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05-0278 (RPL)BUILDING &: SAFETY DEPARTMENT P.O. BOX 1504 ,M �' y�.''(760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777=7153 BUILDING PERMIT 7 * Application Number 05-00000278 Date 1/28/05 Property -Address . . ... 78330 VIA DIJON APN: 604-032-999-20 -305212- Application description'. POOL'- RESIDENTIAL, Property Zoning . .LOW DENSITY RESIDENTIAL Application valuation_*. . . . ;17000 Owner Contractor LENNAR HOME 7.8401 HIGHW LA QUINTA,. LA QUINTA CALIFORNIA PODLS & SPAS P.O. BOX 1280 COACHELLA CA 92236 (760) 398-9222 WCC: SEABRIGHT INS WC BB1 050510 01/01/06 CSLB: 656128 10/31/06 CCC: C8 -C27 -C29-053 Permit. . .. . . . . BLDG POOL PERMIT. ----------------- Additional desc Permit Fee 180.00 Plan Check Fee 117.00 Issue`Date Valuation - 17000 Qty Unit Charge, Per. Extension BASE FEE ,, _ �� ,.1x,45.00 15.00 ----------- --------------------------------------------- 9.0000 THOU. BLDG 2,001-25,000 `------------------- 135.00' PermitELEC 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 SWIMMING POOL 30.00 Permit PLUMBING ------------------- Additional. desc. , Permit Fee,..... 33.00 Plan Check Fie •8.25 Issue Date . . . . Valuation .0 Qty Unit Charge 'Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTUREi 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP '3.00 1 . OOL 3.0000 EA ; PLB GAS PIPE 1-4 OUTLETS ----------------------- 3'.00 ---------- P.O. BOX 1504 • '�C�� 78-495 CAL LE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number:00 Applicant: nn - niY'IC_ Applicant's Mailing Address:oil V Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: -2 • /' D Architect or Engineer's Address: 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 Licen is I force and effect. /��/� „/ License Class ,_` icen No. b x OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 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).): U 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.). (--) 1, 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. for this reason Date 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 maintai workers' compe . sation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is J ire M yvgrkcompensatio onsurance carrier ninu re. Cartier �Yi{y �� iolicy Number _ 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 th , i ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ateJ11,05 Applicant WARNING: FAILURE TO SECURE W KERS' 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 t 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 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 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 cored. gree to mply with all city and county ordinances and state laws relating to building /construction, and hereby authorize representatives of this county to enter upon bov ntio property for inspection purposes. Dat._I2AJ Signature (Applicant or Ageto ): Page 2 Application Number . . . . . 05-00000278. Date 1/2.8/05 .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..00 9.0000 EA MECH FURNACE <=100K 9.00 ----------------------------------------------------------------------------- Special Notes and Comments POOL & SPA. 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 QO 142.50 Grand Total 424.50 .00 C-0 424.50_