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04-7170 (RPL)t04 A 1--P 4 QUINTA BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760),777-7012 C� OFT9 78-495 CALLE TAMPICO R k• FAX (760) 777-7011 LA QUINTA, .CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . U074 -0000717"0>t -Date 11/10/04 Property Address 51355 CALLE JACUMBA - APN: 770-165-016-5 -000000- Application description . . . POOL - RESIDENTIAL Property Zoning MEDIUM DENSITY RES Application valuation 20000 Owner ------------------------ Contractor DAVE TAMASO ------------------------ VICTORIA LANDSCAPES/WATERFALL 51-355 CALLE JACUMBA 82365 HIGHWAY 111, SUITE #104 LA QUINTA CA 92253 INDIO CA 92201 (760) 863-3808 WCC: EVEREST NTNL WC: 3800002849041 08/26/05 CSLB: 801813 12/31/05 ---------------------------------------------------------------------------- CCC: C2.7-053 Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 198.00 Plan Check Fee 128.70 Issue Date . . . . Valuation . . . . 18874 Qty Unit Charge Per Extension BASE FEE 45.00 17.00 9.0000 ------------------------------------------------ THOU. BLDG 2,001-25,000 153.00 Permit . . . . . . ----------------------------- MECH POOL Additional desc Permit Fee 24.00 Plan Check Fee 6.00 Issue Date �. Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 ------------------------------------------------- EA MECH FURNACE <=100K 9100 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 • 4a" VOICE (760) 777-7012 78-49$ CALLS O FAX (760) 777-7011 LA QUINTA, CALIFORNIAFOR 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 041— 171170 Applicant: Applicant's Mailing Addr ss: Date: 11-15-04 Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affimt under penalty of perjury that 1 am licensed �deviswith Section 7000) of Division 3 of the Business and Professionals Co nd my License is in full force and effect. cense Class l %��C�7_ - o. O �I 6I� 1, 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.& P.C. for this reason Date 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. 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 i issued. My workers' compensation i nce carrier and 1* nu ber are: �rrier ZfJI�GG1rT � olicy Number � YO O VO 2. f 91 _ I certify tha , in the performance of the work for which this permit is issued, I shall not emp oy 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. ate 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 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 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 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 enter upon the above-mentioned property for inspecfion purposes. /ate%i3 ' nature (Applicant or Agent): Page 2 Application Number . . . . . 04-00007170 Date 11/10/04 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 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee 29.00 Plan Check Fee .00 Issue Date Valuation . . . . 1126 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 2.0000 ------------------------------------------------------------------------------ HND BLDG 501-2,000 14.00 Special Notes and.Comments POOL /SPA,.52 L.F. 5' GARDEN WALL CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ---------- 329.00 ---------- .00 .00 ---------- 329.00 Plan Check Total 154.20 .00 .00 154.20 Grand Total 483.20 .00 .00 483.20 w8'0 pool 51 17'0 F �' . EL,EC light switch RESIDENCE 6'6H- 51-3 5 5 CALL,E JACUMBA LA QUINTA, CA.,92253 bobcat access AT GAS