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04-3858 (RPL)i. WL BUILDING & SAFETY DEPARTMENT - _ P.O Box 1504 (760),777-7012 OFT �� r17� 8-495RO LLE TAMPICO FAX (760) 777-7011 xpIrl LA QuINT�A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 05 24� BUILDINGPERMIT I ppl=iea ion=l�ir�mber 04-T" _0-F—U5.8 Date 5/04/04 Property Address . . . . . . 77928 DESERT DR APNc .658-140-.999-144.-.29436 Application description POOL - RESIDENTIAL Property Zoning LOW DENSITY.RESIDENTIAL -Application valuation.. : 180.00 Owner Contractor IVANHOE LA QUINTA COVE CALIFORNIA POOLS & SPAS -P.O. BOX 128.0 7979. IVANHOE AVE STE .550. ' COACHELLA. CA 92236 LA `'JOLLA CA 92037. .(760)-'.98 -.9222 CC "STATE FUND' WC: 0.4600061168 01/01/05 CSLB`:.: 656.128 10/31/04 CCC: C8=C277C29-053. Permit : MECH POOL Additional desc . Permit Fee. 24.00. Plan Check Fee 6.00 Issue. Date Valuation 0 Qty. Unit Charge Per .'Extension BASE FEE. 15.00 1.00 9.0000.. EA'. MECH..'FURNACE <=100K.. Permit .. . . . . . BLDG POOL PERMIT Additional desc Permit Fee 189.00 .Plan Check Fee 122.85 .I.ssue Date Valuation .. 18000 Qty Unit Charge Per Extension BASE - FEE 45.00 16.00' 9.'0000 THOU BLDG 2,OOi-25,000 144:00 Permit . . . . ELEC POOL PERMIT -AES Additional desc Permit '..Fee 45.00 Plan Check Fee 11..25 Issue -Date'. ... Valuation., 0 Qty Unit Charge Per :Extension BASE FEE 15.00. P:O. BOX 1504 VOICE (760) 7.77-7012 79-495 CALLE TAMPICO..:. FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: . Applicant: Architect or Engineer 14 Applicant's Mailing Address: Architect or En ' ear' Add Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sedan. 7000) of Division 3 of the Business and Professionals Code, and my Lice7ls in full force and effect. / �� 2 License Class L-' $.3 License No. (O Date Contractor OWNER43UILDER DECLARATION I hereby affirm'under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sea 7031.5, Business end Professions Code: Any city or county that requires a permit to construct alter, improve, demolish, or repair any structure. prior to Its Issuance, also fequiras the applicant for the permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotte) 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 cit penalty of not more than five hundred dollars ($500).): U 1, as owner of the property, or my employees with wages as their sole compensation, win do the.work, and the structure is not intended or offered for sale (Sea 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 Cie walk himself or herself or 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; Che owner -builder win have the burden of proving that he or she did not build or improve for the purpose_ of sale.). U 1. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sea 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.). U I am exempt under Sec. BA PSC. for this reason Date Owner,,_,. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:_ _ 1 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 ft performance of the work for which this permit is Issued. Y I he" 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 �, e�ssumr dd My wo rskoro ensation.Insurance carrier and 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 agree that, If I should became subject to the workers• compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p s. Date �.�/ Applicant � •, 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 ATTORNEYS FEES. 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 (Sea 3097, CIv. C.). Lenders Name Lenders Address 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 applicalloti• 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit wok 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 Le Quinta, Its officers, agents and employees for any act or omission related to the work being performed under or following Issuance of this permiL . 2. Any permit Issued as a result of this application becomes null and void [(work is not commenced within 160 days from date of issuance of such pemdt. or cessation of work for 160 days will subject permit to cancellation. 1 certlty 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 county to ter upon the trove rtmentioned property for inspection purposes. Date r-4 r Signature (Applicant or Agent): .__ I Application Number .. 04-00003858 Page 2 Date 5/04/04 Qty Unit Charge Per Extension 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 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 PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary ----------------- Permit Fee. Total Plan Check Total Grand Total. Charged Paid 291.00 .00 148.35 .00 439.35 .00 Credited Due .00 291.00 .00 148.35 .00 439.35