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05-5204 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00005204 Property Address: 47930 WIND SPIRIT DR APN: 658-140-999-36 -29436 Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 26900 Architect or T ao!t 4 4 " BUILDING &SAFETY DEPARTMENT BUILDING PERMIT Owner: ADAMS WADE 47-30 WIND SPIRIT DRIVE LA QUINTA, CA 92253 a 200 Contractor: ��r: a�� �. '� MC CAECUM POOLS _ _ 46576 VIA CELESTE CITY OF�`OUI�TINDIO, CA 92201 swA-ICEDEAPT (760)275-6403 Lic. No.: 818835 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/29/05 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the ' ass and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C53 License No.' 8835 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -� issued. I -y - Date: 5(J Contractor: - _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation ' OWNER -BUILDER DECLARATION insurance carrier and policy number are: - �,t 1 hereby affirm under penalty of perju at I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' com ensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that d become subject to the workers' com nsa 'on provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the L bor Code, hall forthwith co ly wit p visio s. . 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).: te:pplicant: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 100 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SEC RS' COMPENSATION CO AGE. IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_) 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.). 1 _ 1 I am exempt under Sec. B.&P.C. for this reason Date: Owner: 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: Pik LQPERMIT 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 becomes null 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 cancellation. I certify that I have read this application and sf'a't'ello t the above information is correct. I agree to comply with all city and county ordinances and state laws rel mg to ilding c truction, and hereby authorize representatives of thjs //county to enter upon the a ove-mention prope y f r inspecu r -_ DaDate. l S' ture (Applicant or Application Number . . . . 05-00005204 Permit - BLDG POOL PERMIT Additional desc . Permit Fee . . . . 265.00 Plan Check Fee 172.25 Issue Date Valuation . . . . 26900 Expiration Date 5/28/06 Qty Unit Charge Per Extension BASE FEE 252.00 2.00 6.5000 --------------------------------------- THOU BLDG 25,001-50,000 ------------------------------------ 13.00 Permit . . M uki Puui, Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/28/06 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 5/28/06 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 . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/28/06 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 L 3.00 --------------------------------------- Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE'IN LQPERMIT Application Number . . . . . 05-00005204 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged ---------- Paid Credited -------------------- Due --------------------------- Permit Fee Total 367.00 .00 .00 367.00 % Plan Check Total 197.75 .00 .00 197.75 Grand Total 564.75 .00 .00 564.75 9 LQPERMIT +18" RAISED SPA W/STAKED STONE SPILLWAY QUARTZITE STONE FINISH - - ON OUTSIDE OF SPA - ;� =: SPECTION FEE OF 30. BUILD ,SAFETY I .LL BE CHARGED IF THE APPROVED AppROVED "'LAMS AND JOB CARD ARE NOT ON FOR CNMUCT oN THE SITE FOR A SCHEDULED 1139�� -`� INSPECTION. ®�fi -- hiEyrli:PTlONS! -- -- -- -- -- TONE QUARTZITE WATER, LINE POOL NEW CONC COLORED ' Nov 27 05 09:24p Joseph McCallum 7607755E85 Bin# City of La Quinta Building and Safety Division P.O. Box 1504 78-495 Calle Tampico La Quinta, CA 92253 Building Permit and Application Tracking Sheet Permit# Proiect Address: 47-930 WINDSPMff Owners Name: WADE ADAMS A. P. Number: Address: 47-930 WINDSPIRIT Legal Description: City, ST, Zip: La Quinta, UA 92253 Contractor: MCCALLUM POOLS Telephone: 200-8707 Address: 46-576 VIA CELESTE Project Description: • City, ST., Zip: INDIO, CA 92201 Pool and Spa Telephone: 775-5685 G Af State Lic. # 818835 City Lic.# 1604 Arch., Engr., Designer: NEW Address: It ft X City, ST. Zi Telephone: eaction Type: Occupancy State Lic. #: Project Type: New Add'n Alter Re Demo Contact Person: JOE Sq. ft. #Stories: #Units: Telephone of Contact: 275-6403 Estimated Value: $26,900A0 /"-A C C'# /�� 0�-- C? � � C , 'tn p.1