ---.---w--- -.- - - - - - - - - - - - - - - - --
•-------------
P.ermit .
. . . . PLUMBING'
Additional
desc
P.O. B O a 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 1� 730I Date: 1� 0�
Applicant: Architect or Engineer:
Applicant's Mailing Address:
Co 1\,1 '7ruq C74fC
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
WI
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed u rovisions of Chapter 9 (co ting with Section 7000) of Division 3 of the Business and Professionals
/Code, and Lit-- d:/(� i force and effect. / -5 ��
/License Class�ssr((�� L ens N
✓ Date (`J Contract:; t/
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from a 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 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 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 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.).
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 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
Xof the work for whit this permit is issued.
have and will maint workers' compensation insuranc as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i u wo s' compensation artier insurance carr'
Policy Numbe (��( 2 G jS
I certify that, in the performance of the work f 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 agr a , I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forth
/i'tth comply with those provision/s..
bate V Applicant4ORRS'CO��PENQ)N
(/
WARNING: FAILURE TO SECURE WCOVERAGE 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
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety fora permit subject to the conditions and restrictions set forth or 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 wo ei erformed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if ork is n 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 info ion is torr I. gree o comply with all city and county ordinances and state laws relating to building
construction, and her y authorize representatives of this count me upon the bove- a ioned property for inspection purposes.
,at os-
Signature (Applicant or Agent):
Page 2
Application
Number, '.'"`.05'.-000'0.1430
Date 4/15/05
Permit Fee.
.3 '- 00.> Plan Check.: Fee
8.25
Issue Date
y.
Valuation
0
Qty Unit Charge Per
Extension
BASE -`FLEE
15.00
2.00
6. 0 0.0 0: EA PLB-.'F I XTURE "
12.00
1.00
3,.0000, EA PL -"B' .WATER`:INST/ALT/REP
3.00
1.00
3 . GOOD 'EA PLB GP;'S PIP. -E 1,-4 'OUTLETS
3.00
Special Notes
and ,Comments.
POOL & SPA.
ALARMS%BARRIERS . SHP,LI�'' BE IN " ..
PLACE'PRIOR
TO PRE -PLA; TER. INSPECTION.'
EQUIPMENT ENCLOSURE NOT INCL"UDED IN
_ PERMIT.
Fee summary
Charged- Paid .: Cred'ited
Due
Permit Fee
Total .282.00 .00 +.OQ
282.00
Plan`Check
Total TA 00 00
142.50
Grand Total
424.50 .00 .00
424.50