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04-4482 (RPL);; i T d - BUILDING &.SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 '1;A,. QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760.) 777-7153 BUILDING PERMIT Application Number . . . . .. c0-4:0-0'04482 `> Date 5/20/04 Property Address 5.6'075-WINGED'FOOT APN: 775-300-010-18 -28738 - Application description . . . POOL - RESIDENTIAL Property Zoning . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 30000 Owner. Contractor --=--------------------- ------------------------ BLUMBERG MARC CONSTRUCTION DESIGN SYSTEMS, I 56075WINGED 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: 767086 08/31/05 CCC: A -B Permit MECH ,P.00L Additional' desc t Permit -Fee. 2.4': 00• . .' 4 `Pldi"- Check_ Fee �6.0.0- .0.0Issue issue Date Valuation .. 0 Qty Unit Charge .Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=10.0K 9.00 Permit . . . . BLDG,POOL PERMIT . Additional desc Permit Fee 284. 50,, Plan Check Fee `` 184:93 Issue Date Valuation 300.00 Qty Unit -Charge Per Extension BASE FEE 252:00 5.00 6.50.00 THOU. BLDG 25,001-50,000 32.50 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee . . . 45>.00 -an--Gl�e�EJ F 11.25 Issue Date a�luat�oun 0 Qty Unit Charge Per MAY 21620 4 Extension BASE FEE 15.0 0 1.00 30..0000 EA ELEC PRIVATE S MING POOL IYY OF LA QUINTA 30.0.0 FI61I1dNC ° DEPT :. �'I �ILI P.O. Box 1504 � VOICE (760) 777-7012 78-495 CALLE TAMP.ICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Q D46e: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under pen Ity 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 Lice a isforce and effect. �7 License Class License No.� 'r d Date Lot Contracto6M c1XU&b6W I herebyaffirm under OWNER -BUILDER DECLARATION penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. res thth ,Business and Professions Cade: Ally city or county that requires a permit to construct, alter, improve, demolish. or repair any structure, Prior to its Issuance, also requires e 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 (cam>encing 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 rive 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 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 bolding or improvement Is sold within one year of completion, the owner -builder will have ft burden of proving that he or she did not build or improve for the purpose of sale.). U 1, 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 oontractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Y 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 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. _ 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 issue . �pensation Insurance pmer�n olicYnu r Z3 Carie. Policy Number / ��? _ I certify that, In the performance of the work for which this 'issued, I shall not employ any persm 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 forthwith amply with those provisions. Date 4 Z IES Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COEIS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100, 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 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 work is perforrned 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 Oulnta, 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. 1 certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws retating to building construction, and hereby authorize representatives of this county to enter upon the above- mentioned for inspection purposes. DatSignature (Applicant or Agent): Page 2 Application Number 04-00004482 Date 5/20/04 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 -OUTLETS 3.00 ------------------------------------------------------------------------- -Special,Notes and Comments POOL &`SPA. `ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO 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 1 ' GOLF COURSE SHEER DESCENT t umbrelia sle��� CASCADE GOLF COURSE qud&zite spillway 5 0 brach bwn ® +12"- •',,,, _ ora ® 0 lawn area '✓ ' 1510 ` ir- 1 tanning ledge ® 30' kivn ;Y decking P/! ' lo"id area P i P1.ANTCi25 1 p/n` / a/c P/L pool boss remote J: , RESIDENCE sidewalk 56-075 WINGED FOOT DR. H /E LA QUiNTA, CA. 92253 �— LOT IS EAGLE BEN PCA WEST CITY OF Leg QUI NTA- + BUILDING & SAFETY DEPT. RE -INSPECTION FEE OF -$30 - . APRROVE® WI E CHARGED IF THE APPROVED FO C NSTRUCTIO PLANS AND -JOB CARD ARE NOT ON THE SITE FOR A SCHEDULED DATE BY INSPECTION. NO EXCEPTIONS! .May 20,. 2004 COPY. Mr.` Marc Blumberg 56-075 Wingea Foot La Quinta CA 92253 RE: Poo l/Spa/BBQ/Deck/.Courtya rd/Landscaping ; z Dear Mr. Blumberg: Your contractor has met all of the conditions and approval is given for you to begin installation. , Sincerely, Nancy Wane,ACM; CCAM Association Manager N D/ncp `Post Office,.Box 1658 - La'Quinta, Califomia'92253 - Phone (760) 776-5100 - Fax(760)77.6-5111 i+r ,.