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05-3160 (RPL)gi P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00003160 Property Address: 54880 AVENIDA DIAZ APN: 774-291-007-18 -000000- Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL D Application valuation: 17000 JUL 2 7 2005 Applicant: Architect or Enginee : l.onlT/�iAc To ll ------------------------------------------------ LICENSE ON ACTOR'S DECLARATION I hereby affirm under penalty of perjury that Iam lice d u der provisions of Chapter 9 (commencing with Section 7000) of Div n f e Business and Prof s Is Code, and mira�,acT�_is�" a and effect. License Class: ` icense No.:✓Cf/ f date i���ractor: OWNER- IL ER DECLARATION I hereby affirm under penalty of perjury that I am exempt m 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 1, 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.). (_ 1 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.). (_ I I am exempt under Sec. , B.&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: LQPERn1IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/25/05 Owner: HOWELL 54-480 AVENIDA DIAZ LA QUINTA, CA 92253 Contractor: CALIFORNIA POOLS & SPAS WCC: SEABRIGHT INS WC: EB1050510 01/01/06 CSLB: 656128 10/31/06 ------------------ 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: ©/ /1"6 Go,/,( E}/ Ze Carrier C8 C27 C29 C53 Polic Number yf {py( I certify that, in the performance of the or which this permit is issued, I shall not employ any person in any manner so as to becom ubj t to the workers' compensation laws of California, and agree that, if I shout become su je t the workers' compensation provisions of Section 37100 of the labor Co , I hall forth 4th mply with those provisions. Date C licant: WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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, in nify and hold harmless the City of La Quinta, its officers, agents and employees for any act or 'Nd elated to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null nork is not commenced within 180 days from date of issuance of such permit, or ce saork for 180 days will subject permit to cancellation. I certify that I have read this application and state that thea a informat nt. I agree to comply with all city and county ordinances and state laws relating to building n.1ructiaay authorize representatives of thi ty to a/r/� rr uupon the above-mentioned propert' f/El_ spe ion oses. te: O` "Sig ature (Applicant or Agent): �' A LQPERM[T Application Number . . . . . 05-00003160 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 180.00 Plan Check Fee 117.00 Issue Date . . . . Valuation . . . . 16840 Expiration Date 1/21/06 Qty Unit Charge Per Extension BASE FEE 45.00 15.00 .9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 135.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date 1/21/06 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 1/21/06 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 Issue Date . . . . Valuation 0 Expiration Date,. 1/21/06 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 P1 A LQPERMIT Application Number 05-00003160 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 160 Expiration Date . . 1/21/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. 10 L.F. 4' BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited ----------------------------------------------=---------- Due Permit Fee Total 299.00 .00 .00 299.00 Plan Check Total 143.00 .00 .00 143.00 Grand Total 442.00 .00 .00 442.00 Bin #City Of La Quinta Building & Safety Division Permit # 05– 3/8 P.O. Box 1504,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ,s #80 Building Permit Application and Tracking Sheet Project*Address:_ Owner's Name: L A. P. Number: Address: Legal Description: City, ST, Zip.:. Contractor: C(xLi e- NOLs s Telephone: {.tir nJ:•is•}J:4iii:.ii6i`SY.4{i:,+.:i?�. Plan Sets Plan Check submitted % �/L Item Amount Structural Calcs. Address: 0 Box Izzo Plan.Check Deposit Project Description: Called Contact Person City, ST, Zip: G 14 ��C,. A Construction •Telephone: � � �" � Z Z. •;:�:<i�>s•>J;;:ri:;:'..}<::;:;..: Mechanical Grading plan i Electrical Subcontactor List . State Lic. # : 65 epla 2r City Lic. #;ei s eli Arch., Engr., Designer: Plans resubmitted " IN HOUSE:- Address: Developer Impact Fee /0 Gr—yg i t 84 ock Lk) L L City., ST, Zip: Pub. Wks. Appr Date of permit issue Telephone: <r ;#::`•#:< ?/� :.:>::.... a;;' >; Construction Type: Occupancy: :r'•i�✓.:Lr:4'�.v+}i.[-.`ti}:•:i:f.: n::yyCjC;{'•F,.l?;�v..Y•:t{fA . State Lic. #: <1h>{> ` i s.:;J,:� <€ Project type (circle one): Ne Add'n Alter Repair Demo Name of Contact Person: DAN Z 165,1546T Sq. Ft.:' # Stones: ..._ ....................-- # Units: - Telephone # of Contact Person:,. !r r //,& ��s=�r �. Estimated Value of Project: - t APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted % �/L Item Amount Structural Calcs. Reviewed, ready for corrections Plan.Check Deposit I.Truss Calcs. Called Contact Person Plan Check Balance Title 24 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 correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees �p 1