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11-0008 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. Application Number: Property Address: AM Application description: Property Zoning: Application valuation: A--11---.. 11-00000008 79830 DECLARATION CT 604-511-016-23 -24197 - POOL - RESIDENTIAL LOW.DENSITY RESIDENTIAL 30000 Td -!t °f 4 Q" Architect or Engineer: BUILDING &. SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions oFChapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License Is in full force and effect. License Class_: /A. ,CS_ ' License No.: 310985 ate: j��'� �iOhvaaor• - . OWNER -BUILDER DECLARATION I hereby affirm under penalty of'perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Arty city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its lasuanea; also requires the appiicant.for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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 then five hundred dollars ($500) (_) I, as owner of the property, or my employees with wages" their sob compensation, will do the work, and the, structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State.Lioertse Low does not apply to an owner of property who builds or improves thereon, and who does the work himself.or. herself 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 fovthe purpose of sale.). 1—) I, as owner of the property,.am exclusively contracting with licensed convectors to construct the project (Sec. 7044, Business end'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.). (_) I am exempt under Sec. , B hP:C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury thauthere is a. construction lending agency for the performance of the work for which this permitisissued (Sec. 3097, Civ. C:). Lender's Name: Lender's Address: LQPERMfT Owner: CRAIG CASTER 79830 DECLARATION COURT LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760).777-7011 INSPECTIONS (760) 777-7153 Date: 1/07111 Contractor: CANYON SPECIALTIES 77590 MOUNTAIN VIEW PALM DESERT, CA 92211 O_ (760)345-8200 p�72@1 LiC. NO.: 310985 jQ1� 0 Citi' 4f L.A --------------------------- - - - - -I - -- -- WORKER'S COMPENSATION DECLARATION I hereby affirm under penatry of perjury one of the following declarations: _ 1 have and will maintain a certificate of conserrtto self-litsure 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. 1 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 Issued. My workers' compensation insurance.carrler'and policy number are: Carrier. SECURITY NATL Policy Number SWC1002288 1 -certify that, In the performance of the work for which this permit is Issued, I shall not.employ any parson In any manner so as to become subject to the workers' compensation laws of California, and agree that; if I should become sub)ect,w the workers' compensation provisions of Section 3700 of the bor'Code, II shall forthwith comply with those provisions. PPllcant:usl'tflfaL>tra - L� 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 (8100;000). IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION -3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 Le Quints, 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 ISO 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 applicatiomand state that.the above Information is correct. I agree to comply with -all city and county ordina and state lows.relatirg to building construction, and hereby authorize representatives /If this county to enter the above-mentioned property for inspection purposes. /Date: SlgneNre (Applicant or Agent): Application Number Permit. . Additional desc . . Permit Fee . . . Issue Date . . Expiration Date . . . . . 11-00000008 BLDG POOL PERMIT 284.50 Plan Check Fee 184.93 Valuation 30000 7/06/11 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU -BLDG 25,001-50,000 32.50 Permit. . . . MECH POOL Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/06/11 Qty Unit Charge Per Extension BASE FEE 15..00. 1.00 11.0000 EA MECH FURNACE >100K 11.00 Permit. . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan -Check Fee 11.25 Issue Date . . Valuation . . 0 Expiration Date... . 7/06/11 Qty Unit Charge Per .Extension BASE FEE 15.00 1.00 30.00.00 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 7/06/11 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 ---------------- -------------------------- Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN LQMRMff Application Number 11-00000008 -------------- ------------------------------------------------------------------ Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010 CODES. -----------------.-:-------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 388.50 .00 .00 388.50 Plan Check Total 2.10.93 .00 .00 210.93 Other Fee Total 2.00 .00 .0.0 2.00 Grand Total 601.43 .00 .00 601.43 DWRRMtr Bin # City of La Quinta Building 8r Safety DMWon Permit # P.O. Box 1504, 78-495 Cale Tampko La Qulnta, CA 92253 - (760) 777-701.2 Budding Permit Application and Tracking Sheet Project Address: IM- ?,3o Owner's Name: A. P. Number: Address: % - 9'.,0 (4 v o Legal Description: City. ST, Zip: /% ` A 4bZs Contractor: C r)tDO11-1 Cr Tckphone: Address: '� '� _ yO O UI Zo ,kj Project Description: POOL . S �� 7 City,.ST, zip: p m S-er- la 11 Telephone: 760 q�,9 z U O Stale Lic. # : 3ing City uc. #c... Arch.. Engr., Designer: Address: City, ST, Zip: Telephone: Const action Type: Occupancy; Stag Lia #: Project type (Circle one): New Add'n Alter Repair Demo ,/ Nerve of Contact Penson: l GIIC _1a I've Sq. Ft.: # Stories: #Units Telephone # of CortaCt Person: Estimated Value of Project 0 E) APPUCANT: DO NOT WRITE BELOW THIS UNE N Submittal Req -d Reed TRACMG PERMIT' F_ LES Plan Seb Plan Cheek submitted Item Amount Strachuld Cake. Ravkwad, ready for to.. am Plan Check Deposit Tram Cala. Called Contact Person Plan Cheek Balance, Title 24 Cala. Plans picked sup Construction Flood plain pun Plans resubmitted Mechanical Grading plan 2" Review, ready for correetkbslinve Electrical Subcontaetor List Called Contact Person Plumbing Grant Deed Plow picked cep &M -L H.O.A. Approval as resubmitted Grading IN HOUSE:- 3" Review, ready for arrectlonallaoe Developer Impact Fee Planning Approval Called Contact Perron A.LP.P. Pub. Wks. Appr Date of permit lane School Fees Total Permit Fen ..--�«.a...,..r.�...M�^�-^�^w,..d.-.e-.r.�.......k.......ti..:--...w��ir.,«..«....r..,..--.r-w...r-.. ..,,.r._.r�.x�..._ --- ^"""""•^"...rte. -: POW s „� Ll fie n ism- 01 Gf CiTY ®�� IDEPT.A BUILDING AP p OV E® FOR CONSTRUCTION DAT I BY L tC Q /*r, G-s-�