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04-5311 (RPL)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number0477Q0;005.31.1 Date 7/01/04 ,Property Address . . . . . . 81260 LEGENDS WY APN: 762-420-021- - - Application description POOL - RESIDENTIAL Property Zoning . . . . . . . ,LOW DENSITY RESIDENTIAL Application valuation . . . . 13000 Owner Contractor TOLL BROTHERS INC. CALIFORNIA POOLS & SPAS C/O KEVIN DUERMIT CP�.O. BOX 1280 8901 MOUNTAIN VIEW 200 0 NCOACHELLA CA 92236 SCOTTSDALE AZ 85258("7610) 398-9222 CC: STATE FUND Gv�S�WC: 04600061168 01/01/05 ag G�a'�QCSLB: 656128 10/31/04 CCC: C8 -C27 -C29-053 ------------------------------- - - ---- -------------------------------------- Permit . . . BLDG P,�QOL`__PERMIT Additional desc Permit Fee 144.00 Plan Check Fee 93.60 Issue Date . . . . Valuation . . . . 13000 Qty Unit Charge Per Extension BASE FEE 45.00 11.00 9.0000 THOU BLDG 2,001-25,000 99.00 ---------------------------------------------------------------------------- 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 9.00 ---------------------------------------------------------------------------- Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per BASE FEE ' Extension 15.00 P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 75 Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.. t3UILUING PERMIT DECLARATIONS L CENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C e, and ss LicenW is i ll rce and effect. / / 'cense Class Lic Date!� ons tractor �ER'BUte License DECLARATION I hereby affirm under penalty of perjury th 1 am exempt from t e Cont ors' 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, , 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 Contractors' 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).): U 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 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, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U 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.). U I am exempt under Sec. , BA P.C. for. this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury 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 i su d. My,�Prkers' cor�pensati0 nce carri and number ar . 11 artier �] ' � /��l f,,h t Policy Number cert' that, ifi the performance of the work for which hi emit is is ued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cai fom, , and agree tha if sh uld becom subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p isions. --Crate 7 x/ 0 Li n/,�,�Ir" r L. WARNING: FAILURE TO SECURE WOR ERS' COMPEkSA;Pi COV RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH SAND DOLLARS ( 00,00 , IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTO S FEES_ 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 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 s _ defend, indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being erf ed un er or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is o mmen 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 info anon is core I a re to comply ith all city and county ordinances and state laws relating'to building construction, and hereby authorize representatives of this county to ter upon the ove a 'tined p perty for inspection purposes. ategnature (Applicant or Agent): Page 2 Application Number 04-00005311 Date 7/01/04 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 w Special Notes and Comments SPA, FIREPIT (496 AGAL) ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due ----------------------------------------------- Permit Fee Total 246.00 .00 .00 ---------- 246.00 Plan Check Total 119.10 .00 .00 119.10 Grand Total 365.10 .00 .00 365.10