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06-0828 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 006-00000828 78230 VIA'PAVION 604-032-999-8 -305.212- POOL - RESIDENTIAL LOW DENSITY RESIDENTI 20000 Architect r ErV c&t�v 4 4 w BUILDING & SAFETY DEPARTMENT BUILDING PERMIT BAR ��•�0�6 ------------------------------------------------7-- --- - - 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: C8 C27 'C29 License No.: 656128 Cont ctor. \ . 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: Anycity 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 for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 7044, BusinessandProfessions 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 Dater Owner: CONSTRUCTION LENDING AGENCY I hereby affirmunder*penalty of perjury that there is a construction lending agency for the performance of the . ,work for which this permit is issued ISec. 3097, Civ. C.). ,. Lender's Name: ' .Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/28/06 . Owner: VAN SLEET." 78-230 VIA PAVION LA QUINTA, CA LA QUINTA, CA 92253 Contractor: . CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, 'CA 92236 , (760)398-9222 Lic.- No.: 656128 WORKER'S COMPENSATION DECLARATION 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 ofthe 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 issued. My workers' compensation insurance: carrier and policy number are: , Carrier HRH INS Policy Number BB1060510 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 becomesubject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700ofthe Labor Code, I 1 II forthwith comply with those provisions. B�5_19_000Applic na t: WARNING: FAILURE TO SECURE WORKER '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 it; 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 peimit, 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 con;;tpn �,�on, and hereby authorize representatives of thiscountyto enter upon the above-mentioned property for i c;pec ion ur_posas. Dafe: 'Z_ Signature (Applicant or Agent): L Application Number 06-00000828 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee. 207.00, Plan Check Fee 134.55 Issue Date . . . . Valuation 20000 Expiration Date 8/27/06 Qty Unit Charge Per Extension BASE FEE 45.00 18:00 9.0000 THOU BLDG 2,001-25,000 ------------------------------------------------------------------------------ 162.0-0 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check.Fee 6.50 Issue Date . . . . Valuation . . 0 - Expiration -Date 8/27/06 - Qty Unit Charge Per- Extension 7 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 8/27/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00. ----------------------=-------------------=--=------------------------------ f Permit .. PLUMBING. Additional desc . Permit Fee 33.:00 Plan Check Fee 8.25 Issue Date Valuation- 0 Expiration Date 8/27/06 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 ONLY'. ALARMS/BARRIERS SHALL LQPERMIT _ j Application Number .. 06-00000828 ------------------------------------------------------- Special Notes and Comments BE IN PLACE :PRIOR TO PRE-PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. .Fee summary, •Charged "Paid Credited Due' y Permit Fee Total- 311.00 .00 .00 311.00 Plan Check Total 160.55 .00 .00 160.55 Grand Total 471.55 .00 .00 471.55 LQPERMIT `Bin # \ City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet PeIrl-La U Project Address: V c,,VNov,\ Owner's Name: A. P. Number: Address: Legal Description: \• Contractor:Qo S City, ST, Zip: ; Telephone: Address: b2 PPr—oj�ecctt Description: City, ST, Zip:(�paC�\la CA. . Ci22.3 G T j� Telephone: 760) S9 V% 9 Z Z Z— t State Lic. #: G56 12. S City Lic. #: Arch., Engr., Designer: Called Contact Person Address: A.I.P.P. City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo. Name of Contact Person: 3"e Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 2 6-0- q OZ Y y Estimated Value of Project: 2:& ®v APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted2.810% Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Total Permit Fees Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" 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:- 7nd 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