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06-2631 (RPL)P.O.. BOX 1504 787495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 06-00002631 48665 FULL MOON WY 658-140-999-130 -29436 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 25000 T4ht 4 aCP Q" - Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: MARK WILLIAMS 48-665 FULL MOON WAY LA QUINTA, CA 92253 RD Contractor: MCRAE-POOL & SPAS 79105 DESERT STREAM LA QUINTA, CA 92253 (760)772-2440 Lic. No.: 823017 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/11/06 JUL 12 2006 CITY OF LA QUINTA ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Cha ncing with I hereby affirm under penalty of perjury one of the following declarations: Section 70001 of Division 3 of the Business and Professionals - y Lice _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C53 -C27 Li o.: 017 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is L issue . �/ Date: I� D�" Contractor: _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) br 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 1$500).: 1 _ 1 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 contractors) licensed pursuant to the Contractors' State License Law.). (_ 1 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: LQPEILNIIT Cade, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier EXEMPT Policy Number EXEMPT v— 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 agre that, if I should become subject to the workers' compensation provisions of Section 7� I� I� 00 o the Labor Cod5Zalll rthwith co �with.ose provisions.1 Applic 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 y 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 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 construction, and hereby authorize representatives of this o��ure the above-mentioned property spection purposes. Date: (Applicant or Agent): Application Number . . . . . 06-00002631 Permit . . . . . . BLDG POOL PERMIT .Additional desc . Permit Fee . . . . 252.00 Plan Check Fee 163.80 Issue Date Valuation . . . . 25000 Expiration Date 1/07/07 Qty Unit Charge Per Extension BASE FEE 45.00 23.00 --------------------------7------------------------------------------------- 9.0000 THOU BLDG 2,001-25,000 207.00 Permit . . . MECH POOL Additional desc .. Permit Fee . . 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date 1/07/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 --------------------- 11.0000 ---------------------- EA MECH FURNACE >100K 11.00 . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 1/07/07 — 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 1/07/07 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 Permit. WALL/FENCE PERMIT LQPERAIIT V' - liw Application Number . . . . . 06-00002631 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee'. .00 Issue Date . . . . Valuation . . . . 192 Expiration Date 1/07/07 J Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA & 12 LF. 4' HIGH EQUIP ENCLOSURE WALL. (CITY STANDARD) Fee summary "Charged Paid -------------------- Credited -------------------- Due ----------------- Permit Fee Total 371.00 .00 .00 371.00 Plan Check Total 189.80 .00 .00 189.80 Grand Total 560.80 .00 .00 560.80 LQPERMIT Bin #City of La Quinta Building a Safety. Division' ' PenWt #P.O. Box 1504, 78-495 Calle Tampico U Quinta, CA 92253 • (760) 777-7012 d Building Permit Application and Tracking Sheet X Project Address•. g-FVnjM0rV Owner's Name: A.Y. Numba: Address: Legal Description: City, ST, Zip: GQ < X j� ?C X %K A X Contractor. :Address: City, ST, Zip: Telephone: 2 State Lie: Ii : 922OL2 Arch-, Engr., Desipgr: Address. City, ST, Zip: Telephone: State Lic.: Name of Contact Person:' Telephone # of Contact Person: Plan Check Deposit N 1 Sabmlttal Plan Sets Structural Cilcs. Tess Cala. Eutcgy Cates. Flood "pima plan Grading plan Subcoutactor List Grant Deed - H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees Q04S Mephone: IXPM jexi Description: on: /Z .GF 4 City Lic. N: f.(/'� 0 x =' Consttudion Type: Occupancy: cry; �a • ''�`� : - ''' Project type (circle one):. New Add'n Alta Repair Dano ' li� Sq. FL:N Stories:0 Units: % Value of Project:. APPLICANT: DO NOT WPJTE BELOW THIS UNE Rec'd TRACKING A PERMIT FEES Plaa Check sobmitfed Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Satan" Plans kicked up Construction . Mas resubmitted Mechanical 2•' Review, ready for eorrectiouMmue ' Electrical Called Contact Person Plumbing Plans picked up Pians resubmitttd Grading Review. ready for eorrecticus issue Developer Impact Fee Called Contact Person' A.i.P.P. Date of permit Issue AXIAW" t lA"w0J 'notal Permit Fees