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08-0592 (RPL)4 4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO fir-- FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/28/09 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: ye tp­*� 08-00000592 53461 VIA PISA 772-530-043- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 58000 Architect or Engineer: PSA Owner: TOM SCHMALZRIED 8 MORGAN LANE ROLLING HILLS ESTATE, umracwr HILLWOOD 76280 VIA CHIANTI INDIAN WELLS, CA 92210 (760)200-3046 Lic. No.: 493470 ------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business'and Professionals Code and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B -C27-053 ice o.: 493470 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. __06e: .ntractor: _ 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 EXEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to 1 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 to become subject to the workers' 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 I should become 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 3790 of the Labor Code, 11 forthwith s4rply ith th a provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -JjA any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: J scant: 1 1 1, 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 ISec. 7044, Business and Professions Code: The WARNING: FAIL44E 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, 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 Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City Date: Owner: 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: 04 Lender's Address: LQPERMIT 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 ws relating to building construction, and hereby authorize representatives of county to ter upon the ove-mentioned property f spectian pur pegs. PF D/ate: S' ature (Applicant or Agent): r Application Number . . . . . 08-00000592 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 450.50 Plan Check Fee 292.83 Issue Date . . . . 4/15/08 Valuation . . . . 58000 Expiration Date . . 10/12/08 Qty Unit Charge Per Extension BASE FEE •414.50 8.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 36.00 Pcrmit . . . MDen POOL Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . 4/15/08 Valuation . . . . 0 Expiration Date 10/12/08 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 . . . . 4/15/08 Valuation . . . .. 0 Expiration Date 10/12/08 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 . . . . 4/15/08 Valuation . . . . 0 Expiration Date . . 10/12/08 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 LQPERMIT Application Number . . . . . 08-00000592 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 5/28/09 CHANGE OF CONTRACTOR PERMIT ISSUED. PREVIOUS CONTRACTOR OF RECORD - DESERT SANDS POOLS, ABANDONED PROJECT ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CHANGE OF CONTRACTOR 4.50 Fee summary Charged Permit Fee Total 554 54 Plan Check Total 318.83 Other Fee Total 4.50 Grand Total 877.83 LQPERMIT Paid Credited Due r,Sa sn nn nn 318.83 .00 .00 .00 .00 4.50 873.33 .00 4.50 Hi.11wood Construction, Landscaping and Maintenance OTa s3- 4-(b ► Vx� Pt. 5/28�2ao9 �t4 Z),eda oil 76-280 Via Chianti, Indian Wells, CA 92210 • hiIwd I @aol.com T: (760) 200-3046 • F: (760) 200-3047 • Lic # 493470 P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 I,. Application Number: 08-00000592 Property Address: 53461 VIA PISA APN: 772-530-043- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 58000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. Licensess: C 7 C53 Li ense No.: 883237 ,Jaate: C ractor: py OW ER -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).: (_ 1 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 for the purpose of sale.). (_) 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.). I—) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: LQPERAI IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 DDate: 4/11/08 Owner: TOM SCHMA ED 8 MORGAN APR i ��np ROLLING H LL ESTATE, A 74 CITY OF LA QUINTA FINANCE DEPT, CUIILIdLLU1. DESERT SANDS INC 82719 REDFORD"WAY SPACE 130 INDIO, CA 92201 (760)347-3040 Lic. No.: 883237 WORKER'S 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. 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 issued. My workers' compensation insurance carrier and policy number are: Carrier ENDURANCE WC Policy Number WEN1003300-02 I certify that, in the performance of the work for which this permit is issued, 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. Cate:licant: WARNING: FAI RE TO SECURE WORKERS' COMPENSATION 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 fallowing 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 1 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 ofthiscounty to enter upon the above-mentioned property for inspection purposes. Date: ignature (Applicant or Agent): Application Number _ . . . 08-00000592 Permit . _ . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 450.50 Plan Check Fee 292.83 Issue Date . . . . Valuation . . . . 58000 Expiration Date 10/08/08 Qty Unit Charge Per Extension BASE FEE 414.50 8.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 36.00 Peiwil . . . MDCII POOL Additional desc . - Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/08/08 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 10/08/08 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 10/08/08 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 LQr[anur Application Number . . . . 08-00000592 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 554.50 .00 .00 554.50 ' Plan Check Total 318.83 .00 .00 318.83 Grand Total 873.33 .00 .00 873.33 LQPE2-N4IT Bin # City 0 f La QUinta Building u Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico I -a Quirita, CA 92253 - (760) 777-:012 5q� Building Permit Application and Tracking Sheet Project Address: L'—' �? - Owner's Name: �� yal 'e Ix A2 s� A. P. Number: v� Address: Legal Description: . t City, ST, Zip: f -L '9047Y Contractor: 2J e -S Telephone: Address: V 9 . sV z -ept f v Project Description: d L l axi City, ST, Zip: -:T ow e- AyYo % Telephone: 7k- State Lie. # : �' �J 1j -7 City Lic. #7YV Arch., Engr., Designer: #eA' m � AW . Address: 7 X 3 �. w / ►'► ► (3 Z . . City, ST, Zip: ,oP ` d Telephone: 7k U .. 777— Ol 3 i Constntotion Type: Occupancy: State Lic. #: s Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: To ^"!I --rm G.D Vli- `I Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7& u - �) y ,r"j•� .1 7j Estimated Value.of Project: !} UU APPLICANT: DO NOT WRITE BELOW THIS LINE .. # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Const, action Flood plain plan , Plans resubmitted Mechs mcal Grading plan* 2-' Review, ready for correctionsrssue Electr_cal Subcontactor List Called'Contact Person Plumbing Grant Deed Ptani. picked up S.M.I H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correctionsrissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.E. Pub. Wks. Appr Date of permit issue School Fees