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04-7472 (BLCK)BUILDING. & SAFETY DEPARTMENT P.O. Box 1504 (760).777-70.12 78-495 CALLEsTAMPICo FAX (760) 777=7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 9 BUILDING: PERMIT Application Number 04-00007472 Date 11/24/04 Property .Address; ... . . . . 51109 EL DORADO DR APN: 772-250-996-190 -31349 Application -description . . . WALL/.FENCE, Prope'rty,Zonirig LOW DENSITY RESIDENTIAL Application valuation 80 Owner.'. Contractor TOLL CA V CALIFORNIA POOLS & SPAS C/O KEVIN D DUERMIT P.O. BOX.1280 .890'1.-E MbUNTAIN VIEW. 200 COACHELLA CA 9223'6 ' SCOTTS.DALE .' ..., AZ 85.258:(760) 39.8-.92.22, WCC: STATE FUND... WC: 04600.061168 01/01/05 C.SLB:. 6.56128 1.0/31/06. CCC: C.8 -C27 -.C29-053 Permit MECH POOL Additional desc Permit, Fee . . ' 24.00 Plan'Check Fee 6.00 Issue Date . . . Valuation 0 Qty Unit -Charge Per Extension BASE -.-PEE 15.00 1'.0.0 9.0000 EA MECH FURNACE .<=100K 9:00 Permit BLDG POOL PERMIT Additional.desc Permit.Fee 189.00 Plan Check Fee 122.85 Tssue.Date .Valuation 18000 Qty Unit 'Charge Per Extension "'BASE FEE 45:00 16:00.: .'9:0000 .THOU BLDG 2,001-25,000 144.00 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check. Fee 11.25 Is.sue Date Valuation 0 Qty Unit Charge Per Extension BASE .FEE 15.00. 1.00 30.0000 EA ELLEC PRIVATE SWIMMING POOL 30.00 ---------------------------------------------- ----------------------------- Permit . ... . . . PLUMBING Additional desc . . C N • P.O. BOX 1504eA / 79-495 CALLE TAMPICO :.. w LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT YOKE (7 66) 7.77.7012 : fAX (760) 777-7011 INSPECTIONS (760) 777-7153 Application Number. ©y--: 2 V7 ;l- - j Date: . Applicant: Applicant's Mailing Architect or Engineer Architect or Engineer'srens• ' All Uc. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of tha'Busin4m and PrOfessiomals Lloer"Codeand Clss L Lloenls 53 force and effect..License No. GO 120 pate Z Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury fiat I am exempt from to Contractors' State License Law for the knowing reason (Sec. 7031?, Business and Professions Code: 'Any dty or county that requires a permit to construct, alter. Improve. demolish or.repair any gi ucture, prior to ft hwanoe, also rewires the applicant for the. ptxnit to ice a signed staternant that to or she Is licensed pwwant to the provisions of the Cootreclont State Licama Law (Chapter 9 (ewrowx ing with Section T000) of OMslon 3 0f the Business and Professions Co0e) or -that to at she Is exempt t mefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a perp it subjects the applicant to a Civ . penafly of not more akar rive hundred dollars ($5W).X U I. as owner of fhe property. or my employees with wages as their sole compensation, will do two work, and this structure Is not intended or offered for sale (Sea 7044, . Business and Professions Code: The CoirhactonC State License Law does not appy b an owner of property who builds or improves es thereon, and who dothe work xag himself or herself or th his or her own employees. provided twat the Improvements ars not intwxW or offered for safe. If, however. the building or i provembnt is " sold within one year of completion, the owner -builder will have the burden of provirp trot he or" did not build or Improve for the purpose 0($8144 (,) 1. as owner of the property. am erociu *rely contracting with Ncensed contractors io construct the project (Sea 7044. Business and Professions Coda: The Contractors' State License Law does not appy to an owner of property who builds or improves teroon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). L) 1 am exempt under Sea BA PA. for this mason _ .. . Date Owner] . WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:. _ 1 have and mill maintain a certificate of consent to sa for workers' con nutlon, as provided for by Section 3700 of ♦heli Labor Code, for the perfortnan0e . of the work for which ids permit is Issued.. 1 -have and will maintain workers' compensation insurance, as required by'Secdon 3700 of the Labor Code. far the peAOmrance of the work for which this pemdt Is Mywroows tion. insurance canter and pQYcypymb�r aro: Cartier .4—(Akj Policy Number 8 5�10�� ///e l3 _ (.certify that, in the performance of the work for which this permit-13isake4 I shall not employ any person in arty manner so as to become subject to the workers' compensation laws of Cardortda, and agree that, If.] should became subject b the workers' compensation provisions of Section 3700 of to Labor Code,. I shall fort oft comply with those provtdQm. Dated Applicant, 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 (1100,000), IN.ADDmON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there I a consfrucUon lending agency for the performance of the wok for which this permit is Issued (Sea 3097. Civ. C:). Lenders Name. Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a pemdt subject to the condi8on3 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 resuft of this application, the owner, and the applicant, each agrees to, and shall, deferi4 indemnify and hold harmless the City of Le Oudnta, its offioers, agents and employees for any act or omission related to the wbirkbielag performed under or fallowing fsauance of this penNt 2 Any permit Issuled as a result of this application becomes mi and void K b 00111110noed wit ln.leo days tronw data of Issuance of such pan* w Cessation of work for 180 days will subject permit b cancellatlor>L I certify that I have read this application and state that the above Info tion Is I to comply with ad city and county ordinances and state laws relating to building construction, and h7by authorize representatives of this count'7 upon Gonad property for inspection purposes. Date Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00007472 Date 11/24/04 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. WATER FEATURE. BBQ ANSI Z21-58-1995, FIREPIT 496 AGAL. 5 FL 4' BLOCK WALL CITY STND. ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited. Due --------------------------------------------------------- Permit Fee Total 306.00 .00 .00 306.00 Plan Check Total 148.35 .00 .00. 14"8.35 Grand Total 454.35 .00 .00 454.35