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06-2298 (RPL)mss: 0 P.O. BOX '1504. VOICE (760) 777-7012 *495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT , 'Date: 6/07/06 Application Number: 06-00002298 Owner: Property Address: 79892 WILLIAM STONE WY w HILL APN:- 604-492-004-15 -24197 - 79-892 WILL STONE WY Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL ' - ApPliicatlon valuation: 23500 t• Contractor: • Applicant: Architect or Engineer: CALIFORNIA POOLS & SPAS } <• �. P.O. BOX � 1280 �'X D Iforce COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 2006- ----------------------------------7------------ `LICENSED CONTRACTOR'S DECLARATIONy�NTA WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions oP1. I hereby affirm under penalty of perjury one of the following declarations: Section 70001 of Division 3 of the Business and Professionals Code, and my License is inect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C8 C27 C29 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: 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: I.hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier SEABRIGHT Policy Number BB1060510 - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_ I'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 o become subject to the workeis' compensation 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, if 1 should come subject to the workers' compensation provisions of Section • License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor qode s gall o hwith comply with those provisions. 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 ($5001: Da:L�=—� Applicant: - r I, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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.). - APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. .property who builds or improves thereon, and who contracts for the projects with a, contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License L w.l. - whose benefit work is performed under or pursuant to any permit issued as a result of this application, • - - (_ 1 I am exempt under Sec. , B.&P.C. for is reason. 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 actor omission related to the work being performed under or following issuance of this permit. _ Date: "�� Owner: 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 CON Icon TION LENDING AGENCY - permit to cancellation. hereby affirm under penalty of perjury that there istruction lending agency for theperformance of the I certify that I have read this application and state that the above formation is correct. I agree to comply with allwork for which this permit is issued (Sec. 3097, Civ...; city and county ordinances and state laws relating to buil ' co uction, and hereby authorize representatives - - - of this county to enter upon the above-mentioned prope y, f ec ' n purposes. - Lender's Name: - . . • _ - - .. Date�ignature (Applicant or Agent): : :3 Lender's Address: LQPERMIT - Application Number . . . . 06-00002298 Permit . . ..``BLDG POOL PERMIT Additional desc . Permit Fee 243.00 Plan Check Fee 157.95 Issue Date . . . . Valuation 23500 Expiration Date 12/04/06 Qty Unit Charge Per Extension BASE FEE 45.00 22.00 9.0000 THOU BLDG 2,001-25,000 198.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Data " 12/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 . 1'.00 11.0000 EA MECH FURNACE >100K 11.00 Permit ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . 0 Expiration Date 12/04/06 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 12/04/06 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 3.00 Permit . .. . . . WALL/FENCE PERMIT - .LQPERMIT Application Number 06-00002298 '. .Permit WALL/FENCE PERMIT • Additional desc Permit Fee . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 240 Expiration Date.. 12/0.4/06 Qty Unit Charge Per Extension BASE FEE 15.00 S ecial Notes. and Comments P dL/SPA, 15LFX4FT EQUIPMENT WALL CITY STANDARD ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee Total 362.00 .00 00 362.00 Plan Check Total 183:95 00 .00 183.95 Grand Total 545.95 .00 .00 545.95 LQPERMIT ��T � 0 T'l