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04-6848 (RPL)BUILDING .& SAFETY -DEPARTMENT P.O.. Box 1504 (760)•777-70.12 78-495 CALLS TAMP.Ico FAX (760) 777=7011 LA QUINTA, CA1IFOR141A.92253 INSPECTION REQUESTS (760) 777-7153 . BUILDING. PERMIT .,.Application Number 04-00006848 _ Date 10/20/04 Property..Address.. :, 60280 DESERT ROSE .DR • APN: _ _ .764 -270 -999 -13. -300233 - Application -description.. POOL. -.RESIDENTIAL Property. Zoning . . . MEDIUM.HIGH DENSITY RES Application valuation ,` .17000 Owner Contractor .. SHEA LA QUINTA CALIFORNIA POOLS & SPAS C/O jEFF.MCQUEEN P.O. BOX: 1280 $800 N GAINEY CENTER 350 .COACHELLA...CA.,92236' SCOTTSDALE AZ 85.25$. (-760) 398-9.222 t.. WCC: :. STATE FUND WC`- 0460:006116.8 01/01/.05 CSL$:: 656128 10/31/0.4 CCC: C8 -C27 -C29-053 Permit MECH POOL Additional desc Permit Fee 24.00 Plan Check Fee 6.00 Issue Date Valuation 0 Qty Unit Change.. :.Per Extension BASE..F.EE 15.00 1.00 9..0000,.EA MECH FURNACE: <=LOOK : 9.00 --------=-----._-.-----=--.---=-----=-=--------�.--------- Permit ---------.-----q=------- BLDG POOL PERMIT Additional. desc.. Permit.Fee 180.00 Plan Check Pee,. 117.00 .Issue Date:: Va=luat,ion17000 . .. ' �40'�'.�� : ' . . Qty Unit Change Per Extension BASE FEE .:'i• �� �, .�. ��� ' �� ��� 1�� 45-.00 15.00. .9:.'0000 THOU BLDG 2, 001-25�" Q'00 � :� u�� 135.00' --- ----------------------------- s - � _ -------- -:- ------ ----- ___ Permit Permit ELEC POOL PERMIT -RES " � Additional desc Permit Fee -45.00 Plan Check Pee 1.1.25 I�s.sue Date Valuation 0. Qty: Unit Charge Per Extension BASE. FEE 15.00 1.00- 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.0.0 ------------------------=--------•--------------------=---------------------- Permit . . . . . . PLUMBING Additional desc ' p.o: Box l sot VOICE (760) 777'-7012 '78-495 CALLE TAMPiCO :.FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number,Ozf_ Date: . Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Add UC. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTitACTOR'S DECLARATION -I hereby affirm under penalty of pedury ithat I am licerised under provisions of Chapterill (eomnnenclng wan Sediorm'700o) of oidcion s of the Businoss and Professionals and Lloensg.is kn full foroe and.effect. L fa�� /2 S' Lloense—. 53 License No. Ddtal� ,. Coihlador OWNER-BUILDF-R DECLARATION I hiHtby.atrirm"under penalty of perjury fiat 1 am exempt from ane Contractors" State License Law lor to foaowkq reason (Sec. 7031,5, Buskhesrsnd PToiessfons Code: 'My city or county that rooms a b per" mwb%rct alter. Wvr ve, demolish. or.mpak any structure, prior to Its Issuance. also mo es ane appocant e: Pam* b fee a signed statament that he or ". is Roen"d pursuant b the pmvl"w on. the ContradojV State lkense Law (Chapter 9 (comma nokng with Section 7000) for tho(Division a of ane Business and Piotessbns C40e) orthat he or ehe.ts amkenpt ttneretiom and the bests forte alleged exemption. Any violas m of Section 7031.5 by any appIoant for a pemdt subjects the applicant b a CNi, penally of not more than five hundred dollars ($500�r (, I. as owner of the property.'or my employees with wages. as their sole compensation, will do the work and the structure is not intended or offered for sale (Sea 700, . Business and Professions Code: The Contractors' State License Law does not appy b an owner of property who bolds or improves thereon, and who does the work hGnself or herself or through his or her own employees, provided -that the knprovernats.are not hwnded or offered for safe. If. however. tiro buAEirng or i np vmWent is sold wit*% one year of completIon, the awnerbutlder wit have. the burden of provkq that he or she did not b Ad or• improve for the purpose at sale.) 1. as owner of the property. am ezdu*wvfy contracting with licensed contractors b construct to pmjed (SeG 7044. Business and Professions Code: The Contractors' stale License Law does not apply toan owner of property who builds or Improves thereon, and who contracts for the projects with. a oontract)Ods) licensed pursuant to the contractors' State license Law.), L) I am exempt under Sea BA PSC. for this reason ^ Date Owner•_•, , WORKER$' COMPENSATION DECLARATION , 1 hereby affirm under penalty of perjury One of the following declarations:. have and.wtti maintain a certificate of consent to seR4ns4re for workers' compensation, "'provided fir Dy Section 3700 of the Labor Code, for the Pwfomnanoe of the work for which this gem* is Issued.. 4have and uta mslntatn workers' compensation Insurance. as required by -Section 3700 of the Laboc Code. for the pecbrnhance Of the wok for. this permit Is swQ. MY wor�grs' can ensadon:IAsuranoe cancer and l.corlify that In Via performance of the work for which this, penNtls lssued. I " not employ any Person In any manner so as to become subject b the worker' compensation laws of Centomla, and agree that if.l should become wMed b the workers' compensation provisions of Section 3700 of the Labor Code, i shall forthwith comply vdth those n Date% l ° Appnar,t__J WARNING: FAILURE TO SECURE WORKERS' COf4PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000). N 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 1 hereby atfrn under penalty of peNry that there Is a ronin don lending agency for ane performance of the work for which iNS gem* Is Issued (Sec. 3097. Civ. C.). Lender's Nama Lenders 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 applicatiok 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 b, and shall, defend. Indemnify and hold harmloss the City of Le QufMa, its officers. agents and employees for any act or omission relateI rformed under or toltomMng Issuance of this permit 2. My permit Issued as *'result of this application becomes nullt commenced wltdn.160 days from date of Issuance of such pemhit or cessation of wortk for 180 days will subjectpermit b cancetla1 certify that I have read this application and state that the above Informab comply with aft city and county ordinances and state laws.relating to buildingconstruction, and heSreby authorize representatives of this county entetioned property for inspection purposes. Oate ' © ' l d Signature (Applicant oeAgent): Page 2 Application Number 04-00006848 Date 10/20/04 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 Issue Date . . . . Valuation . . . . 240 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. 15 LF 4' BLOCK WALL CITY STND. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER 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