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09-1036 (RPL)e P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 'Application Number: 09-00.001036 Property Address: <-80740 VIA PORTOFINO APN: 777-150-006-. - - Application description: POOL - RESIDENTIAL Property Zoning: LOWDENSITY RESIDENTIAL - Application valuation: 20500 Tu!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: PRIEM 80740 VIAi LA QUINTA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/28/09 - /� _ ContractDr: Applicant: Architect or Engineer: AZURE POOL.. A —S. P.O. BOX 10641 PALM DESERT, CA 92255 (760)322 . Lc. NO.::802 802919 LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION I hereby affirm underpenalty 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 d 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 Cla s: C53 License No:: 802919 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is " issued. Date: C or. - I have and will maintain workerscompensation 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 DELOS INS CO Policy Number 02DKRM12002794 " following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I 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 requiresthe 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,, I sh 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 Labor C de sh ith comply with those provisions. /7VURETO that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by i1 / any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:- ate v �/ant: ". (_ 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 WARNING: FCURE WORKERS' COMSATION 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 (5100,000)• 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 I, 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 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 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. Date: Owner: - 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 CONSTRUCTION LENDING AGENCY permit to cancellation. hereby affirm under penalty.of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to buildi u nd hereby authorize representatives Name:p fc�mtormauon of thi c nt a upon the bove-mentioned propertyspe ti pu osestender's �7 ig re (Applicant or Agent): Lender's Address LQPERMIT Application Number .. . . . 09-00001036 Permit BLDG POOL PERMIT Additional desc . Permit Fee 216.00 Plan Check Fee 140.40 Issue Date . . . . Valuation . . . . 20500 Expiration -Date -3/27/10 Qty Unit Charge Per Extension BASE FEE 45.00 19.00. 9.0000 THOU BLDG 2,001-25,000 .171.00 Permit MECH POOL Additional desc . Permit Fee 26.00 Plan'Check Fee 6.50 Issue Date . . . Valuation . . . . 0 Expiration Date 3/27/10 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 3/27/10 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 3/27/10 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 LQPERMIT Application Number . . 09-00001036 Special-. Notes and Comments PLACE AT PRE -PLASTER INSPECTION. t EQUIPMENT ENCLOSURE NOT INCLUDED. 2007 ' CODES. ----------------------------------------------------------------------------.. Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit.Fee Total 320.00 , .00 .00 320.00 Plan Check Total 166.40 .00 .00 166.40 Other Fee Total 1.00 .00 .00 1.00 Grand Total 487,.40 .00 .00 487.40 i Bin # City of La Quinta Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #Ip i�10� Project Address: O My Owner's Name: A. P. Number: Address: W6 0 Legal Description: City, ST, Zip:_ Contractor: e�- Gt -P ev s 1 a Telephone: .......................................... Address:jz 0 Project Description: City, ST, Zip: Telephone: — State Lic. #: 1AZO ( of City Lic. #; Arch., Engr., Designer: �` �f/ /hn Address: a► City, ST, Zip: And hilY?l h TeleP one . State Lic. #: Name of Contact Person:S Type: Occupancy: roJ Pe t. hPe ew Add'n Alter er Repair Demo _J Ft.: # Stories. # Units: Telephone # of Contact Person: te 0'.7�7, bo Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2pd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- "d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 0 EG �0016.6 m (1017) ' — — �� oE) — — 660 po (.Q ¢1 rice. s �' .:. ._ 4 In�r �._ 1015 IL -�.�1SG►'�= -_ 5 TOE). �C o <1e1s o roR) • 5 E6up - •I EXTERIOR DININGPRIVATE v b O EXT.LIVING pY - I BARS - MASTER. BEDROOM 'Fibem :'BREAKFAST.' V "eL hD4v �' { Qu. , I `FAMILY ROO OOLMS (� 1016.5 ATH' � j ,v1 I ` Y 7 q,7. I MASTER. 1 I (i o I WARDROBE i n -r.