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07-1909 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description Property Zoning: Applicaijon valuation: Applicant: 07-00001909 52385 VIA CASTILE 772-410-998-19 -32453 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 15000 Architect or Engineer: 01/k ------------------ 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 Class: B C27 C53 License No.: 810111 Date:% I^W7 Contractor: OWNER -BUILDER DECLARATION 1 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 155001.: (_ 1 1, 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.). I 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: LQPER111IT Owner: JACK "J.J. DUDUM.DR. 52-385 VIA CASTILE LA QUINTA, CA 92253 (510)502-9885 Contractor: PICASSO POOLS INC 78078 COUNTRY CLUB BERMUDA DUNES, CA (760)345-4600 Lic. No.: 810111 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/29/07 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: . 1 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 STATE FUND Policy Number 290-0001790 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�sha/ll forthwith comply with those provisions. Date! (�� Applicant: 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county toenter upon the above-mentioned propert i spection p es: Date:7 C$ oed / Signature (Applicant or Agen Application Number . . . . . 07-00001909 Permit . . . . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 12/26/07 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.000.0 ---------------------------------------------------------------------------- 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 12/26/07 Qty Unit Charge Per Extension BASE FEE 1S.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 . . 12/26/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 -------------------------------7-------------------------------------------- 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 12/26/07 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' -----------------------------------------------------7---------------------- Special Notes and Comments POOL, SPA, ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number . . . . . 07-00001909 ---------------------------------------------------------------------------- Special Notes and Comments, PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 260.00 00 .00 260.00 Plan Check Total 129.80 .00 .00 129.80 Grand Total 389.80 .00 .00 389.80 LQPERMIT IPS C 1 y o a Quinb BLuMp . az Saf-ery. Division P:O. Bax I.504, 78 :-9'.Cabe Taal; i=. La QWnra, Cfi 92ti3 - (760) 7i7=7012 BLdil Permit Appfic2don.and Tracking.�h;z ,. , ,1 �F .4 j Jo Pm= Addr-S A.. P.13t�Dcr Adores . .�02- 3 85 lt, _--1 D==ir6om Ciw. ST. Zip: dcphonc Cott�t zo 1 p /0 6�-988 Ate` ` ' l Pray Ucscrmnaa. , r. Cm.ST.iapj� T6#bon 'st3L1_S. 4 ' - OI 1: I Chy L.ic-s: � .� t y - - Cin',-St mp- Tcl.=hon--:- _ -= ;= `L--- _ - Con=crion Typc Stab Wit"_: Prtij= ttipc (arde a=):Tv`.r 4dd'n .�it_r P.� Demo. -t�ame!tsf Eo>Batz?ersor� I SQ_ FL: I r Stori= l U'rits Tdmnc �i C�ntaa Person —� �p®® ed Value orProic= R I 1 - APPLICANT: DO NOT WR=E BELOW THLS L:INc Subraiaal Req'd i JL='d TRACRUNG ..... ' PEPMITT man G� I I Plan Checksubmitted :. Isom Amount Sn-.term Calm I I Reviewed- read• for-corrcctious I Plan Check Dcg sit Truss Calms Called Contact Person. Plan Check 112.12ncr Ttit.9 Cis Plans picked up I Conaxrnetion I TTood plain pian I Plaru resuburin:d I �Ieeianical Gradin-, psn I „ Revinr. readv for correetionsl- sue El_-aricai Subeontaor Lst ' I Called Contact Pei-sonI plumbing �ianS D i I Plans picked ug 'sRt 1. 1 Ii 0A_AFprvwai I I I'Plaas rtsubmined Grading INHCaUS=- I '' Revirw. r=d' foreorrenioo_iirssue Doti-toper Impar ice -PZnming praval ( Called Contact Person I.PuhL Wks 4ppr I Dztc or permit i�uc 1 :Schond.F I 1