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06-3483 (RPL)I P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: Architect or Engineer: Qfifpal� WAN BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LICEN ED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ofessionals Code, and my License is in full force and effect. License C ass: 8 C27 C29 license No.: 656128 Q !_« Date:? Contractor: � OWN -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exem from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Profession 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.l. (_ 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 whictr this permit is issued (Sec. 3097, Civ. C.). / Lender's Name: _ Lender's Address: LQPERMIT Owner: SETH 48700 FULL MOON WAY LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/28/06 Contractor: D U CALIFORNIA POOLS & SPAS P.O. BOX 1280 2 COACHELLA, CA 92236 SEP 9 2006 (760)398-9222 Lic. No.: 656128 CITY OF LA QUINTA ---------------------------------7------------- 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 SEA13RIGHT Policy Number BB1060510 I certify that, in the performanc of the work for which this permit is issued, I shall not employ any person in any manner so as become subject to the workers' compensation laws of California, and agree that, if I should be subject to the workers' compensation provisions of Section �0 of the Labor Code, I I fart 'th comply with those provisions. �`Date� Applicant: 1 WARNING: FAILURE TO SECURE WORK S' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE C ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTERES 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 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 inf rmation is correct. I agree to comply with all city and county ordinances and state laws relating to building ch nd hereby authorize representatives of this county to e5ter upon the above-mentioned prope insp tion pur es. Date: 4 `4gnature (Applicant or Agent): - 1 Application Number: 06-00003483 Property Address: 48700 FULL MOON WY APN: 658-140-999-136 -29436 Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 24000 Applicant: Architect or Engineer: Qfifpal� WAN BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LICEN ED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ofessionals Code, and my License is in full force and effect. License C ass: 8 C27 C29 license No.: 656128 Q !_« Date:? Contractor: � OWN -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exem from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Profession 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.l. (_ 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 whictr this permit is issued (Sec. 3097, Civ. C.). / Lender's Name: _ Lender's Address: LQPERMIT Owner: SETH 48700 FULL MOON WAY LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/28/06 Contractor: D U CALIFORNIA POOLS & SPAS P.O. BOX 1280 2 COACHELLA, CA 92236 SEP 9 2006 (760)398-9222 Lic. No.: 656128 CITY OF LA QUINTA ---------------------------------7------------- 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 SEA13RIGHT Policy Number BB1060510 I certify that, in the performanc of the work for which this permit is issued, I shall not employ any person in any manner so as become subject to the workers' compensation laws of California, and agree that, if I should be subject to the workers' compensation provisions of Section �0 of the Labor Code, I I fart 'th comply with those provisions. �`Date� Applicant: 1 WARNING: FAILURE TO SECURE WORK S' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE C ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTERES 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 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 inf rmation is correct. I agree to comply with all city and county ordinances and state laws relating to building ch nd hereby authorize representatives of this county to e5ter upon the above-mentioned prope insp tion pur es. Date: 4 `4gnature (Applicant or Agent): Application Number . . . . . 06-00003483 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 243.00 Plan Check Fee 157.95 Issue Date Valuation . . . 23783 Expiration Date 3/27/07 Qty Unit Charge Per Extension BASE FEE 45.00 22.00 ---------------------------------------------------------------------------- 9.0000 THOU BLDG 2,001-25,000 198.00 Permit . . .. MECH POOL Additional desc . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/27/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 ---------------------------------------------------------------------------- 11.0000 EA MECH FURNACE >100K 11.00 Permit 0 ELEC POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 3/27/07. 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 3/27/07 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 LQPERMIT Application Number . . . . . 06-00003483 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee. 15..00 Plan Check Fee .00 Issue Date Valuation 217 Expiration Date 3/27/07 Qty Unit Charge -Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA ALARMS,10•L.FX60' HIGH EQUIPMENT CITY STANDARD WALL/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due Permit Fee Total 362.00 .00 .00 - 362.00 Plan Check Total 183.95 .00 .00- 183.95 Grand Total 545.95 .00 .00 545.95 LQPERMIT Big # Permit # ^ 3*� Project Address:yf-700 City of. La Quinta Bulic ing u Safety Division P.O. Box 1504, 78-495 Calle Tampico La QuiniA, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet . �„ LL ��� .. Owner's Name: - A P. Number: Address: -: -P aJ Lt tJ Legal Deseripuon: City, ST, Zip: �..► � lv'c/� Contractor' ,` Y", t Telephone: Address: ' T .O • so Z CP Project Description: City, ST, Zip• C' 2�3 Q� � w (_ Telephone: State Lie. #:6656> � City Lic. #: Arch., Engr., Designer: Address:.• City, ST, Zip: Telephone: State Lic. #: Construcfion TYpe: Occupancy: 7MMProject type (cirple one): Add'n'. Alter Repair Demo Name of Contact Person: �� Sq. Ft: #Stories: # Units: Telephone # df Contact Person: Estimated Value of projecx . X- Y, 0 0 0 f. APPLICANT: DO -NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG , PERMIT FEES Plan Sets Plan Check submitted 9 L-7 Item Amount Structural Coles. _Reviewed, ready for corrections Plan Check Deposit Truss Coles. Called Contact Person.. Plan Cheek Balance Energy Coles. Plans bicked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan' 2" Review, ready for corrections/issue Electrical Sabcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL E O A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr . Date of permit issue School Fees • Total Permit Fees