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06-2352 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: W �,d �w 06-00002352 53875 AVENIDA DIAZ 774-151-019-7 -000000- POOL - RESIDENTIAL COVE RESIDENTIAL 15000 c&ht 4 4 Q" Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 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: C12-053 nse No.: 746 Date: 0.6 Contra 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: 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 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 than five hundred dollars ($500).: (_ 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 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 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.). (_ I 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.). (_ 1 I am exempt under Sec. , 8.&P.C. for this reason 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ----------------------------------------------- WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1576693-2005 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ 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 hall forth c y with those provisio Date: /�3 GrApplica r 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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 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 repre tives of this county to enter upon the above-mentioned pr e r ins pur S. Date: �� 66 Signature (Applicant o gen Date: 6/13/06 Owner: RUBEN & JOSIE NAVARRO 53-875 AVENIDA DIAZ LA QUINTA, CA 92253 (� D lj Contractor: juN e 14 NUN NEUBUAGER EQUIPMENT RENTAL/ D P.O. BOX 623 CITY OF LA QUINTA LA QUINTA, CA 02253 FINANCE i)EPT• __J (760)771-9822 Lic. No.: 746662 ----------------------------------------------- WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1576693-2005 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ 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 hall forth c y with those provisio Date: /�3 GrApplica r 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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 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 repre tives of this county to enter upon the above-mentioned pr e r ins pur S. Date: �� 66 Signature (Applicant o gen Application Number . . . . . 06-00002352 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 12/10/06 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30.00. Permit . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 12/10/06 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 117.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/10/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION.EQUIPMENT ENCLOSURES NOT INCLUDED. Fee summary Charged ----------------- ---- Paid Credited - ----- ---------- ---------- ---------- Due Permit Fee Total 234.00 .00 ..00 234.00 Plan Check Total 123.30 .00 .00 123.30 Grand Total 357.30 .00 .00 357.30 LQPERMIT ���aJrll l / _ i Q- /'� R a L, 'erV, — — P� on A RE -INSPECTION F EE WILL BE CHARGED IF THEAPPF $3D ED PLANS AND JOB CARD ARE NOT ON THE -SITE FOR A SCHED TON INSPECTION. UL ED NO EXCEPTIONS! Ci �,l -�° vim OF Lq (QUI NG SAFiq APp� DEP/-• FOR CONSOVED CnON DA Way �x ,r. ; ,t ..., .3 Steve Fischer - i .r Uc'6 ,53746662 ualdy.P Is anti Spas�at'Affordable t? e� T�,.es'rree, • . - ouc,beautiful poo1s. t www:a-1poolconcep Custom P - - _ Serving the Coachella Valley for Thirty Years SIZE 5 1 X // r/--'. AREA '� CU PERIMETER DEPTH VQ Q " -- S' Ww4v 0 TILE CHOICE SQ. GASLINE BY. e -S FT. RBB. + Lo " .A ' ELECTRICAL BY COPING POOL CAPACITY GALS PUMP CAPACITY GPM MOTOR HP w►. v HP /, 0 MOTOR HP HP FILTER CC-,? 3=1,0 SQ FT SUCTION LINES " RETURN LINES l /a'' SKIMMER MODEL Ww4v 0 CHECK. VALVE N 0 GASLINE BY. e -S FT. POOL LIGHT CLOCK cg ELECTRICAL BY FT. AUTO CLEANER CHEM. FEEDER PLASTER COLOR Wim_ TS D DECK BY S- Z SQ. TO -7 DECK TYPE Colo IL* - SrA-T STEP FT. SPA SPECS. SIZE RAISED. LITE ATTS DUALLEVEL TS DAM WALL DAMWALL To0P SPILLWAY IZE 21N WIDE DATE SPILLW #JETS Name: Wfag4-� N ihJia Address: 93 g? S �A Z. City: C QjI.� TRACT ' CadC, LOT# Bi" # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Per//m--it.# c� • X352 Project Address: � Owner's Name: A. P. Number: Address: 53 Legal Description: City; ST, Zip: a01, Contractor: L4 er- ti �t va3 Telephone: Address:/ Project Description: /�1 City, ST, Zip: C 2 -3 _ . a f Telephone: aab - 8 / / J State Lie. # : 7 G 66 Z City Lie. #: Arch., Engr., Designer: Address: City, ST, Zip: ' Telephone: Construction Type: a� ccupancy: State Lie. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: n2 ani Sq. Ft.: #Stories: # Units: Telephone # of Contact Perso . Estimated Value of Project: Q a C-) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMIT FEES 24 Plan Sets Plan Check submitted // k9 Item Amount Structural Calcs.. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan 2°" Review, ready for corrections/issue Electrical Subcontactor. List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Q Total Permit Fees