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04-5270 (RPL)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 771-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04-0.0005270 Date 6/30/04 Property Address 53837 EL DORADO DR. APN: 772-250-996-164 -31349 - Application description POOL RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation 19000 Owner Contractor TOLL CA V CALIFORNIA POOLS.-& SPAS C/O KEVIN. D .DUERMIT P.O. BOX 1.28.0. . 890,1 ..E.. MOUNTAIN VIEW .200 COACHELLA CA 9223.6-- SCOTTSDALE AZ. 85258 (760) 398-9222: WCC: STATE FUND WC: 046000.6.1168 Ol/Ol/OS CSLB': 656128 10/31/04 CCC:., C8 -C.27 -C2.9-053. Permit . ... . . . BLDG POOL PERMIT Additional desc Permit Fee 198.00. Plan Check Fee 128.70 Igsue.Date Valuation 18892 Qty' Unit Charge: Per Extension BASE FEE 45.00 17.00 9:0000 THOU BLDG 2,001-25,000` 153:'00 Permit MECH POOL Additional desc Permit Feo 2.4.00. Plana Check Fee 6.00 I-ssue:Date.. Valuation 0 Qty Unit Charge Per EX,tension BASE FEE\ \� 15:00 1.009.0000 EA MECH FURNACE <=100K. .�`��` 9.00 .F� Permit . . .'. . . ELEC POOL-PERMIT=RES�� Additional desc Permit Fee 45. 00' . Plan Check., Fee. 11.25 Issue -.Date Valuation 0 Qty. Unit Charge Per Extension BASE FEE 15.00 P.O. BOX 1504 VOICE(760) 777-'7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �%' �� %d Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICE N CON CTOR'S DECLARATION 1 hereby affirm under penalty of perjury that 1 am licensed under proud of Chap 9 (commencing with Section T000) of Division 3 of the Business and,Ptotessionats• Code. and my se I force 8nd effect. �— �ense ClasE � J /� --t nsl(filo. _qftER-WILDER DECLARATION I hereby affirm under penalty of penury that L exempt from the to 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, demoli it 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 (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 pemdt subjectik the applicant to a civil penalty of not more than five hundred dollars, ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the stnkture 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 or 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-buitder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (, 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,end who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). .0 I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: . _ 1 have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance _Kof the work for which this permit is issued, I have and will, maintain works 'compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issu My ' corm cationy' � - carrier cy r �nier L o�P licy Number _ 1 certify that, id the performance of the work for which tht pe tis iss . I shall not employ any person In any.manner so as to became subject to the workers' compensation laws of Califom1a,)p agree that, ff I s ouId bjact to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those proons: / WARNING: FAILURE TO SECURE WORKErS'COMPENSATI0_l`qt(XE_RAQf IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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 I hereby affirm under penalty of perjury that there is a construction lending agency for the perfomnance 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 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 wok 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 tt)e work g performed under or following issuance of this permit 2. Any permit issued as a result of this application becomes null and void ff w is no menced 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 1 have read this application and state that the above irtfpnnaGon is ogrr I ag to corm ly with all city and county ordinances and state laws relating to building construction, and hereby authorize. representatives of this countyenter upon 00 a tioned party for inspection purposes. ated Sigma nature (Applicant or Agent): Application Number . . . . . 04-00005270 Page 2 Date 6/30/04 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 --------------7------------------------------------------------------------- Permit . . . I. . . 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 ----------------------------------------=-------------------------- Special.Notes and Comments --------- POOL/SPA, WATER FEATURE, 5 L.F. 5' BLOCK WALL, CITY STANDARD ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECT ION. Fee summary Charged ----------------- ---------- Permit Fee Total 31.5.00 Plan Check Total 154.20 Grand Total 469.20 Paid Credited Due ---------- -------- 7-- ---------- .00 .00 315.00 .00 .00 154.20 .00 .00 469.20