06-2041 (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: 5/16/06
Application Number: '06-00002041 Owner:
Property Address: 52883 EISENHOWER DR KALB/GALLANT
APN: 773-326-019-8 -000000- 52883 EISENHOWER DRIVE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 14000
Contractor: D /1
Applicant: Architect or Engineer: JAZO ENT INC DBA AZUL POOLS
48934 BUENA VISTA DRIVE
.� • ... MORONGO VALLEY, CA 92256 A
(760)363-6340 MAY 17 2006�lu
Lic. No.: 841585
CITY OF LA QUINTA
------------------
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: C53// License No.: 841585
�eate:� �' �G Contractor, f ?iiiLL 0�0 _ S Jl}?� •E� 7 / '
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
Data:
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
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 EXEMPT Policy Number EXEMPT
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 forthwith comply with those provisions. �J
Dates 7—o b S%Applicant: �Ji7 7ifl Cl't1) ;.1t I/ 0 • t.� tom. P`� ZCc. i:- /o 0
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, 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 ot 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. 1 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 inspection purposes. a �
Dat }_/ V orz—06ignature (Applicant or Agent): n t jJ� r n)( _ AC' /td - UL A004
Application Number . . . . . 06-00002041
LQPERMIT
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 153.00 Plan Check
Fee
99.45
Issue Date Valuation
. . .
. 14000
Expiration Date 11/12/06
Qty Unit Charge Per
Extension
BASE FEE
45.00 .
12.00 9.0000 THOU BLDG 2,001-25,000
----------------=-----------------------------------=-----------------------
108.00
Permit . . . MECH POOL
Additional desc .
Permit Fee 26.00 Plan Check
Fee
6.50
Issue Date. . . . . Valuation
. . .
. 0
•+�. Expiration Date 11-,61-2/06
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,. 11/12/06
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 11/12/06
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
LQPERMIT
LQPERMIT ,
Application Number . . . . . 06=00002041
-----=--------------------------------------------------------------
�I
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
•EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
--------------------
Paid
Credited
--------------------
Due
-----------------
Permit Fee Total 257.00
.00
.00
257.00
Plan Check Total 125.45
.00
.00
125.45
Grand Total 382.45
:00
.00
382.45
LQPERMIT ,
05/15/2006 14:21 760-992-3302 BISHOP -MAKE IT GREAT PAGE 02
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A-1 Cesspool Service, Inc.
P.O. Box 580188,.North Palm Springs, CA 92258
`Since 1959'
(760) 329-6875 Fax (760) 251-3405
State Lie. 4265214
www.alcesspool.com
BILL
CITY
JOB
JOB INVOICE
/-"' Uib AW- W5 P tOC i >1,9 iv,
SERVICE ❑ PUMP SEPTIC TANK HAS SEPTIC TANK BEEN 11UG UP? ❑ Yes ❑ No ❑ PMP. ON SITE
REQUESTED ❑ PUMP SEEPAGE PIT AT ITS RISER [IOFFICE BILLING
(
� e:4
QUANT. DESCRIPTION OF / - _91 M PRICE AMOUNT
Pumping Fee per 1000 Gallons (or fraction)I �,00�
9+�
• 6 CJ
AY
Waste Discharge Fee per 1000 Gallon�J Y
V.n
Locating and Opening Fee (114ry Min)
Out of Area Fee /
t
d e,
WWIe
�
a
^POO
IS � w t' CJ
C - c
❑ THE LEACHING SYSTEM HAS FAILED.
❑ THERE IS AN OBSTRUCTION "UPSTREAM" OF THE SEPTIC TANK.
It will be necessary to contact a tate cleaning company.
❑ WE RECOMMEND MAINTENANCE PUMPING OF THE SEPTIC TANK E VERY
❑ YEAR ❑ OTHER YEAR ❑ 2.3 YEARS
To remove built up solids. This will increase the life of your leaching system.
❑ THIS PUMPING WI LL PROVIDE ONLY TEMPORARY RELIEF AND NOT
SOLVE CUSTOMERS SEPTIC PROBLEM BECAUSE OF THE ABOVE.
❑ CUSTOMER HAS BEEN GI VEN AN "EXPLAMATION" PACKET.
• A SERVICE CHARGE OF $22 WILL BE DUE
ON ALL RETRUNED CHECKS.
A FINANCE CHARGE OF 11/2% PER MONTH; 18% PER YEAR, WILL BE
CHARGyE�D ON PAST DUE ACCOUNTS OVER 30 DAYS.
K,"%"LiLi 1cK STATE
DRIVERS LIC. q
c '�pletJ"' on of a fbove desal Ed work
SIGNATURE / / �
1 hereby adwL—r--b
Total
_r .'
Due
V