The URL can be used to link to this page

04-5545 (RPL)o� 0 B-JILDING & SAFETY DEPARTMENT u�.+o c� P. Ox 1504 (760).777-70 12 OF a 78- CALLE TAMPICO 'FAX (760),777-7011 D LA NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760),777-7153 G JUL 2 1 204 BUILDING PERMIT CITY OF LA QUINTA Fd E.DEPT* k a on Number '`0-4=•00005545 - Date 7/16/04 Property Address . . � 443,8-0 VTA'•'CORONAD0 APN:, 604-211-037-44 -23971. Application description POOL RESIDENTIAL Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation . . 15000 Owner Contractor ZENS MARK THOMAS OWNER. 44380 VIA CORONADO LA QU�INTA CA 92253 Permit .MECH POOL Additional desc Permit Fee . . 24.00 Plan Check Fee 6:00 Issue..Da-te Valuation 0 Qty Unit Charge Per- Extension BASE rFEE . :.. r� : t""15.00 - a ., ti .1-00 9.0000 EA MECH FURNACE <=100K., 9.00 Permit . . BLDG POOL PERMIT Additional desc Permit Fee 162.00 Plan Check Fee 105.30 Issue. Date. Valuation 15000 Qty .-Unit Charge Per Extension" BASE FEE 45.00 13.00 9.0000 THOU BLDG 21001-25,000 .117.010 Permit . . ELEC POOL PERMIT -RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . -Valuation . . 0 Qty .Unit Charge Per Extension BASE FEE 15.00 1'.00 30.0000 EA ELEC PRIVATE SWIMMINJ POOL 30.0.0 Permit . . PLUMBING Additional desc Permit Fee . . 33.00 Plan Che.::k Fee=-. 8.25 dwo% P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: Architect or Engineer: r Architect or Engineer's A d' s: Lic. No.. BUILDING PERMIT DECLARATIONS 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 License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profe sions 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 thescant to a civil penalty of not more than five hundred dollars ($500).): 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 or 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.). U 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.). U I am exempt under Sec. BA P.C� this reason . 1-Y Date 7 �i / WORKERS' 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: Cartier Policy Number 1 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. 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. 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 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 applicafion. 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 Ouinta, 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 to enter the above-mentioned property for inspection purposes. Date q Signature (Applicant or Agent): IN i Page 2 Application Number . . . . . 04-00005545 Date 7/16/04 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6:0000 EA PLB.F.IXTURE 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 PLACR PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee•summary Charged Paid Cre3ited Due Permit Fee Total* 264:00 .00 .010 264.00 Plan Check Total 130.80 .0.0 :00 130.80 Grand Total ; 394.80 .00 .00 394.80 j l • .., �,, CITY. OF LA QUINTA SUB -CONTRACTOR IST CV/ d �Jn1c� PERMIT NUMBER'. OWNER ��i� c - BUILDER �f�" ' JOB ADDRESS � � � -D% _ This form shall be'posted on the job with the Building InspectionZard.at all -times in a-consoicuous place. Only'-p_ersons.appearing on this list or their: employees are authorized to -work on this job.` Any changes to this list must be approved'by.,the Building Division prior to.commencement of work. Failure to comply will result in a stoppage of work and/or .the voidance of building permit. For each applicable trade, -all information requested below, must' b'e,completed:by applicant:_ "On File" is not:an acceptable response. ...... .. ........ Td3rlo 1 !`IAct�fihAtiAFf I :.::.:.:::::::::.:::::...................... ContfeCto Stat¢ ConttBCt or s L�cessse :::. workers Cons f tlCe::::::.:................................. P ensat�on.lnsu .a .........:....1..::...........:.................................... y Nuber. Licensem. Ex .Date Carrier Name Policy Exp. DateLClassification lc en se Nuber m.. < .x . Da te�� C-81 xxxxxx1 z xx xx1 State Fund CaIComP1 e. . (Format 1xx xxxx1xe.9•AB (2kx xx/xx xx1 ` .....::.. :; .....;:.:.:::: 0 t=ARTH �J �Q. n!i O Z1 O- 3/ 0 D O O 57k — OZ t O$ O z- cbNCRET�:I.c: 81.:::::> ;:::: L 1'V1 c, y. x - - SRAM.::::;>...... _ ................................ STRUCT STEEL::{C:Sa:.:»s: - -,.: t . MASONRY (C 291 ::::':........: -.- PLUMBING IC 361 2eZ (, $3 �' . �/ 30 0 tAiJ _ i /. -3 ::I;ASTi=R>LC. 3,..1.:::::. 3 O �• Z Z t , 2 0 e' 9 ..........::.:... r _ cTIICAL (c II31>(.. 6 G� 3 S D.G. 571�,,�s 2Joe ( t o r .. N> . 00 � � ^ • -_ . 4 - SHEE7IVIET.=431 1 a , _ t •L t VE 0 IN - - 7 _ _.. ..:::::::.. GLA INes C'.:-- 7: ;::.:::::.::.:::::::.. - A o - n .. ....::::::.: ....:::.:::.. PAINTING {G«33J:: 1 , CERAMIC CILE tC A. • I-DirlZ r , , Y F , , � �,;. CABINETS �.. .. - •. r ; n • J .. I� ,