06-2321 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002321
Property Address: 79931 PARKWAY ESPLANADE N
APN: 609-380-999-12 -293234-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 23000
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
ar'
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/09/06
Owner:
ZEMNICK
79-931 PARKWAY ESPLANDE N.
LA QUINTA, CA
LA QUINTA, CA 92253
Contractor.JD A
CALIFORNIA POOLS & SPAS
P.O. sox 1280'JUN a 9.2006
COACHELLA, CA 92236
(760)398-9222
Lic. NoCB4
.: 656128 VOFLAQUINTA
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LICENSED CONTRACTOR'S DECLARATION
--------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to -self -insure for workers' compensation, as provided
License Class: CS C27 C29 -., -License No.: 656128
for by. Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Dae:a/r�—:a
-
have and will maintain workers' compensationinsurance, as required by Section 3700 of the Labor
Code, for the performance of the work forwhichthis permitisissued. My workers' compensation
0 ER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under.penalty of perjury that I am exempt from the Contractor's State License Law for the.
Carrier SEABRIGHT Policy Number BB1060510
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve,.demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers: compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of, Division 3 of the Business and Professions Code) or
3700 of the Labor Code; I,shal forthwith comply with those provisions.
that heor 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).:
Date:` l: `� `r',Appl
1 _ 1 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.
WARNING: FAILURE'TO SECURE WORKERS' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, '
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improveofor the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT
1 _ 1 I, as owner of the property, am exclusively contracting with licensedcontractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety, for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.):
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
of La Qumta, 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 build construction, and hereby authorize representatives
of this
%ccounty,to enter upon the above-mentioned pro o spection purposes.
D67q�D Signature -(App
Application Number . . I. . . 06-00002321
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
234.00 Plan Check
Fee
152.10
Issue Date . . . .
Valuation
. . . .
23000
'Expiration Date
12/06/06.
Qty Unit Charge
Per
Extension
BASE FEE
45.00
21:00 •9:0000
THOU BLDG 2,001-25,000
189.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue.Date
Valuation
. . . .
0
Expiration Date
1'2/06/06
Qty -Unit Charge
Per
Extension
BASE FEE,,
15.00•
1.00 11.00.00
EA MECH:FURNACE >100K
11.00
Permit.
ELEC`,POOL PERMIT -RES
ha"
Additional desc .
Permit'-.
45..00 Plan Check
Fee
11.25
Issue Date
Valuation
0
Expiration -D'ate
12/0.6/06
Qty, Unit Charge'
Per
Extension
BASE FEE
15.00
1.00 30.0000
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EA ELEC PRIVATE SWIMMING
POOL
30..00
Permit . . .'
PLUMBING
Additional desc .
Permit Fee
33.00- Plan Check
Fee
8.25
Issue.Date . . . .
Valuation
. . . .
0
Expiration Date
12/06/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000•EA
PLB FIXTURE
12.00
11.00 3.0000
SEA PLB WATER•INST/ALT/REP
3.0.0,
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
LQPERMTT
Application Number . . . . . 06-00002321
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Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION
EQUIPMENT ENCLOSURES NOT INCLUDED.
Fee summary Charged Paid Credited Due
-- - - - - - - - - - - - - - ------ -- - - ------ - - - - ------ - - - - ------ - - - - - -
Permit Fee Total 338.00 .00* .00 338.00
Plan Check Total 178.10 .00 .00 178.10
Grand Total 516.10 .00 .00 516.10
LQPERMIT
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P O Box 1`504; 78 495 Calle Tampico'
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La ulnta, CA 92253 (760).777 7U12
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Project Description:
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Project type (circle one), Add'
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��Name of Contact Person
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Ttielephone # '"IR Person
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APPLICANT D N0
O 7 WRITE BELOW THlS
LINE
TRACING PERMIT FEES
PIan;Sets:,
,.
Plea Check submitted
Item
Amount
,Structural Calcs
r
:
:..;;.
Renewed;. readytorcorrections
Plan Cfieck Deposit
z
Truss Calcs
Galled Contact Peison
Plan Check Balance
i Eiergy.;CalCs.
Plans picked
up
Construction
Flood plan;plan
Plans resubmitted
Mechanical
Grading plan
Zoe Review, ready -for correctionslssue
Electrical
Sabcontaetor List
Called Contact Person
Plumbing
'` Grant.Deed
'Plans picked
up
_ Approval
Plans resubmitted
.... . .
.Grading
"'Dq ROUSE
Review, ready for correctioiis/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
_:.
Pub .Wks Appy .
.........:....:.
Date ofpermif issue
Scfiool•Fees'
-Total Permit Fees
4
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