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12-1153 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4bt 4 a (P 4" Application Number: 12-00001153 Property Address: 52777 EISENHOWER DR APN: 773-326-014-2 -000000- Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 15000 ApplicanArchitppt or Engineer: elti BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: B C53 License o.: 185102 Date: /D __2__1 Contractor: 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) 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 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: LQPERMIT Owner: KASPER 52777 EISENHOWER DRIVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/02/12 Contractor: ID & a CALIFORNIA POOLS & SPAS PO BOX 2889 PALM DESERT, CA 92261 !��q �� (760)000-6141 "''y Lia. No.: 185102 1 1 CBTY 3F i -A i o41° -TA ----------------------------------------------- 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 GREAT AMERICAN Policy Number WC260048201 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall fo�th mply with those provisions. L Date:/D-,?-/2 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 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, indemnity 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 county to enter upon the above-mentioned property for inspec 'on p es. Datela 2-/2 Signature (Applicant or Agent): r 1. Application Number . . . . . 12-00001153 Permit BLDG POOL PERMIT Extension Additional desc . BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . Additional desc . Valuation . . . . 15000 Expiration Date . . 3/31/13 6.75 Issue Date . . . . Qty Unit Charge Per Expiration Date Extension. BASE FEE 45.00 13.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 117.00 Permit ELEC POOL PERMIT -RES 1.00 3.0000 Additional desc . . 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/31/13 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 . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/31/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 ONLY, NO HEATER. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT. INCLUDED. 2010 CODES. ---------------------------------------------------------------------------- Other.Fees . ... . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee.summary Charged Paid Credited ----------------------------------------------------_---- Due Permit Fee Total 234.00 .00 .00 234.00 Plan Check Total 123.30 .00 .00 123.30 Other Fee Total 1.00 .00 .00 1.00 LQPERMIT Application Number Grand Total LQPERMIT . . . . . 12-00001153 358.30 .00 .00 358.30 Bin.# Ci�jr Qi11t1�d Building 81: Safeiy Division P.O. Box 1504,78-495 Calle Tampico Permit # �` La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: Sz . -7 Owner's Name: . ' A. P. Number. Address: Z7 E o j Legal Description: City, ST, Zip: Contractor. Telephone R. h; Address: Po Project Description: N City, ST, Zip: Cd 9a 6 o H j Telephone: State Lic. #: City Lic. #.: Arch., Engr., Designer. Address: City., ST, Zip: % L a %C CGtx,', Construction Type: . Occupancy: Telephone'. State Lic. #: - . • �..•%�,w�j» Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: JC�0-4N Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project .S o00 °— APPLICANT: DO NOT WRITE BELOW THIS LINE ff Submittal Req'd Recd TRACMGr, PERMIT FEES Plan Sets Plan Check submitted ( Item Amount Structural Ca[cs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction ' r _ Flood plata play_ .___— _Pleas-resubmitted -Mechanical - Grading plan r' Review, ready for correctiionViissue Electrical - -SubcontactorList Call ed Contact Person-=--- - _-^_ Plumbing - - --- - Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading 6( $OUSE:- '"° 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