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05-00004504 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05.-00004504 Property Address: 52425 VIA CASTILE APN: 772-410-998-22 -32453 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 9000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/06/05 Owner: ND LA QUINTA PARTNERS 375 N FRONT ST STE 200 U/l\_ n COLUMBUS, OH 43215. U OCT QC tor: Applicant: Architect or Engineer: 1005 C ORNIA POOLS & SPAS CITyop W SEABRIGHT INS -------- F�NaNCEp U rA C: BB1050510 �/ T CSL 656128 -------------------------------------------------- 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 m License i in fu`s. force and effect. License Class: a License No.: JS Date:�CJ -d Contractor �� 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 stateinent 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 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 01/01/06 10/31/06 ------------------ 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. 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 C8 C27 C29 C53 Policy Number - - - - - - - - - - - - - - - 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 J 3700 of the Labor C , I shall forthwith comply with those provisions. ate f 'G 1 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 buildin construction, and hereby authorize representatives of this co tfr to ant upon the above-mentioned prope for inspection purposes. Dail Signature (Applicant or Age /���. Application Number . . . . . 05-00004504 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 108.00 Plan Check Fee 70.20 Issue Date . . . . Valuation . . . 9000 Expiration Date . . 4/04/06 Qty Unit Charge Per Extension BASE FEE 45.00 7.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000•. 63.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 16.35 Plan Check Fee 4.09 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 1.35 Permit . . . PLUMBING . Additional desc Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 ---------------------------------------------------------------------------- EA PLB GAS PIPE 1-4 OUTLETS 3.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 21.00 Plan Check Fee 5.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . 4/04/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 ---------------------------------------------------------------------------- Special Notes and Comments BARBEQUE #Z21-58-1995 AND FIREPIT AGAL 496 ONLY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 7.02 LQPERMIT Application Number . . . . . 05-00004504 Fee summary Charged Paid Credited ---------- Due ----------------- Permit Fee Total ---------- 163.35 ------- -- .00 ---------- .00 163.35 Plan Check Total 84.04 .00 .00 84.04 Other Fee Total. 7.02 .00 .00 7.02 Grand Total 254.41 .00 .00 254.41 LQPERMIT Bin # City of La Quinta Building 81 Safety. Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # OS -1 210La ProjectAddresse2- !,Z.: Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor \S Telephone:„ Address:V 'U, \;2,160.* Project Description: City, ST, Zip: Loa C a'. 22: (O ` i S g Telephone.77 ,2 ` State Lic. # : rjt7 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: - Project type (circle one): New Add n Alter Repair Demo Name of Contact Person:C�(J e 7 Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 2,50 - (14a5 �s O.Z��SI � Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING., PERMIT FEES Plan Sets Plan Check submitted l v Item Amount Structural Calcs. Reviewed, ready for corrections Plan Chect Deposit Truss Cales. Called Contact Person Plan Chect Balance Energy Calcs. -Plans picked up Constructihn SOT Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue ^ Electrica*0 r Subcontactor List Called Contact Person o� \ Plumbin F —Z Grant Deed meq. Plans picked up �� �-r��C ` S.M.I. H.O.A. Approval v( v Plans r mit d������4 \� Grading IN HOUSE:- 'd Rl�jcorMecctuo /issu �Q1 A \Developer Impact Fee Planning Approval V C IIe�CC tact�Po Cj�� �.I.P.P. Pub. Wks. Appr V Dat of permi &, .( School Fees OP Total Permit Fees