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07-1808 (RPL)e 44Q P.O. BOX 1504. 79495•CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: bno VOICE (760) 777-7012 FAX (760) 777-7011 1 INSPECTIONS (760) 777-7153 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 License is in full force and effect. License Class: C53 License No.: 802919 Date. '•l �� z ontractor: - OWNER -BUILDER DECLARATION _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 Contractor's 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).: (_) 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 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 fort he purpose of sale.). 1 1 I, as owner of thproperty, 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.). ' (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 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: LQPERMIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of .perjury one of the following declarations: - 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, asrequired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: - Carrier SIRIUS/DELOS Policy Number 01DKRM11000814 I certify that, in the performance of the work for which this permit is issued,'( 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 70.06111 the Labor Co with comply with those provisions. - Dater �- Applicant: i WARNING: FAILURE TOSECUREWORKERS' COMPENSA N 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. 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 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 th's coun nt1U\respllon the above-mentioned property f i urposes. ' Date Signature (Applicant or Agent): t Date: 6/20/07 07-00001808 Owner: 53783 VIA PALAGIO LANE RESIDENCE - 772 -560-050- - - 53-783 VIA PALACIO POOL - RESIDENTIAL LA QUINTA, CA 92253 LOW .DENSITY RESIDENTIAL 9500 D 6 Contractor: Architect or Engineer: AZURE POOLS AND SP JUN pt J d P.O. BOX �oo� G N PALM DESERTRT,, CUCA 9'255 CITY (760)322-7665 ��%IA9C QRd'MZA t Lic. No:: 802919�� (. 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 License is in full force and effect. License Class: C53 License No.: 802919 Date. '•l �� z ontractor: - OWNER -BUILDER DECLARATION _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 Contractor's 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).: (_) 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 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 fort he purpose of sale.). 1 1 I, as owner of thproperty, 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.). ' (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 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: LQPERMIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of .perjury one of the following declarations: - 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, asrequired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: - Carrier SIRIUS/DELOS Policy Number 01DKRM11000814 I certify that, in the performance of the work for which this permit is issued,'( 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 70.06111 the Labor Co with comply with those provisions. - Dater �- Applicant: i WARNING: FAILURE TOSECUREWORKERS' COMPENSA N 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. 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 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 th's coun nt1U\respllon the above-mentioned property f i urposes. ' Date Signature (Applicant or Agent): t ... Appli'cation Number 07-00001808 '.. PermitBLDG POOL'PERMIT Additional desc . Permit:'Fee., 117.00 Plan Check Fee 76.05 • Issue Date ',. ,Valuation 9500 Expiration Date .. 12/17/07 ,. Qty- Unit Charge Per Extension BASE FEE 45-00 . . 8.00."•. 9.0000 THOU BLDG 2,001-25,000 72.00 . '•Permit ELEC=MISCELLANEOUS Additionai'.desc Permit.Fee 15.75 Plan Check Fee 3.94 Issue.Date Valuation. 0 • Expiration Date 12/17/07 r Qty Unit Charge Per Extension BASE FEE 15.00 1.00:' _7500 PER ELEC DEVICE/FIXTURE 1ST 20 .75 Permit PLUMBING Additional _desc.. - Permit Fee 21:00 Phan Check Fee 5.25 Issue DateValuation 0' Expiration.Date 12/17/07 . Qty Unit Charge Pere Extension BASE FEE 15.00 1.00 61.0.000 EA PLB FIXTURE 6.00 -------------------------------------------------- Special. Notes and Comments ---------- COURTYARD POND PER APPROVED PLAN Fee ,summary Charged Paid Credited Due ---------- Permit Fee Total 153:75 ------- ---.- .00 .00 ------- 153.75 Plan Check Total 85.24 .00 .00 85.24 Grand Total 238.99 .00 .00 238.99 . .. 'LQPFRA4IT Bin # Ci . of La Quin'ta u ding U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # /� Project Address:' `Q aG` Q Owner's Name:. La Y � 'A. P. Number: V/1J Gt 40 9 Legal Description: City, ST, Zip: Contractor: i D� �S Q,� Telephone: Address: QD x �� C� Project Description: u �- City, ST, Zip: 7AIro Da -e r k e -7-z Telephone: State Lic. #: D2 r City Lic. #: Areh., Engr., Desig=: Q 11 ( bt c r .. 146CY- tf %"O 6M1VeW7 M47 -r.41.8 A5 A -J4 45 Pff L Address: I �' I Usl lm / Iw ' City, ST, Zip: AM km(, q 2- Telephone: I Vo State Lic: #: t Name of Contact Person: ,��,e Construction. Type: Occupancy: Project type (circle one . New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: - !72• 60 Telephone # of Contact Person: Z-77-. Estimated Value of Project: s1ro' APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Sets Plan Check submitted 101t9 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calc& Plans picked up Construction Flood plain plan. Plans resubmitted Mechanical "=AIIA = Grading, plan 2°" Review, ready for correctionstiissue Electrical t17%7 Subcontactor List Called Contact Person Plumbing Ai(IJ Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`" Review; ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees -- C1 i V1 Rt LDI Gl & AI't 1 ULr Total Permit Fees d u uv mu . FOR, CONSTRUCTION DAM 13Y _. _---- 4