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07-0804 (RPL)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/28/07 Application Number: 07-00000804 Owner: Property Address: 80546 HERMITAGE PHIL GOLDSTEIN D APN: 762-210-005- - - 80546 HERMITAGE Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 —>q Property Zoning: LOW DENSITY RESIDENTIAL APR. Application valuation: 51000 APR.o L'' 2007 0 Contractor: Applicant: Architect or Engineer: PLATINUM POOLS & SPAS i77564 COUNTRY CLUB DRIVE #108 ` PALM DESERT, CA 92211 lk • (760)77 Lic. No..::890 890670 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business P ssionals Code, and my License is in full force and effect. License lass. C53 License No.: 890670 Date: ContracCusin OWNER-BUILDER DECLARATION I hereby affirm under penalty oat I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5and ProfessionsCode: 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.). (_ 1 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.). 1 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: LQPEPNIIT WORKER'S COMPENSATION DECLARATION 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 STATE FUND Policy Number 1863573-2007 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 bec a bject to the workers' compensation laws of California, and agree that, if I should becom sub. t the workers' compensation provisions of Section 3700 of the Labor Code, I shall rt i omply h those provisions. Date: 15*07Applicant: WARNING: FAILURE TO SEC RE WORKER 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT'AN EMPLOYER TO RIMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADD HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, 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 inforr do is correct. I agree to comply with all city and county ordinances and state laws relating to building con stru ion a hereby authorize representatives of this co tyLto enter upon the above-mentioned property for inspe io p ses Date: '5'0 Signature (Applicant or Agen lk Application Number . . . . . 07-00000804 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee 419.00 Plan Check Fee 272.35 Issue Date Valuation . . . . 50892 Expiration Date 9/15/07 Qty Unit Charge Per Extension BASE FEE 414.50 1.00 4.5000 -------------- ------------------------------------------------------------- THOU BLDG 50,001-100,000 4.50 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation. 0 Expiration Date 9/15/07 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 9/15/07, 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 9/15/07 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 I N Application Number . . . 07-00000804 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check -Fee .00 Issue Date . . . . Valuation . . . 108 Expiration Date 9/15/07 Qty Unit. Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, WATER FEATURE & 5 L.F. 5' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION Fee.summary Charged =--------- Paid Credited Due --------------------------- Permit Fee Total 538.00 ---------- .00 ---------- .00 538.00 Plan.•Check Total 298.35 .00 .00 298.35 Grand Total .836.35 .00 .00 836.35 LQPERAIIT Bin # , City of La Quinta Building ac.Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # .• La Quinta, CA 92253 - (760) 777-7012 Building Permit Applicadon and Tracking .Sheet milli I ME PmjedA dress �o�yla t'�►(n ��• - o"cesNme: A. P: Num Address: bp Legal ption:. City, sT, zip: LA OR dizz53 contracto . VL-Nn S T Cob 7 Address: �p! // l_Wg 1 ProjectDesaiptiow City, ST, p: A\.-M J%ES£'�T A Telephone (meq. / l.�C' t0 State Lia `0 (O-jO City Lic. #: - Arch,. ., Designer. 7(i G. ,• Address: City; Sr, p= Telephone- Coustruction Type: Occupancy: State Lac. Projod typo (drde one):. Ne, v - Add'n Alba Repair Demo . Name 44"t Person: \1,0 14,4 C fliAAiA Sq. Ft: -: #Stories '# Units: Telephone of contact Person (stn - 115 -7559 value orProjerk APPUCANT: DO NOT WRITE BELOW THIS LINE a Sub ttal RWd •• Arun TRACICENG. PERMIT FEES Plan Plan Cheek submitted Iter Amount. Strn Cales. Reviewed, n ady for corrections Pfau Chfcc Deposit Calcs. Called Contact Person Plan Check Balance Fns Catea. Pians Wked.ep Constraetion Flood pima plan Pians resubmitted Mechanical Grading, plan Z' Revitw,,eady for eorrectionsliune. Electrical So 'tactor IM . Called Contact Person Plumbing Gran Deed Plans picked up S.M.L - BO Approval Piaus resubmitted Grading Ui R USE:= s'' Review, ready for corrections/issue Developer Impact Yet Pia Approval Called Contact Person A.LPB: Pab. App, Date of permit issue Schooj Fees Total Permit Fees 51000