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05-2575 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. Application Number: lc�05-00002575 , Property Address: 81340 LEGENDS WY APN: 762-420-008- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 Applicant: Architect old 1 - Ole a 7_A-Cl(V2 / Ti-Itt 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I reby affirm under penalty of perjury that I am licensed under provisions of C apter 9 (commencing with ection 7000) of Division 3 of the Business and Professionals C de, and,>0 cense is in full force and effect. �Li ee lass: /� Licen e N DatB:'� Contra �C� �i 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.). (_) 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.). (_) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/24/05 Owner: WILLERTON KEITH 81-340 LEGENDS WAY LA QUINTA, CA 92253 Contractor: PICASSO POOLS, INC WCC: STATE FUND WC: 1709395 CSLB: 810111 12/01/05 07/31/06 ------------------ 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. 1 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 B C27 C53. Policy Number - - - ----- - -- - - - - 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 ecome subect to the workers' compensation provisions of Section 3700 of the Labor Code, 1 h II rth h comply with those provisions. r ate: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMP NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 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.l have read this application and state that the above information is correct. I agree to comply with all city andpounty ordinances and state laws relating to building onstructi , and hereby authorize representatives of thi unty enter upon the above-mentioned property r i pectin urposes. Date: Signature (Applicant or Agentl: Application Number . . . . . 05-00002575 Permit . . . BLDG POOL PERMIT Additional desc :.. Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 12/21/05 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-251-000 117.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/21/0.5 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 12/21/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL . 30.00 YM Permit . . . PLUMBING Additional desc . Permit Fee . . . . 33.00 Plan Check Fee .7.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/21/05 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 ONLY. ALARMS/BARRIERS SHALL LQPEnfIT Application Number . . . . . 05-00002575 Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 266.00 .00 .00 266.00 Plan Check Total 130.55 .00 .00 13.0.55 Grand Total 396.55 .00 .00 396.55 LQPERMff . -. !Rin i tPermit n �I f54o ' a P. fi=b=—. b Telephone: -- `Y"::�:_ -- _ `-_ - Co=t ion Type: -_ State U.C. r. _-. - . - - Pro;ea n -pe (circle one): New Add' , .Aitcr Rx it Demo cit . St. T-1 Telep)ioflc Qt ., 11UL'��.J' 'QIST. Addre Cita•. ST_ ?iv . R I -C .cod L2 Quinb' ILY Balding. K Safety Division P.O. Box 1504, 78-41-0D.- Calle i arrpico . !a Qilinca, CA 92-73 - (760) T/7-7012 Building Permit Appficadon and Tracking S1` es. le cin-. ST. Zip: 1 clephone: — Pro; Description: Cin• Lic Total Prrme'f= Telephone: -- `Y"::�:_ -- _ `-_ - Co=t ion Type: -_ State U.C. r. _-. - . - - Pro;ea n -pe (circle one): New Add' , .Aitcr Rx it Demo 1�lame'nfCotaact?etson: S.q.'rt: f Stories L'rits Telcomne of Cbntaa Person: nuM& - 4 to®© -mated Value of Prom AF°PLICANT: DO NOT WRITE BELOW THIS LINE .� R I Submi=d I Req'd I R --'d TRACKING CP�`.ffT FEES Plan sem I I Pian Check- submitted Avo �23! Item I Amount Stru[eral %.ales. I I Reviewed. ready for corrections , Plan Check Dppas�i I Truss Calms Called Contact Person. I Pian Check Bzfanc- -Title _ C -:n Pians picked upI Construction i I Flood plaice plan I I Plans resubmitted I Mccizaniczl I. Grading pin Rminc. r=dv for corrtctionsitssue I EI=ricnI _ Subcnu'==r List I Called Contact Prison I PSumbirt^ Gcatu Des I Pians picked up SM1I_I. I HCJ,�.AFProval I P12ns rtsubminrd Grading TN HCaUS - I ( '"Revir'W. read_• for corrmnonsAssuc ` Dc:•cioper Repan Fcr Tianaing approval -I: I Called Contact Ptrsan n_LP.P. I I.Pub.,wh&.Appr I Datoorpermitissue Total Prrme'f=