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05-1695 (RPL)'U BUILDING & SAFETY DEPARTMENT P. ox 1504 4� (760);777-7012 F 78- CALLE TAMPICO FAX (760) 777-70YI y la �ooA TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 7.77-7153 nu�NTA BUILDING PERMIT c�F�rof °S.�, Application Number . . 05-00001695 Date 5/03/05 Property Address . . . . . . 60485 WHITE SAGE DR APN: 764-270-999-76 -300231- Application description.. POOL - RESIDENTIAL Property Zoning . . . . . MEDIUM HIGH DENSITY RES Application valuation 15000'- Owner 5000-Owner Contractor , ----------------------7-7-------- ----------------------=---------- LAUBSCHER FAMILY_POOL CONSTRUCTION 60-485 WHITE SAGE DRIVE WCC: STATE FUND LA QUINTA,'CA 92253 WC: 1344032-2005 03/01/06 CSLB: 658996 11/30/06 CCC: C53-HIC P.O. BOX 1504 VOICE (7,60) 777-7012 78-495 CALLE TAMPICOFAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4:44 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Architect or Engineer: Date: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: wA BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perju4effect censed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals / Code, and my License ' • i force` ��License Class License No. ate Contrac v OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am ex pt from the Contractors' 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 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 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 -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U 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.). U 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: 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. J�e and will intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is w9rkersmpensation insurance carrier and is 9er are: Crier , 1/ Policy NumberL� 1/S 57ZOO — c rtify that, in the performance of the work for hich 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 hat, if I me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall to rthwir comply with those provision ate 1 (/> Applicant✓ WARNING: 41LUL TO SECURE WORKERS' COMPE 4SATION A VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL ($100,000), IN 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 performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's 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 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, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes1 1 -and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to tante lation. I certify that I ha,e read this application and state that the e m o atio is correct. I agree to comply with all city and county ordinances and state laws relating to building construct/ion, her y a orize representatives of this coun a er on the above-mentioned property for inspection purposes. Date./ Signature (Applicant or Agent): --------------------------------------------------------------------------- j. Application Number . . . . . 05-00001695 ---------------------------------------------------------------------------- Permit . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation 15000 Expiration Date 10/30/05 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU. BLDG 2,001-25,000 117.00 ---------------------------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date Valuation . . . . 0 Expiration Date •10/30/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------------------------------------- Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/30/05 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 . . . . 27.00 Plan Check Fee 6.75 Issue Date Valuation _ . . . 0 Expiration Date 10/30/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 ---------------------------------------------------------------------------- Special Notes and Comments SPA ONLY. 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 258.00 .00 .00 258.00 Plan Check Total 129.30 .00 .00 129.30 Grand Total 387.30 .00 .00 387.30 rA :. Golf C non Ix105pm o% pAppy $ C -71Y IOPp L—,AuPSGr1fP _ G048� Whi/c Sage r,)f ve i 0uifila, Gti 92253 r Stub for rowidn r--- 101---1 �* _C' I I p/I O O� 8, I El I A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED I PLANS AND JOB CARD ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. NO EXCEPTIONS! CITY OF LA QUINTA BUILDING & SAFETY DEPT, APPROVED FOR CONSTRUCTION I DATk:E, d_ BY G GJA 0 Construction oolS 5pa5 rourrlain5 (760)�64 3G�� Lic, #6�8996 a,