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04-6743 (RPL)�rw BUILDING .& SAFETY DEPARTMENT P.O.. Box 1504 (760).777-70.12 78-495 CALLS TAMP.IC6 FAX (760) 777=7011 LA QUINTA, CALIFORNIA .922.53 INSPECTION REQUESTS (760) 777-7153 . BUILDING: PERMIT Application Number 04-00006743 Date 10/12/04 Property Address... 43-650 CALLE ESPADA ..APN: 609-580-017- - - Applicati.on . description ... POOL _-RESIDENTIAL Property Zoning-. LOW DENSITY RESIDENTIAL Application valuation 19000 Owner. Contractor PONDEROSA HOMES II, LLC CALIFORNIA"POOLS & SPAS 400 S. FARRELL DRIVE, B103 P.O. BOX .1280 .PALM.SPRINGS, CA 92264 COACHELLA CA 92236 LA QUI.NTA.. CA 92253 (760) 39.8-92.22.. WCC: STATE FUND WC- 04600061168 0:1/01/05 CSLB:: 65.6128 1,0/31/04. CCC: C8 -C27 -C29-053 Permit Fee 24.00 Plan. Check Fee 6.00 Issue Date Valuation 0 Qty Uhit.ChargePer Extension BASE. FEE .. 15.00 1.00 9.0000 EA. MECH FURNACE.<=100K 9.:00 Permit . . . BLDG POOL PERMIT Additional dese Permit Fee ... . . 198.00 Plan Check Fee:. 128.70 Issue Date. Valuation 19000 Qty Unit Charge Per Extension ...BASE FEE 45.00 17.00 ..9'. 0000 THOU BLDG 2,001-25,000 153.00 ------------------------------------------------------------------------------ Permit ELEC POOL PERMIT -RES Additional desc Permit Fee .45.00 Plan Check Fee 11-25 Issue Date Valuation 0 Qty Unit Charge Per -Extension BASE FEE .15.00 P.O. BOX 1504� VOICE (766) 777-7012 78-495 CALLS TAMPICO : FAX (760) 777-7011 LA QUtNTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number. �Jy--�p 7� Date: Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Eng r s: Uc. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of ply that 1 am icedsed under provisions of Chapter 9 (commencing with Section 7000) of Dividon 3 of tto'Busimu and Professionals Code. and my LJoe7ls in full farce and effect.656'12 License Class L-' S3 License N0. Data Ofs�id Contractor ' OWNER43U0.DER DECLARATION I hereby affirm under penalty of perjury Mat I am exempt from the Contractors- State License Law for the Ibltowing reason (Sec 7031.5. Business and Professions Code: Any city or county that mquiros a permit lo construct, after. improve. demolish, or repair any ouctu a, plor t01ts issuance, also ropuk" the gp*ent for the.perm3 to tae a signed statement that he or "Is licensed pursuant to the provisions of tha ContrAcloW State License Law (Chapter 9 (commencing with Sec4an 7000) of Division 3 of the Business and Professions Coo) or tat he or she is exempt therefrom and the beds for the alleged exemption, Any violation of Section 7031.5 by any applicant for a Writ subjects the applicant to a civi, penally of not mom timer five hundred dollars ($SW0 r U 1, as owner of the property. or my employees with wages as their sole oompensaam wo do the work, and the structure Is not Intended or offered for $ale (Sec- 7044, Business and Professions Code: The Cohtractors' State License Law does not appy 10 an owner of property who bunds or improves thereon, and who does the work himself or herself or through his or her own erploy ses, provided that the improvements we not Inlended or offered for safe. It. however, the building or improverrbntis' sold within one year of completion, the owner-buider win have the burden of provkig lhat he or ata did not bund or improve for the purpose of 68164 • U 1. as owner or the property. am exclusively contracting with licensed contractors to construct the pr*d (Se6.7044, Business and Protessions Code: The Contre4ora' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a contractors) licensed pursuant to the Contractors" State License Low.). L) I am exempt under Sea BA PA. for this mason ^ pate Owners 0 . WORKERS' COMPENSATION DECLARATION I hereby affirm under penatty of perjury one of the following dedarations:. _ 1 have and.wfi malntain a certificate of consent to sW4nsuro fur workers' compensation, as provided for by Section 3700'of the Labor Code. f0rthe performance . of the work for which this permit Is Issued.. I have and will maintain wo keW compensation insurance, as required by'Sectlon 3700 of the Labor Code. for the performance of the work for which this permit is —f�ssuue�d My ' compensation-lAsurana center and px><b mbar aro: Carrier ` -tP .tet—tAi.j Ponty Number O 5�(o/71Y� le I.catify 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 b the worker' con pensatk n laws of Cafifomia, and agree that if 1 should beoome subject iota workers' compensation provisions of Section 3700 of the Labor Code. I shat forth/witjh comply with those provisions. WARNING: FAILURE TO SECURE WORKERS- CO�A�PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINE$ UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), 14 ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that there Is a construction lending agency far the performance of the work for which this permit is Issued (Sea 3097, civ. C.). Lenders Name Lenders Address 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 apptkalioih. 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 10 any permit issued as a result of this appliicatfon, the owner. and the applicant, each agrees 10, and Shan. defend, indemnify and hold ha miess the city of La Quints, its officers. agents and employees for any act or omission related to the waitbrk p6rformed under or following issuance of this Perri[ 2 Any permit issued as a result of this appncation becomes nun and void Kw rot commenced vAwn 180 days from date or Issuance of such pemhit- or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above linfowatilon is agree comply with all city and county ordinances and state laws relating to building constructionn,, and hereby authorize representatives of this county upon the a property for Inspection purposes. Date �« o Signature (Applicant or Agent): a Application Number . 04-00006743 Page - 2 Date 10/12/..04 Qty Unit Charge Per -Extension 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 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. BBQ ANSI Z31-58-1995. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 300.00 .00 .00 300.00 Plan Check Total 154.20 .00 .00 154.20 Grand Total 454.20 .00 .00 454.20