07-2059 (RPL)P.O. BOX 1504
78-495 CALLE"TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00.002059
Property Address: 783:6.0 HERITAGE WY
APN: 643-170-=999=39. -31348
Application description: POOL -RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15400
Applicant:
T4&t 4 4 Q�&&
Architect or Engineer:;
alp
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I,lierebyaffirm under penalty of perjury tha[.I am lioensad under provisions,of.Chapter 9 (commencing with
Section' 7000)'of'Division3'of the Business and Professionals Code, and my Licenswis in,full force and effect..
Loen- class: B C27 C53 - 'LicenseNo.: 810111
ate _ontractor',-
OWNER -BUILDER DECLARATION
I:fiereby affirm under penalty of perjury that Lam exempt.from,,the'Contractor's State License,Law. for.the
followirig reason.(Sec: 7031:5, Business and Professions.Code: Any cityor county that requires a permit to
construct, after, improve, demolish, or.repaieany.structure, prior to its issuance, also requires, the,appficantfor the
per mit 'to file a signed statement that he,or she is licensed pursuant to the.provisions of the Contractor'sState;
License Lew'(Chapte(91(commencing with,Section 7000) of, Division 3 of the'Busmess and Professions Code)'or,
that or;she'is exempt therefrom andthe�basis for the alleged exemption: ,Anyviolation of`Section 7031.5'by
any applicant for. a.permit'subjects.the applicant to,a civil,penalty.df not more than five hundred dollars (5500).:
(_) I, as'owner of the property, or, my empfoyess,witfi wages as their sole compensation, will do the work, and
the structure isnot intended,or offered for sale (Sec: 7044, Business,and:Professions Code.The
Contractors' State License Law does not apply town owner of property who buildsor 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 tiavethe burden of proving that he 'or she did not build'or
improve'for the purpose at saleJ.
(_ 1 I, as�owner of the property,, am exclusively. contracting with licensed"contractors to construct the project (Secs.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an, owner of
property who builds',or improves:theeeon, and ;Who contracts for the projecmwith a'contractor(s) licensed
pursuant to,theContractors' ;State License Lew).
(_ 1 I am exemptynder Sec., , B.&P.C. for this�reason
Date:'. • Owner:
'CONSTRUCTION: LENDING-.. AGENCY
I hereby affirm under penalty of perjury that there We construction1ending,'agency for the,performance of the
Work for which this permit is issued (Sec..3097;,Civ: Cil.
Lender's Name: - --
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777=7011
INSPECTIONS (760) 777-7153
Date: 7/16/07
Owner:
GARY LEVINSON
78360 HERITAGE WAY
LA QUINTA, CA, 9225,
Contractor:
PICASSO POOL'S INC
780.78 COUNTRY GLU
BERMUDA DUNES, CA
(760)345-4600
Lic. No.: 810,111
JUL 19 200 r
WORKER'S' COMPENSATION DECLARATION
I hereby affirm under penaltyof perjury one of the following declarations:
I have and will maintain a certificate of•consentto,self'insure for workers' compensation, as provided.
foeby Section 3700 ofrthe Labor Code; for the performance'of the. work for whichfthis pemtif'is
issued.
1 have and will maintain workers' compensation insurence,,.as required bySection 3700 of the Labor
Code, for the performance of the work for which this;permitis issued. My workers'.compensation.
insurance carrier and poficy:numberare:
Carrier STATE FUND Policy Number 290-0001790
_ I certify that, in the performance of the work.for which this permit is issued, [;shall not employ any
personin!any,manner spas td. ecomwsubject-to-the workers -compensation laws of California,
And agree that; if 1 should become subjectLto the•warkers' compensation provisions of Section
37 6,d Cilie Labor, Co oAshall:forthwith?compfy with those provisions.
WARNING: FAILLIRETO SECURE' WORKERS' COMPENSATION COVERAGE IS'UNL.AWFUL„AND ; SHALL
SUBJECT ANI.EMPLOYER TO CRIMINALPENALTIESAND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION' TOTHE.COST OF COMPENSATION; DAMAGES: AS PROVIDED,FOR.IN
SECTION'3708 OF THE LABOR CODE;,., INTEREST, AND ATTORNEY'S FEES:.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application;is hereby made to theDirector of Building and Safety fora permit'subject to the
conditionsand restrictions setforth`on this application.
1, Each person upon.,"ose,behalf this application is made, each person at whose requestand4or
whose benefftwork is performed under or pursuant manypennitissued as,a result of -this application,
the owner„and the applicant, each agrees to, and shall defend, indemnify end hold harmless the City
of La 0uinta, its officers, agents and employees for any act oromission'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 voidlif work is not commenced
within 190.daya: from date,of issuance`of'such permit, or cessation of -' work 'for 180 days wilfsubject
permit to cancellation..
I certify that I have read this'application and state that the aboveinformation is correct.. I agree to comply with all
city and `countyordinances-and siate,laws relating to.building construction, and hereby authorize,represomatives
of this county t6 enter upon the above-mentioned propertyf--zinspecrion urposes:
Date: nature (Applicant of Agent):
fJ4'
Application Number . . . . 07-00002059
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
171.00 Plan Check Fee
111.15
Issue Date . . . .
Valuation . . .
. 15272
Expiration Date . .
1-/12/08
Qty Unit Charge
Per
Extension
BASE FEE
45-60
14.00 9.0000
THOU BLDG 2,001-25,000
126.00
Permit . . .
MECH POOL
Additional desc . .
Permit Fee . .
26.0.0 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration. Date
1/12/08
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 . . .
. 6
Expiration Date
1/12/08
Qty Unit Charge
Pet
Extension
BASE FEE
15.00
.1.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
PLUMBING
Additional des'c .
Permit Fee
33.00 Plan Check Fee
8.25
Issue. Date . . . ..
Valuation . . .
. 0
Expiration Date
1/12/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 3.0600
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
LQPERMrt
' Application Number . . . . . 07-.00002059
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee'. . . : . 15.0:0 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 128
Expiration bate 1/12/08
Qty Unit Charge. Per:
Extension
BASE FEE
15.00
---------------------------------
Special Notes and.Comments
POOL/SPA,8 L.P. 4' EQUIPMENT WALLS,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged. Paid Credited
Due.
Permit Fee Total 29.0.00 .0.0 `.00
290.00.
Plan Check Total 137.15 .0;0
..00"
137.15
Grand Total 427.15 .00
.00
427.15
LQPERMir
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BcQ7cft. zr Safes Division
P. -P. Bax 1504, 78-4-95. Cage Tampico .
La Qcmm, CA 9225'3 - (760) 777-7,012
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