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04-6439 (RPL)a x BUILDING & SAFETY DEPARTMENT 504 (760).777-7012 CSM, 9 78-495 v) LE TAMPICO FAX (760) 777-7011 @LMUIN �, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 ixA :WIN BUILDING PERMIT Application Number . . . . . Z 04---00=0-0-64,39 Date 9/24/04 Property Address . . . . . 78218 CALLE LAS RAMBLAS APN: 770-014-013-1 -29586 - Application description . . . POOL - RESIDENTIAL Property Zoning . . . . . MEDIUM DENSITY RES Application valuation 17000 Owner - Contractor ------------------------ --- =-------------------- LECHLITNER CALIFORNIA POOLS & SPAS 78218 CALLE LAS RAMBLAS P.O. BOX 1280 LA QUINTA CA 92253 COACHELLA CA 92236 (760) 398-9222 WCC: STATE FUND WC: 04600061168 01/01/05 CSLB: 656128 10/31/04 CCC: C8 -C27 -C29-053 ---------------------------------------------------------------------------- Permit BLDG POOL PERMIT Additional desc Permit Fee . . . . 180.00. Plan Check Fee 117.00 Issue Date Valuation 16936 Qty. Unit Charge Per Extension BASE FEE 45.00 15.00 9.0000 THOU BLDG 2,001-25,000 135.00 ------------------------------ ---------------- 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 9.00 ------------------------------------------------------------------------------ .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 P.O. Boa 1504 78-495 CALLE TAMPICO ll{/ VOICE (760) 7777-701 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �% / .Date: !J,,Q T0Y 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 lice:nice provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals e, and my Lice p is j rce and effect. c/ / �� License Class " d e No. 56 e 1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury.tha 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 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 k<of the work for which this permit is issued. I have and will maintai workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is � is ued y worke compensation in cRich qperm—itis iyy r er. �A� olicy Nu(J _ I certify that, in the performance of the work for issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agreeat, if I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall - forthwith comply with those provisions. a WARNING: FAILURE TO SECURE WO ERS' COdP SAT N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TFfOUSAND DOLLARV$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 CA IMPORTANT Application is hereby made to the Director of Buildingand Safety APPLICANT ty Apermit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person atrequest and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the apA h rees to, nd shall, defend, indemnity and hold harmless the City of La Ouinta, its officers• agents and employees for any act or omission relabeing pe ormed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes ni work is notacommenced within 180 days from date of issuance of such permit or cessation of work for 180 days will subject permit to cancelI certify that I have read this application and state that the above inform1 Ayre to comply with all city and County ordinances and state laws relating to building construction, and hereby authorize representatives of this county ena v entioned propeAy for inspection purposes. Date G ignature (Applicant or Agent): I Page 2 Application Number . . . . . 04-00006439 ---------------------------------------------------------------------------- Date 9/24/04 Permit . . . . . . PLUMBING Additional desc 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 Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 ,z Issue Date . . . . Valuation . . . . 64 Qty Unit Charge Per Extension BASE --------------------------------------------------_-------------------------- FEE 15.00 Special Notes and Comments POOL/SPA, 4 L.F. 4' BLOCK WALL, CITY ` STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER -INSPECTION. Fee summary Charged ------------------ Paid Credited Due -------------------- Permit Fee Total 297.00 ---------- .00 .00 ---------- 297.00 Plan Check Total 142.50 .00 .00 142.50 Grand Total 439.50 .00 .00 439.50