04-5370 (RPL)°�
BUILDING & SAFETY DEPARTMENT
P.O: Box 1504 (760).777,1-7012
C��IpF 4%9 787495 CALLE TAMPICO" FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777=7153
BUILDING PERMIT.
Application Number 04�=0`0005370 Date 7,/.07/04
Property Address . . . 53440 AVENIDA VILLA
APN:� 774-094-011-14 0:00000-
.Application description-. POOL.- RESIDENTIAL
Property Zoning -COVE RESIDENTIAL
Application valuation 15000
Owner. Contractor
SCHERBER HANNES ALL VALLEY, INC.
68100 RAMON RD STE C10 P.O. BOX 2263
CATHEDRAL CITY CA 92234 PALM.SPRINGS CA 92263
(760) 324-4507
WCC: EXEMPT
WC: -EXEMPT 07/31/05
CSLB : 828407 12,/31/05
CCC: B
Permit BLDG POOL PERMIT
Additional desc
Permit Fee 162.00 Plan Check Fee 105.30.
Issue Date . . Valuation 15000
Qty Unit Charge .Per Extension
BASE FEE 45.00
.13.00 9..0000. THOU BLDG 2,001-25,000 117.00
---------------..-----------------------------.----------------------:-------
Permit MECH 'POOL
Additional-dese
Permit Fee . . . . 24.00 Plan Check. Fee • 6:,00
Issue DateValuation_ :. 0`
Qty Unit Charge Per Extension
BASE'FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
Permit . . . . ELEC POOL PERMIT-RES
Additional desc
Permit Fee 45.001, Plan Check Feer. 11..25
n Lssue ;Date Valuatior_ 0
/f d
Q y_ it Charge Per Extension
Ak 0BASE FEE 15.00
930.0000 EA ELEC ,PRIVATE SWIMMING POOL •"30.00
DgPl. r
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING &C SAFETY DEPARTMENT
Application Number: 0
Applicant:
Applicant's Mailing Address:
Date: 1-1-0
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 ZenspeiNo.
visions of Chapter 9 (commencing with Section 7000) of Division 3 of.the Business and Professionals
C de, and my License is in full force and effect.
icense Class �
Date-7 — /' 0 41 Contractor ei/L
OWNER -BUILDER DECLARATI
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 I am exempt under Sec. , BA P.C. for this reason
Date Owner.
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.
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 Policy Number
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 provisAs.
Date PPlicant , fit ✓!/TY �� 4,—V ,'z dA, or
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AN LL 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 i
Lender's Address 1"!
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, indemnity and hold harmless the City of La Ouinta, 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 relafing to building
construction, and hereby authorize representatives of this county to enter upon the above-menfionned property for inspection purposes.
Date 7'_ �)— 41 S�re (Applicant or Agent):
Page 2
Application Number . . . . 04-00005370
Date 7/07/04
Permit . . . . . . PLUMBING
Additional desc-.
Permit Fee 33.00 Plan Check Fee
8.25
Issue Date . . . Valuation . .
0
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
' PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT -.ENCLOSURE NOT INCLUDED
- Fee summary Charged Paid Credited
Due
Permit Fee Total 264.00 .00 .00
264.00
Plan Check Total 130-.80 .00 _.00
130.80
Grand Total 394.80 .00" .00
394.80
CITY OF LA QUINTA SUB CONTRACTOR LIST. .
JOB ADDRESS
PERMIT NUMBER -OWNER' BUILDER
This-form shall be posted on the job with the Building
Inspection Card at all'times in a conspicuous place: Only persons appearing on this list-or their employees are authorized to work
on this job. _ Any changes
to this list must be approved
by the Building Division prior to commencement of work. Failure to .comply will result in.a stoppage- of
work, and/or the voidance
-
of building peimit. For each applicable trade, all information requested.below must be completed
by,applicant. "On File" isnot: an acceptable response.
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