05-5315 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA-, CALIFORNIA 92253
Application Nurnber:�05=0
000515.3
Property Address: 77415—CALLE -ENSENADA
APN: 773-284-001-2 -000000-
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 15000
Applicant: Architect or Engineer:
1
T4ht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
---------------------------------------------------
LICENSED CONTRACTOR'S CLARATION
I hereby affirm under penalty of p ry that I am license der Prov' io sof Chapter 9 (commencing with
Section 70001 of Division 3 of th Bu y ass d Profes ionals Code, an my License is in full force and effect.
License Class: $-1213 License o . 634981
�te: �-g�S ontractor: _
// OWNER -BUILDER DECLARATION-.
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
e'
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 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 am exempt under Sec. , BAP.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: pf
LQPERMIT
Owner:
POWER FINANCE
P.O. BOX 134
LA QUINTA, CA 92253
Contractor:
CORONEL CONSTRUCTI
P.O. BOX 389
LA QUINTA, CA 9224
(760)564-4604
Lic. No.: 634981
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/05/05
OID
N
7 DEC 0 8 1005
CITY OF LA QUINTA
FINANCE DEPT.
WORKER'S COMPENSATION DECLARATION
1 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.
K 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 STATE FUND Policy Number 1744453
_ 1 certify that, in the per mance of the work for which this per it is i sued, I shall not employ any
person in any man r s as to become sublet the worke s' co pensation laws of California,
and agree that, if 1 houl becom subject to he workers' c mp sation provisions of Section
/ 3700 of the Labor ode, I shall f hwith c ply with thos p visions.
Dace: �a 'SS -Q�cant: _
/WARNING: FAILURE 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 issu6d 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 isfcom
within 180 days from date of issuan of such permit, or cessation of work for ubject
permit to cancellation.
I certify that I have read this application and state at a above formation ' correct. I agrth all
city and county ordinances and statelaws relating bui ing con ruction, a d hereby authoves
of this countytoenter upon the above-mentioned pr a for in ection pu oses.
Cate: ��- a"G� ature (Applicant or Agent
Application Number . . . . . 05•-00005315
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 162.00 Plan Check Fee 105.30
Issue Date . . . Valuation . . . . 15000
Expiration Date 6/03/06
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 desc .
Permit Fee 26.00 Plan Check Fee 6.50
Issue Date Valuation . . . . 0
Expiration Date 6/03/06
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 6/03/06
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 6/03/06
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. ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . . . 05-00005315
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION..
EQUIPMENT ENCLOSURE NOT.INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 266.00 .00 .00 266.00
Plan Check Total 131.30 .00 .00 131.30
Grand Total 397.30 .00 .00 397.30
LQPERMIT
1
City of La Quinta
Building & Safety Division.
P.O. Box 1504
78-495 Calle Tampico .
La Quinta, CA 92253.
Building Permit Application and Tracking Sheet
Owners Name: M
Address: Av4e, V
City,ST, Zip:— 5
Telephone: e
Project Description:
City Lic. #:254
C onstru coonType: Occupancy:
....ProjecttYPe
(circle one New w Add n Alter Repair Demo
Un,a
FSq. Ft.:
# Stories:
# Units:
Estimated Value of Project: �S, 6GO