04-4319 (RPL)0 TAlf
9 2004BUILDING & SAFETY DEPARTMENT
c CITY F u, 4 - (760).777-7012,
e , z
OFTt9— Fli�r.7lgr-ag-5FEALLE MPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT:
Application Number 04 0,0004319 Date 5/17/04
Property Address 5605-5 WINGED FOOT
APN: 775-300-005-13 -28738 -
Application description . . POOL - RESIDENTIAL•
Property Zoning . . . LOW DENSITY'RESIDENTIAL
'Application valuation 30000
Owner Contractor
----===--=--------------
FLORES RICHARD CONSTRUCTION DESIGN SYSTEMS, I-
56055 WINGED FOOT. 78401 HIGHWAY 111, SUITE F-2
LA QUINTA CA 92253 LA QUINTA CA 92253
(760) '771-3593
WCC: STATE FUND
WC: 1709785-03 02/01/05
CSLB: 7631086 Q8/31/05
CCC: A -B
Permit . . MECH POOL
Additional desc
Permit Fee . . 24.00 Plan Check. Fee.' 6..00
Issue Date Valuation0
Qty' Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
Permit BLDG POOL PERMIT
Additional desc
Permit.Fee. 284.50 Plan Check -Fee 184.93
Issue Date . . . Valuation . . . 30000
Qty Unit Charge Per. Extension.
BASE FEE 252.00
5.00 6.5000 THOU BLDG -25,001-50,000 32.50
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
1.00 30.0000 EA ELEC PRIVATE SWIMMING"POOL 30.00
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-701 I
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: (9 Date:
Applicant:
Applicant's Mailing Address: u4iah
Architect or Engineer:
Architect or Engineer' s
t>
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby.affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Li ns i II force and effect. /^ i
License Class n License N� 7&7076mo/ ,
OW14ER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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 stricture, 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 I, as owner of the property, or my employees with wages as their sdle 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._aj�2�
. C. for this reas
Date Q Own
WO RS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declV0 ns:
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.
_ 1 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
d. ork compens i n insurance camier an 1icy�Q� a re'
Carrier a� Policy Number l o y -5 ^Q3
_ I certify that, in the performance of the work for which this permit is is ue , 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
foQrthwith comply with those pro ' ns.
Date ✓ ! Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS U WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 Buildingand SafetyA
1. Each person upon whose behalf this application is made, each person atwhose request rmit and to efoor Moose benefit work isons and performedunder or pus set forth on this rsuant 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 Ouinta, 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 state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and
hereby authorize representatives of this coun ent upon the abov n n roperty for inspection purposes.
Date C/ % / Signature (Applicant or Agent):
_ d l'` � Y 1.. . F' W Ti:fi fi - h ,' 4i •� _
� .
Page 2
Application Number., 04-00004319
Date. 5/17/04
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 OUTLET'S.
3:00
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL'
BE IN PLACE PRIOR'T.O PREPLASTER
INSPECTION.
Fee summary. Charged Paid Credited
Due
Permit Fee Total 386.50 .00 ..00
386.50
Plan Check Total 210.43. .00 .00
210.43
Grand Total 596.93 ...-00 .00
596.93.
GOLF COURSE-
quartzite
OURSEquartzite spillway
umbrella sleeve
pool
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SPA G
r i
J 3' ..
1 t
+1811
tan shelf MAINTAIN TREES 5' FROM
SIN TREES 5' FROM P/L .............................................. ............_ ......
Q... .
0
deckin
DECKING 9 BBQ ....
existing wall
P
G/E _
x)0
bcat access
iNSP I FEE IF $30
P/L _
SIDE LK
GATE
A RE- - -
WILL BE CHA ' E A PROVED HOA REVISIONS g� i
4 DRAINS DOWN SIDEYARDS AND CORED 9� Q V I YA
PLANS 1393. CARD ARE NOT ON
THE SITE SCH DOLED DEEP ROOT BUBBLERS FOR TREES OR ' LING & SAFETY DEPT.
T ESPALIERED TO ALL R®V E ® EQ
INSPECTION.: �— ALL VINES o BE AP.P
MAINTAIN TREES 5' FROM P/L FOR CONSTRUCTIOI 1 1�1a
NO CEPTIONS. 1
8
/ � r BY -0
DATE