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04-4923 (RPL)BUILDING & SAFETY DEPARTMENT PA., Box 1504(760),777=7012: 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-00004923 Date 6/14/04 Property Address . . . . . . .50715 EL DORADO DR P,PN: 7727250,.-999-173.-30357 - F,pplication,description .... POOL—RESIDENTIAL . Property Zoning .' LOW DENSITY RESIDENTIAL Application valu.at.i..oii.::. 19.00.0 . Owner. Contractor . TOLL CA V --CALIFORNIA'POOLS & SPAS C. KEVIN D DUERMIT. P.O. BOX 1280.... :... 1'': E. MOUNTAIN VIEW 2:00.: ' :. COACHELLA. CA'.92236 SCOT.SDALE AZ' 852:58 (76:0): .3`98-.9222 .. . .:., . ... .. - STATE FUND WCC: WC;.. 04600061168: 0,1/.01/05 .. CSLB::. 656128 _.( .. ..10/31/04 " CCC:. ': C8-C27:=C29-053. Permit :.:.: MECH POOL Additional desc .. Permit . Fee 24 .00 Plan. Check Fee .. .. 6.00 Issue Date Valuation0 Qty. Tin, it .Charge Per :Extension BASE :.FEE '15.00 ` 1.00 9.0000 EA= . MECH FURNACE <=10 o .9.0.0 Permit.- BLDG POOL .PERMI.T Additional desc.. ' Permit Fee. 198.00. •. Plan Check Fee -128.70 Issue Date.Valuation: 19000 Qty Unit Charge Per Extension BARD .FEE 45:00 .17.., GO '9.-0000 THOU ° - BLDG 2,001--25;000 1'53 : 0Q Permit ELEC POOL PERMIT -RES Additional desc Permit Fee 45°.00. Plan Q. ek Fee 11.25 0. �• Issue Date . Valuation .� 0 Qty Unit: Charge Per*. ��°#� . 6 2"04 ..Ex�t',ension BASE FEE----�.�. 15.00 r�F*J. ®'� P.O. BOX 1504 VOICE (760) 7777012 78-495 CALLE TAMP=.... FAX (760) 777 7011 LA QUiNTA, CALIFORNIA 92253 INSPECTION$ (760) 777-7153' BUILDING & SAFETY DEPARTMENT Application Number. `� '- q oZ -� Date: Applicant: Architect or Engineer Applicant's Mailing Address:Cd_ Architect or Engineer's Addr Jj fv Uc. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of pe*xy that I am licensed under provisions of Chapter 9 (commencing with section 7000) of Division 3 of the Business and Prolassionals Code, and my Ucensg,is in fun force and effect. 6,5-( 12 S License Class L. :53 License No. DaleefD �% Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for Che following reason (Sec. 7031A. Business and Protesslons Code: Any city or county that requires a permit b constni t, atter. Improve. demolish. or repair any struchm prior to its issuance, also requires to applicant for the per" b file a signed statement that he or the is licensed pursuant to the provisions of the C.ontracl6W State I ioenue Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions CoQe) 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 cilli penalty of not more than trve hundred dollars U 1. as owner of the property, or my employees with wages as their sole compensation, wrdl do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Coihtractors' State license Law does not apply b 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 safe. a hnomwever, the building or Imhprcvement k sold within one year of conpietion. the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U 1, as owner of the property. am exclusively contracting with licensed contractors b construct rie project (Sec. 7044, Business and Professions Code: The Cw*asxors' State License Law does not apply b an owner of property who builds or Improves tihereon, and who contracts br the projects with a codractoKs) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. B.3 PSC. for this reason Date Owner_••.._ WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations:, _ I have andmill maintain a certificate of consent to set -insure for workers' compensation, as provided for by Section 3700 of the Labor Code. iorthe 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 tabor Code. for the performance of the work for which this permit is yrs tion -Insurance carrier and po �p ►ober aro: Canter _<�PMy w«�-t.r., Pdicy Number //le _ I.ceftiy that, in the perfognance of the work for which this Permit Is Issued, I shall not employ any person in any manner so as b become subject b the workers' compensation taws of Catifomta, and agree that, lf 1 should became subject b the wakens' compensation provisions of Section 3700 of the Labor Code, I shat fo mith comply with those proviWons. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), W 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 affirm under penalty of pefjury that there is a constriction lending agency for the peffomnence of the work for which this permit Is issued (Sec. 3097. Civ. C.). Lenders Name. Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject b tha conditions and rest ttions set font 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 b any permit Issued asa result of this application, the owner, and the applicant, each agrees to, and shat. defend, Indemnify and hold harmless the City of La OA -da, its officers. agents and employees for any act or omission related to the vrak being performed under or following Issuance of this permit 2 Any permit issued as a result of this application becomes null and void lf wtxk 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 certiy that I have read this application and state that the above Information Is corecL I agree b comply with an city and county ordinances and state laws relating b building construction, and hereby authorize representatives of this county to uponjoe above-mentioned property for inspection purposes. Date Va Signature (Applicant or Agent): Page 2 Application Number 04-00004923 Date 6/14/04 Qty Unit Charge Per' Extension 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 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 . . . . 108 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------ 7 ---------------------------------------- Special. Notes and Comments POOL`&: SPA. BBQ ANSI -Z21-58-1995 STUBS. 5 LF 5- BLOCK WALL CITY STND. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited --------------------------- Due -------------------- Permit Fee Total 315.00 .00 .00 ---------- 315.00 Plan Check Total 154.20 .00 . .00 154.20 Grand Total 469.20 .00 .00 469.20