08-1902 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001902
Property Address: 53435 FREMONT WY
APN: 767-200-998-90 -330762-
Application description: POOL -.RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 70000
Applicant:
ep,
Tiht 4 4v Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 P ofessionals Code, and my License is in full force and effect.
License Class: tC2�7pC53 Lic se No.: 635896
�uate: ✓ Vp ntractor:
or
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjur that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Bus, ss 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 thew
for the
permit to file a signed statement t at 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.).
(_) 1, 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 contracior(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.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: W
LQPERMIT
Owner:
AZOFF
53435 FREMONT WAY
LA QUINTA, CA 92253
OR
Contractor:
DUNN'S DESERT LANDSC
74866 LENNON PL, SUI
PALM DESERT, CA 92260
(760)773-9923
Lic. No.: 635896
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/01/08
WORKER'S 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 DELOS INS CO Policy Number 02DKRM12000717
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 come subject to the workers' compensation laws of California,
and agree that,/OMPENSAT,ON
&nn
ect to the workers' compensation. provisions of Section
3700 of the Laco
ly with those provisions.
ate: ' /�RETO
WARNING: FS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO NALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND
DOLLARS ($100,000). INADHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Applications 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 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 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 relating to building co ruction, and hereby authorize representatives
of . county to enter upon the above-mentioned property f in ection purposes.
Date: nature (Applicant or Agent):
Application Number . . . . . 08-000019.02
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 504.50 Plan Check Fee 327.93
Issue Date . . . . Valuation . . . . 70000
Expiration Date 5%30/09
Qty Unit Charge Per Extension
BASE FEE 414.50
20.00 4.5000 THOU BLDG 50,001-100,000 90.00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . Valuation 0
Expiration Date 5/30/09
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 5/30/09
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
c.
Expiration Date 5/30/09
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 . . . . . 08-00001902
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due.
------------------------------------=--------------------
Permit Fee Total 608.50 .00 .00 608.50
Plan Check Total 353.93 .00 .00 353.93
Grand Total 962.43 .00 .00 962.43
L
LQPERMIT
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permit #
nJ o �
1
Prujeot Address _
City of La Quintal
Building at Safety Division
P.O. Box 1504, 78-49S Cale Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
S" r Owner's Name: 20 F-P
A. P. Numbor:
Addms: 3 '�_ '[76x0/1 r {,t/
Legal Description:
Contractor QvAA
Address: —7 — g
City, ST; Zip: .
ArA
>;S [.f �Od� l Telephone: -$^
LVAAo11 ?L ° A ` 1 Proiect Datription:
City, ST. Zip a,,3,(v0
Tclephone: 0 711-%17IT
State Lic. # : 5,940. City Lic. le:
Arth_, Engn. Designer.
Address:
City, ST, Zip:
Telephone:
Slate Liu. 4;
warn of Contact Person:
Construction Type: Occupancy.
Project type (circle one): New Add'a . Alter Repair Demo
Sq. Pt.: d Stories. U '
Tolephow A of Contac[ Pawn:Estimated
Value of project �a
APPLICANT: 00 NOT WRITE BELOW THIS UNE
M
Sabmitiai
Req'd
Ree'd
TRACT MG
PERM" FEES
Plea Sets
Plan Cheek submitted
Win Amunat
structural Cales_
Rerkwed,, ready for corrections
Plan Chak Deponit
Truss Ca
Caged Contact Person
Plan Ckvck Bahmee
Energy Gks.
Plata picired up
Construction
Flood plain pita
Pyrans ra ubmitted
Mechanical
Grading Plan
2" Review, twcdy for eorreetiomd'aqne
Electrical
Subcuntactor List
Called Contra Person
Plumbing
Grant Deed
flans picked up
SALL
H.O.A. Approval
Plana resabmitted
Grading
IN HOUSE;-
30 Review, ready for ewrtcuonsrusae
Oevdoper Impact Eec
Planning Approval
Called Cuataet Persou
Pub. Wks. Appr
Date ofperwit i"ue
School Fees
Toad Pcrmit Fees
TO -/TO -MtI1 i,4 -4n nisi viNInn Ci ITOLLLL09L 90:80 800Z/EZ/60