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05-3875 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA .92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: c0: _L 0 3875' 81300 LEGENDS WY 762-420-012- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 15200 Architect or Engi Ta!t " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 ,R FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: KIA 81300 LEGENDS WAY LA QUINTA, CA 92253 Contractor: PICASSO POOLS, INC WCC: STATE FUND WC: 1709395 12/01/05 CSLB: 810111 07/31/06 Date: 9/02/05 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Da tiS Contract 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 OWNER -BUILDER DECLARATION - insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier B C27 C53 Policy Number - - - - - - - - - - - - - - - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I s all forthwith comply with those provisions. 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 ($5001.: Dale% " S Applicant: (_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby madeto the Director of Building and Safety for a permit subject to the . 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) I am exempt under Sec. B.&P.C. for this reason 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. - Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). 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. er's Name: Lener's e:—f-05ignature (Applicant or Age .. LendAddress: LQPERMIT Application Number, . . . . . 05-00003875 Permit BLDG POOL PERMIT Additional desc . . . Permit Fee . . . . 171.00 Plan Check Fee 111.15 Issue Date Valuation •. . '15136 Expiration Date 3/01/06 Qty Unit Charge Per. Extension BASE FEE 45.00 14.00 9.0000 ---------------------------------------- THOU BLDG 2,001-25•,000 --------------------------------- 126.00 Permit . . . MECH POOL , Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . - Valuation 0 Expiration Date 3/01/06 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 3/01/06 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 3/01/06 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 Permit . . . . . . WALL/FENCE PERMIT LQPERMIT LQPERMIT Application Number . . . . . 05-00003875 Permit . . . WALL/FENCE PERMIT Additional desc - Permit"Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 64 Expiration Date 3/01/06 Qty Unit Charge Per Extension BASE FEE 15.00 -------------------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. 4 L.F. 4' EQUIPMENT BLOCK WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited Due ~~ Permit Fee Total 290.00 .00 .00 290.00 Plan Check Total 137.15 .00 .00 137.15 Grand Total 427.15 '.00 .00 427.15 LQPERMIT Iain # C1�y Lq Quin b Bwl&d . &Safety Division P.O. Boz 1.504, 78-s 9S. Calle Tampico . Scitood.F'� I � . I Total Permit+pots f 4 1 Permit my La Quirts, CA 51 3 - (760) 777-7012 ' Building Permit Application and Tracking Sh; F., �✓, I Pmjtxt Addi•.ss:: meas T�iamc: • Sl-�D t � A P. N=b= �Addr=: O D LcgiL.Dsaiprion., Cin•. ST. Zip:ai2&, 04d, `-S I Cottttaear 7VT elcphone: Addres< `l e' l P *ct Description: X (� f j Ctn•. ST, Z:tp .4 Telhonc:OW)a40-4600(D x !' StateLs. � : a I Citm• Lim r: ��� � L F CA t Arc E=_ Jt. -_-n S. Addt—_ Cray. sm Ta' Telephone: _ -_ --- - - - < '<-::' CatLstrocrion l ype_ c?ca Fes': _ '>;- • ::- .. Stan Lie r: - -- - -- _ PT n Pe (eit cie one): Tvetr Add'n .Ait`r P --par. Demo 1�Iame!of Cotsact?etson: 5.9. FL: Stories I L`rits Telepoanc �f C?ntaa Pinson: d �p�® mated Value ofProlC= 415 Q APPLICANT: DO NOT WRITE BELOW THIS LINE I R I Submitral I Rcq'd l Rec'd TiLaC JNG PERF.fIT FEES TUB Sets ) Plan Check submitted I L(� Item' I :Amsunt Strucuuml `'ales I I Reviewed. reach- for corrections I Plan Check Dcpos�t 1 Truss Cale I ailed Contact Person. Pian Check B-fanct •Title 24 Cess � Plans picked up I \ Construction I 'Mood plaia Plan I I Plans resubmirt.d I �tecbanical IBrading pan I I „ Rmim. rcadv for rorrcctionshssue - Elcrtrieal Subeon*mmr' List ' I Called Contact Person I Plumbic: G'raat Deet? Pians picked up S_ti1_l. H O �.AFProval I Plans resubmitted Grading 'IN ACaUS__ i I ''"-Review. readv for correetiottsfissue Developer impact Fee Pianming Approval 'i: Called Contact Person j I .Pnb.Wlts kppr I Date of permit issue Scitood.F'� I � . I Total Permit+pots f 4 1