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05-1593 (RPL)P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX '(760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: /) j % _3 Date: Applicant: Applicant's Mailing Address: 001V rr24c77 U? Architect or Engineer: Architect or Engineer's Address: 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 Li nse j l force and effect. � / „ n mq License Class ss icense b'` L nlaie Contr OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for thelollowing 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 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 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 j am exempt under Sec. , BA P.C. for this reason Date 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. —YI 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 s coo rs' Aco, n sation insurance carrier n oli y bgL e: amer ,C% — �L 1 11J Policy Number EJ�`17' 2,00 I certify that, in the perform cir�e work for which this permit is issue, 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 forthwith comply with those provisions. Date 24 b Applicant WARNING: FAILURE TO SECURE WORKERS' CO ENSATION COVERAGE IS UNLAWFUL, 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 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. 1 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 construct/ion, and hereby authorize representatives of this county to enter/ pon the above-mentioned property for inspection purposes. 2 O�Date Signature (Applicant or Agent): .--------.--------------------------- - - - - ------------- ----- ------ - - - - -- - .,, Application Number . ---------------------------- . . 05-00001593 Permit . . . . .. BLDG POOL PERMIT Additional desc Permit Fee 414.50 Plan "Check Fee 2.69.43 Issue Date Valuation . . . 50000 Expiration Date 10/24/0.5 r Qty Unit Charge Per Extension. BASE FEE 252.00 25.00 6.5000 THOU BLDG 25,001-50,000 162.50 Permit MECH POOL Additional desc Permit Fee . . . . ! 24.00 Plan Check Fee 6.00 Issue Date Valuation, 0 Expiration Date 10/24/05 Qty Unit Charge, Per. Extension.. BASE FEE 15.00, 1.009.0000 EA -MECH FURNACE. <=100K 9.00 Permit . . . ELEC POOL PERMIT -RES Additional desc Permit Fee 75.00 Plan Check Fee 18.7.5 Issue Date . . . Valuation, 0 Expiration Date 10/24/05 ..Qty Unit Charge Per Extension. BASE FEE 15.00 2..00 30..0000 EA ELEC PRIVATE SWIMMING POOL 60.00 ,Permit .. . . . PLUMBING Additional, desc Permit Fee 39.00 ..Plan Check Fee 9.75 Issue Date Valuation 0 Expiration Date 10/24/05 Qty" Unit Charge Per -Extension BASE FEE 15.00- 5.006.0000 6.0000 EA PLB FIXTURE. 18.00 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 & WATERFEATURE 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 552.50 .00: .00 552.50 ''Plan Check Total 303.93 .00 .00 303.93 Grand Total 856.43 .00 00 856..43 • I � QB a ftiona GD udlfls `'• timber beams and Joists 1010 h�a f...._. :. ; j I gt� finish seat back �J I planter Wa U to match existing i tw155 1 / Stucco {fnish ILO 1 I fire lac enclose , tl / Concrete paved service aM4 equipment yard I jpool iEcl color and finish to match resicaence I I-r-LTis Ow '-:• :` ` r f I f - - , `_''_� ;V�r�-i-(3!-•'-f- ! j t•. _'- ni I I I 1 asl�. loo jy�� ! iy�_ _I�' ° I4 (- G,O s ,i' .'C.;•./.'•ii C_''• —1—_ 1----I -r" 1 I 1 V,:�.T i �i j �` , i I I �� - ! ii gi rf�aeaQt i f f! /seat ,�`J! l.' ` ;1O/V!t t� �/��N — — ' ,LAU.GOIFCAR . i 1 ' ' l tr II I B g�L_� �- ! ---•�� STORAGE . I ! I I ! .�— -!-•r � i { ! Mortared 14"6q. Conterra stone pd1 0 1 _ _ i reinf, cont, base over I I I t - - , - ! 71 tries set, on acted I • I ; ��is W 3 sand on comp ( t !! r i trod r s -' s�rrt \ I -- 4t D'_ • '• � I I t o f � i C-1) !POR. IGTCHEN IL l,Ontar L.oter O I NOOK I ! ` _ 1 III I L;R I I s l butt step I OrnaMental terra cotta , ! j ! I _ , ! - ed ste� I tris I I 1____, ! i °Conterra g`tpneibl, i ; ! pots w/saucers, drained , �� ! I i •dam Jtit� rise�r�`aces i — w/deco lite rrs f ces j I I i I and Jertgated ! 1 l y 1-- ° r I II I i 1 a iNc r n ; 1 ou,! finish Ontr ; erre stone iiia j ! ° , --� - — Mortared 24 sq. cont t + " inf. concrete , ! t i I ; b -0 i I pavers set over re �_� �. - O [�y r�.-y.. gtone cap xr ucFt s , I I r Ttt�d sur a basin I sub -slab �-Weir wail ' �4 I 1 t I'il.. fill I and i ,<< _Tiled L019— -I— t ` j I I i Qter sea 'tg _ i ! L� � �— I , I \ !� �___ t . y T- `• t it tried sto- \ ►antin u I Slope areas p 9 - -- --' {,� s -- ton to remain protect - o - , -I-- I ENTRY and irrlgat r , -•-� o Cascade t —__ ! I ! , T ROOM t and maintain wring construction. bs °7 pool 1 ! i ! _ e _ i� I `ff105 I ! j tflf5- I Replace/repair all damage awe i eW b5 i '` IED PO4L. i 'Q I ` 1 ' I _ ! j i ' > �r�., I - ` ucco frnith e f traction g wl 95 �_ — -�-- l ! I ! ! ' , Low I ! to construction wl 8.0 i 1 g ; ._.I. -I -- � L i ;Y `� watts, X42 ht , ! I t. ! I --r---�--'�'-"'i I ! StOn6 �a8 _ I I i �` I Tiled �0" weir'edge`* tC�J , ` I O _ ... ry tile at" r gide waif mtd water jets l6J t ," _ ! '' ! a Tena cotta pots tW135 ! W/ saucers i i , ! ;! ? ! _ i (Conter't$ gtone) I+ j i j I I __ 1_ O t I I i I !I ti f WI L HAR D1THEIPPROVED PL N JND )0 R -D -ARE NOF•ON I J l ' ' 'r`adi! area i�I I I — �Y TH ITE'�FO,R SCNIEDU'L j 4"s . Conterra stone pacer a1 ' W g Conterra stone ed steps — / ' E-� i Mortared ? q; ! t _,, / I INS E N. t f ' ! I ,�/ deco Bile f' � I � tiles set on reirit: cont. � e o 9�A� �)— -- -� p — � i 1 riser p _ ste -, -12 'tree I •-� i t min 3 sand on Com t ,� BASTER BEDROOM a IVIS L'kCEfIONS 1. y aVREAT MASTER SO" fs, 01 ova \ i t47 a __ , -- —_ — fte _ --- j . — . c -�—I _,' ____ _ ,J _ `�� MYt1�OF QUINTA ftft ` ! l8c itdtny Erf Wi4 AWRY�� ` ,` . t , •'• , , _ EiJ-- P' front hearth w/ buIKOsed Cont stone RCOS`fRUCTIONB� F FO 3C stucco finish tw155 r?- 6 lamer Wats X,.� Q .3 -•------------------ . ------ --- ---- p r r•-.1•��"� I 1 1 j ^. I i !1 !t IEi ..✓. �U�� . ",~—- line wall, twhtstucco finish proper 19 provide iron y 15 Wios �glat ing 5fx 42OW sef-C iandings t tread osesand finish to maresidence 361above color d 08.4 ood gat rr' Ii I � -•-----I e � . I i t DRaWE it/k°6r s I C. NOTE - see Civil Eng r plans for for site and landscape ' drain locations i I . I