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05-1617 (BLCK)U OZ BUILDING &t SAFETY DEPARTMENT P.O. BOX 1504 OFTt�9 78-495 CALLE TAMPICO (760).777-7012 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT 2 9?005 Applica ion er . . . . . 05-00001617 Date 4/28/05 P;rape�r sN YA r ss . . . . . . 78721 DEACON DR E 00CEDEPT. 770-230-012- - - Application escription . . . WALL/FENCE Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 300 Owner Contractor --------------------------------- --------------------------------- HARRISON HOWARD F CALIFORNIA POOLS & SPAS 78721 DEACON DR P.O. BOX 1280 PALM DESERT, CA 92255 COACHELLA, CA 92236 (760)398-9222 WCC: SEABRIGHT INS WC: BB1050510 01/01/06 CSLB: 656128 10/31/06 CCC: C8 C27 C29 C53 ---------------------------------------------------------------------------- P.O. BOX 1504�� VOICE (760) 777-7012 TaY 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: . o5—/&/l. I . Date: Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: A) /A Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals , C and my Lic a i€'n II force and effect. / icense Class ense No. S��Zd' Date V Z / / 0ontractor I4L . OWNER -BUILDER DECLARATION 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.). L) 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. S ave and aint ' workers' compe ion insurance, as required by Secti 3700 of the Labor Code, for the performance of the work for which this permit is iss d w r com ensati nsurance carrier y� e mer y p Policy Nu ber � (C7yL%[% //� _ I certify that, in the performance of the work fo 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 d agre at, i should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr vis, ns. 29/0 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. 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 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, indemnify 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 voi it 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 ect. 1 agree to comply with all city and county ordinances and state laws relating to building construction, nd hereby authorize representatives of this county to ter upon the ve-mentioned property for inspection purposes. ate Z9/ ' �Lignature (Applicant or Agent): ------------------------------------------------------- ;i Application Number . . . . . 05-00001617 --------------------------------------------=------------------------------- ------ --------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . -. Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 300 Expiration Date 10/25/.05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 12 L.F. 6' BLOCK WALL, ORCO SYSTEM Fee summary Charged Paid ----------------- Credited Due -------------------- Permit Fee Total 15.00 ---------- .00 ---------- .00 15.00 Plan Check Total .00 .00 .00 .00 Grand Total 15.00 .00. .00 15.00 79 "?Z 1-bFAcoN D2iJt t`AS'-r CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE r Bin # Permit # Project Address: A. P. Number: City of La Quinta Building w Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Shee f D V L I OVii- Owner's Name: �J Address: City, ST, Zip: rL VY /•, Contractor: Telephone: CCI.�I Fo � l a Poo & Address: Pp 60( l Zqc Recd TRACKING PERMIT FEES Project Description: City, ST, Zip: L ;?.;L 3 (0, Structural Calcs. Telephone:/l �V qI W� ��•l:.h.�'::'i:f;::^{):'µ'-::1"}?v$.v::vi.},fi.ii�: Truss Cales. State Lie. # I #: Title 24 Calcs. Arch., Engr., Designer: Construction Flood plain plan Address: Mechanical Grading plan . City, ST, Zip: Electrical o� '70Z,t �4C/G ✓� ji�ii'�C.. �D��® Telephone: State Lic. #: Name of Contact Person: b,4AJS��_ Y'°" �.'•'r)''�c•2yf{r'if} q2{~ikj;��x:23�#.;:'r. r . ;s fi; _;; „,.....Ttr` Construction Type: Occupancy: Project type (circle one): Ne Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units:• Telephone # of Contact Person: ��g��"� �j"�=Ci��% Estimated Value of Project:- 00 H.O.A. Approval 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 Cales. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan . 2"' Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I.. H.O.A. Approval Plans resubmitted Grading .IN HOUSE:- 7rd Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees