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05-1508 (RPL)' BUILDING SAFETY DEPARTMENT P. 1504 (760) 777-70.12 78-4 ALLE TAMPICO FAX (760) 777-701-1 A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 c►ty®R�, BUILDING PERMIT iaa++�� Application Number 05-00001508 Date 5/05/05 Property Address . . . . . .. 81385 LEGENDS WY APN: 762-420-039- - - Application description POOL - RESIDENTIAL Property Zoning.. LOW DENSITY RESIDENTIAL Application valuation 15000 Owner Contractor --------------------------------- --------------------------------- DORENBUSH PICASSO POOLS, INC 81-385, LEGENDS WAY.. WCC: STATE FUND LA QUINTA, CA 9.2253 WC: 1709395 12/01/05 CSLB: 810111 07/31/06 CCC: B C27 C53 P.O'Box 1504 • ►tlr� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: S— Applicant: Applicant's Mailing Address: ila -« MK Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 de, and my Licgg��se is in full force and effect. p icense Class G f1 'I 3 License O /iD ®Ate �/ s Contractor z '�-,�.S O OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 1, 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.). L) I am exempt under Sec. , BA P.C. for this reason Date WORKERS' 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 insurancecarp and policy number are: �rrier iekna Policy Numb 1709.395 _ I certify that, in the performance of the work for which this permit is issued, 1 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 t;se�pisions. a� to Appli 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. CONSTRUCTION LENDING AGENCY 1 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 _ 444 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 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 1 have read this application and state that the above into ation 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 ter upon the above-mentioned prop for inspection purposes. Date Signature (Applicant or Agent ---------------------------------------I------------------------------------ �. Application Number . . . . . 05-00001508 ---------------------------------------------------------------------------- Permit . . . . . . Additional desc . . Permit Fee . . . . Issue Date. . . . . Expiration Date . . BLDG POOL PERMIT 162.00 10/19/05 Plan Check Fee . . 105.30 Valuation . . . . 15000 Qty Unit Charge Per. Extension BASE FEE 45.00 13.00 9.0000 -------------------------------------------------------- THOU BLDG 2,001-25,000 ------------------- 117.00 Permit . . . . . . MECH POOL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date'. 10/19/05 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 . . . . 75.00 Plan Check Fee 18.75 Issue'Date . . . . Valuation . . . . 0 Expiration Date 10/19/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 60.00 Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 39.00 Plan Check Fee 9.75 Issue Date . . Valuation . . . . 0 Expiration Date 10/19/05 Qty Unit Charge Per Extension BASE FEE, 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 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 & WATERFEATURE ONLY. BBQ BY SEPARATE PERMIT. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ---------- 300.00 -------------------- .00 .00 300.00. Plan Check Total 139.80 .00 .00 139.80 Grand Total 439.80 .00 .00 439.80 ury or La quin.ra Building ar Safety Division Permitl P.O. Box 1504, 78-•495. Calle Tampico . La .Quinn, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet .JC Project Addr-m: e I Aja Le 'k0,-%rners Name: J1y `ice -4 ;X .)e A. P. Nurdber- Legal. escription:. Contractor- PIC'(1c;S0 Address: Cin'. St. -Zip: Telephone:3q,5-- State Lie. *: Arch- Eng:_ Designer: Address: Cirv. ST. Zip: Telephone: State Lic. #: Nameiaf Contact Person: *-Telephone # of Contact Person: Submittal Req Plan Check Deposit Plan Sets Called Contact Person j i Structural Cala. Plan Check Balance Truss C21cs. Plans picked up Titre 24' Cafes. 71bod plain pl2n Mechanical Grading plan 2' Review. ready for cor-rectionsriss-ile Subcont2ctor List Electrical :Giant Deed Called Contact Person 1 R.O.A. Approval IN HOUSE: - S.M.l. 'Planning Approval .'Plans resubmitted Pub. Wks. Ap!pr Grading School Fees "'Review. ready for correctionsrissue 'Address: 07 f3 I City. ST..Zip:Lo - Telephone; Project Description: Lic. ... .. ...... ..... - - - - - - - - - - J Construction Type: Oca;panq Project type (circle one): NeerAdd'n Alter Repair Demo Sq. FL: Stories: Units: scls- Estimated Valu . e of Project. /Z e0i) APPLICANT: 00 NOT WRITE BELOW THIS LINE d l Rec'd TR..kCKING PERMIT FEES Plan Check submitted Item 4mount Reviewed. ready for corrections Plan Check Deposit Called Contact Person j i Plan Check Balance Plans picked up Ctinstruction Plans resubmitted Mechanical 2' Review. ready for cor-rectionsriss-ile Electrical Called Contact Person 1 Plumbing Plans picked up S.M.l. .'Plans resubmitted Grading "'Review. ready for correctionsrissue Developer Impact Fee Called Contact Person AJ.P P. Date of permit issue Total Permit Fmc