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05-5338 (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: L05-00005338 } 52265 VIA CASTILE 772-410-998-11 -32453 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 15000 T,iht 4 4 Q" Architect or Engineer: P l4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT DfD 0 7 -,IV-, aas -------------------------------------------------- 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 Classy,C8� C27 C29 License No.: 656128 �ate:IZ T �� ractor: 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).: 1 _ 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 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 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: 12/06/05 Owner: ND LA QUINTA PARTNERS 375 N FRONT ST STE 200 COLUMBUS, OH 43215 Contractor: CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 ------------------ 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 SEABRIGHT INS Policy Number BB1050510 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. te: � pplicant: 17— WARNING: FAILURE TO SECURE WOR ERS' 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 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 I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building ns,,uction, and hereby authorize representatives of tc unty to enter upon the above-mentioned property fo/his�/spection purposes. atm e: i ure (Applicant or Agent): Application Number . . . . . 05-00005338 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 14664 Expiration Date 6/04/06 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 26.00 Plan Check Fee .6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/04/06 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 6/04/06 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 . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 Application Number . . . . . 05-00005338 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 336 Expiration Date . . 6/04/06 Qty Unit Charge Per Extension BASE FEE. 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SLA, 21 L.F. 4211 -EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION Fee summary Charged ------------------------------------- Paid Credited ---------- ---------- Due Permit Fee Total 275.00 .00 .00 275.00 Plan Check Total 129.80 .00 .00 129.80 Grand Total 404.80 .00 .00 404.80 LQPERMTT Qin # Permit # �3 b Project Address: J'52--,?& i A. P. Number: Address: U -d -go City, ST, Zip: Telephone:7630122 State Lic. # Arch., Engr., Designer: lyr Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: ^� Telephone # of Contact Person: -0- # Submittal Plan Sets Structural Calcs. Truss Calcs. Energy Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: Address: City, ST, Zip: Telephone: Project Description: 922 5(:� City Lic. #: : Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Estimated Value of Project: ll3esS0- APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACKING . Plan Check submitted Reviewed, ready for corrections PERMIT FEES Item Amount Plan Check Deposit Called Contact Person Plan Check Balance Construction Plans picked up Plans resubmitted Mechanical Electrical 2ad Review, ready for corrections/issue Called Contact Person Plumbing Plans picked up S.M.I. Grading Developer Impact Fee Plans resubmitted Review, ready for corrections/issue Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees 15000 336 I yam'