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04-6337 (RPL)Ar BUILDING & SAFETY DEPARTMENT w� IX. Box 1504 (760).777-70.12 78,-�495 CALLE TAMP.ICO FAX (76O) 777.-7011 D L"'rQU1NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 . Q �,au�c�c� BUILDING: PERMIT . Application Number 04-a0006337+YDate 9/16/04' Property .Address: -- 4.47.35 VIA- CATALINA. APIC: 604-032-999-80 -305212-' Application description POOL .- RESIDENTIAL Property.Zoning LOW.DENSITY RESIDENTIAL Appl.iGatdon valuation : 17000 Owner.. Contractor. , LENNAR.HOMES.OF CALIFORNIA CALIFORNIA POOLS & SPAS 78401 HIGHWAY 111,. STE C.. P.O. BOX 1280 :LA.QUINTA,:"'CA ..COACHELLA CA 9.2236" LA QUI,NTP;.. CA 9.2.253:: (760) 398-9,22.2. . :•WCC : STATE FUND ' WC'. 04.600.0.61168 01/01/05 CSLB:: 656128 10/31/04. - CCC':. C8 - C27 - C29.C53 Permit. MECH POOL Additional desc Permit. Fee _24.00 Plan Check Fee 6.00 Issue Date Valuation 0 Qty Unit Charge Per Extension _. BASE FEE 15.00 1.0.0 9.00.00. EA ' MECH FURNACE ;<=1;00K 9'.00 Permit BLDG POOL PERMIT Additional.desc Permit.Fee 180..00 Plan-Check-Fee'. 117.00 Issue-Date Valuation.. 1700.0 Qty. Unit Charge Per Extension BASE FEE 45:00 15:00.. 9:0000 THOU. BLDG .2,001-25,000- 135.00 Permit . . ELEC POOL PERMIT=RES. Additional desc Permit Fee 45.00 Plan Check:Fee 11.25 Issue Date.` Valuatiori 0 Qty Unit Charge Per Extension BASE .FEE 15.001 P.O. BOX 1504 78-495 CALLS TAMPICO 4'�C;�. VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (7'60).717-7011 INSPECTIONS(Z60) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: __ O— t'v337_ I Date:. . Applicant: Applicant's Mailing Addeess: Architect or Engineer Architect or Engineer's Id LIC. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby amirm under penalty of force and d a.effed: t 1 am licensed under Code, and my Lice taprovisions of Chapter 9 (conn»tamp with Seckn 7000) of DMsion 3 of the Business and Prdessbnals License Class. is ic full License No, Date Contactor ig 1 hereby etfirm under penalty of perjury that 1 am OWNER43UILDER DECLARATION exempt from the Contractors' State. License Law for the following mason (Sec. 7031.5. Business and Professions Code: 'Any statementrcounty that requires a permit he or etre is to ��' alter. Improve, demoash, or mpatr any structure. prior to its issuance. also requires lite applicant for the: permit to file a signed ons Cie pursuant to the provisions of the Contractors° State License Law (Chapter 9 (commencing with Section 7000) of DMslon 3 of the Business and the aP G� to a cNd) or he or she is exempt therefrom and the basis for rote alleged exemptlpr Any viclatbn at Section 7031.5 by any applicant for a pemdl subjects pp Penalty of not more than fire hundred dollars ($5W r U 1, as owner of the property. or my employees with wages as their $ole oanpensatlom Will do the work and the structure Is not Intended or offered for sale (Sea 7044, Business and Professions Code. The Contractors. State License Law does not appy to an owner of property who builds or Improves thereon, "who does the work himself or herself or through his or her own employees, provided -that the Improvements :are not intended or offered for safe. If. however. the building orb ovement Is,* sold wilhGi one year of completion, the ow rw4ader will have the burden of proving that he or she did not build or improve for tha purpose of sale.). U I. as owner of the property. am exclusively contraWno with licensed contractors 10 construct the project (Sea 7044. Business and Professions Code: The Contractors' State License Law does not appy to an owner of property who builds or Improves Thereon, and who oo th fix the projects with a contractor(s) licensed pursuant to the Contractors` State License Law.). U 1 am exempt under Sec _ BA PA. for this reason Date Owner. WORKERS' COMPENSATION DECLARATION . 1 hereby affirm under penalty of perjury one of the following declarations:• _ 1.iave andmill maintain a certificate of consent to selfdnsure for workers' compensation, as provided for by Section 3700' of the labor Code. for performance of the work for which this permit is Issued.. P.tava and will maintain workers' compensation insurance, esrequired by 'Section 3700 of the Labor Code, for the perfartmanmis of the work for which this Permitis Carter P rs,• �mpen sation.insurance carter and poi y��nber em: - ,1 Policy Number D 5(0/9_ I.cerLfy that. In the peAommance of the work for which this partNYis Issued, I shall not employ any person in any manner so as to become subject To the workers' forthwith comply laws of California, and agree that, if.l should become subject b 1ha workers' compensation provisions of Section 3700 of am Labor Code, I shall comply with those ns. 1. 6 . Data APPnt WARNING: FAILURE TO SECURE WORKERS' CofjPENSATION 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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 hemby affirn under penalty of perjury that there Ise construction lending agency for the perfomrenoe of the work for which this permit is Issued (Sea 3097. Civ. C.). Lenders Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application Is hereby made to the Director of Building and Safety for a pamrit subject to the conditions. and restrictions set forth on this application. 1. Each person upon whose behalf this wftos application is made, each person at e 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 Le Quirda, its officers, agents and employees for any ad or omission related to the.work nder or following Issuance of this pemmtl 2 . Any permit issued as a result of this appfication becomes null and void tf wbcic not cornrtmen within -1180 days from date of issuance of such permit. a cessation of work for 180 days will subject perdt to cancellation 1 cerUy that I have read this application and state that the above Information is 1 to y with all city and county ordinanoes and state laws.relating to building m onstruction rad here �authorize representatives of this county to upon the property for Inspection purposes. Date % Signature (Applicant or'Agent): Y Page 2 Application Number . . 04-00006337,' Date 9/16/04 Qty Unit Charge Per Extension 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE ;a 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 . 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 ONLY.' ALARMS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE -NOT INCLUDED IN PERMIT. Fee .summary Charged Paid Credited Due Permit Fee Total 282.00 .00 .00 282.00 Plan Check Total 142.50 .00 .00 142.50- ' Grand -Total 424.50 .00 .00 424.50'