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06-1107 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 06-00001107,. 52605 VIA CASTILE 772-410-998-27 -32453 - STRUCTURES OTHER THAN BUI LOW DENSITY RESIDENTIAL 8000 Architect or ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ND LA QUINTA PARTNERS 375 N FRONT ST STE 200 COLUMBUS, OH 43215 ARXContractor: 02406 CALIFORNIA POOLS & SPAS P.O. BOX 1280 MgN�a� Q(/�NT COACHELLA, CA 92236 (760) 398-9222 LiC. No.: 656128 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: C8 C27 C29 License No.: 656128 Da Contractor _T+� O NER-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 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 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: 3/17/06 --————————————————————————————————————————————— 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 HRH INS Policy Number BB1060510 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 s all forthwith comply with those provisions. Da</ Applicant WARNING: FAILURE TO SECURE WORKES' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES 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 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 con [ruction, and hereby authorize representatives of this cou ty to enter upon the above-mentioned prop y e tion purposes. Dat Zo Signature (Applicant or Agent): a Application Number . . . . . 06-00001107 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 99.00 Plan Check Fee 64.35 Issue Date . . . . Valuation . . . . 8000 Expiration Date 9/13/06 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 54.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 2.25 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 5.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000'EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB GAS PIPE 1-4.OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments BARBEQUE (Z21-58-1995) AND FIREPIT (AGAL 496). ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 6.44 Fee summary Charged --------------------------- Paid Credited ---------- Due Permit Fee Total -------------------- 140.25 .00 .00 140.25 Plan Check Total 73.91 .00 .00 73.91 Other Fee Total 6.44 .00 .00 6.44 Grand Total 220.60 .00 .00 220.60 LQPERMIT Bin # City of. La Quinta Building U, Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 5;2405- `f l.,P— Owner's Name: u IC�. Cc, Qs'v.�. A. P. Number: Address: Legal Description: City, ST, Zip: Contractor420. Y1�5 Telephone: Address: ��© !2-3-6p Project Description: City, ST, Zip• .CA.. 2- Z3 G t C Telephone:.%� Total Permit Fees State Lie. # : 2 City Lie. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lie. #: Construction Type: Occupancy: Project type (circle on_e): Add'n Name of Contact Person: D Alter Repair Demo Sq. Ft.: #Stories: #Units: Estimated Value of PrgJ • . 4', O o 0 Telephone # of Contact Person: # Submittal Req'd APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 3 Item Amount Structural Calcs. Reviewed; ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Flood plain plan Plans picked up Plans resubmitted Construction 5078 Mechanical Electricak Grading. plan' Subcontactor List 2°" Review, ready for corrections/issue Called Contact Person 3• F�I�TuR E5 Plurobinglp _ mv�l�.l Grant Deed Plans picked up H.O.A. Approval Plans resubmitteYrading IN HOUSE:- 3.e R e v,,�e d or e De eloper Impact Fee Planning Approval Called tieh�e�rsot� A.I. Pub. Wks. Appr Date of rmit is ue School Fees 19 r Total Permit Fees