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04-5313 (RPL)BUILDING & SAFETY DEPARTMENT P.O. Box 1504. (760).777-70.12 78-495 CALLS TAMPiCO FAX (760)'777=7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 . BUILDING. PERMIT Application Number 04--0.0005313 Date 7/02/04 Property Address_.. 5 -1753 -EL DORADO DR. APN: 772-250-996-167 -31349 - Application description POOL RESIDENTIAL Property.Zoning LOW DENSITY RESIDENTIAL Application valuation 217 Owner. Contractor' i TOLL CA V CALIFORNIA POOLS & SPAS C/O KEVIN D DUERMIT P.O. BOX 1280 8901.E MOUNTAIN VIEW 200 COACHELLA CA 9.2236 SCOTTS'DALE AZ 85258. (760) 398-9.222. WCC: STATE FUND... WC 04600:061'168 01/01/05 CSLB: 6561.28 10/31/04• 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 Charge. Per Extension BASE.FEE 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 Issue.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' 'Fe_ .11 25 Issue Date lu ion 0 Qty Unit Charge Per D 004 Extension BASE . FEE JUI� �. 15.00 CITY OF LA QUINTA FINANCE DEPT. P.O. BOX 1504 78-495 CALLE TAMPICO ^/ LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT VOICE (760) 7.77-7012 • : FAX (760) 777-7011 INSPECTION$. (760) 777-7153- Application 77-7153 Application Number. 0 5-3 /3 Date: . Applicant: Architect or Engineer A Applicant's Mailing Addeest: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (coo, in ndng with Section 7000) of Division 3 of the Business and Professionals Code, and my Licens is in full force and effect.. /_,!6 12 Dense Class License No. lD Date (� Contractor OWNER -BUILDER DECLARATION I herebyeffirm under penalty of perjury that I am exempt from the Contractors' State Uoense Lawfor 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 Contractors' State License Law (Chapter 9 (conn wising 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 unaged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (:500).), U I, as owner of the property, or my employees with wages as their sole oompensaflon, will do the work and the structure is not intended or offered for sale (Sea 7044, Business and Professions Code: The Contractors State License Law does not appy to an owner of property who builds or frnproVes thereon, and who does the work himself or herself or through his or her own employees, provided that the knprovemeMs.are not intended or offered for safe. If, however, the building cr improvarrhent is " sold within one year of completion, the owner -builder will have the burden of proving that he or she did not bulb or improve for the purpose of sale.). () 1. as owner of the property. am ezdusivey contracting with licensed contractors to construct the project (Sea 7044. Business and Professions Code: The Contractors' Slate License Law does not appy to an owner of property who builds or Improves thereon, and who contracts for the projects with a contractor(s) kensed pursuant to the Contractors' State License Law.). U I am exempt under Sea . BA PSC. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations _ I have and.wfll matntain a certificate of consent to self4nsure for workers' compensation, ea provided for by Section 3T00 Of the Labor Code. forthe 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 pertormance of to work for which this permit Is �iys My rs, comijensation.1ftsurance carrier andpoiu��ymber aro : Carter _�P �c.c., Policy Number D �/(o/JGt/� // e 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. 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with time ns. WARNING: FAILURE TO SECURE WORKERS' CONi.PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FiNES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), N-ADDmON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37013 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 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 (SM 3097. CN. C.). Lenders Name. Lender's 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 an this application. 1. Each person upon whose behalf this application Is made, each person at whose u whose benefit work b pedormed under or pursuant to any permit Issued as a result of this application, the owner, and tma applicant, each agrees d Shan. de , Indemnify and hold harmless the City of Le Quinta, its officers, agents and employees for any act or omission related to the workarmed and or following issuance cf this permit. 2 Any permit Issued as a result of this application becomes nun and Vold if not cowmen wfWn.180 days from data of Issuance of such permIL or cessation of work for 180 days will subject permit to cancellation. certify that 1 have read this application and state that the above Info tion is ooret to with an city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to upon the for inspection purposes. Date Signature (Applicant or Agent): a Application Number . . . 04-00005313 Page 2 Date 7/02/04 Qty Unit Charge Per Extension 1:00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 ------------------7--------------------------------------------------------- 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 . . . . 217 Qty Unit Charge Per 'Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. 10 LF 5' BLOCK WALL PER CITY STND. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged ----------------- ---------- Permit Fee Total 306.00 Plan Check/Total 148.35 Grand Total 454.35 Paid Credited Due ---------- ---------- ---------- .00 .00 306.00 .00 .00 148.35 ..00 .00 1454.35