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07-1025 (RPL)1. - ('. - e P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-4bt- 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: �07-0_0_01025 , — Property Address: 53340 VIA DONA-- APN: 772-420-999-19 -298944- Application description: POOL RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL -Application valuation: 20000 Applicant: n Architect or Engineer: Owner: MIKE JEHA 53340 VIA DONA LA QUINTA, CA 92253 Contractor: MCINTYRE POOLS 83695 AVENUE 45 INDIO, CA 92201 (760)342-3612 LiC. No.: 6146 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 • CITY OF � Q(� Date: 4/04/07 1111 . ----------------------------- -- fl -et- INrA---- ' - LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION N I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section70 01 of Division 3 of the Business and Professionals Code, and my License is in full force and effect. - I have and will maintain a certificate of consent to self -insure for workers' compensation,'as provided - License I ss: C53 License No.: 6146_11 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate: ontractor.� - - 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: - hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier MAJESTIC INS CO Policy Number 020060333602 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,. permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section , 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 - 3700 of the labor 1 shall forthwith comply with those/provisions. _J any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 6 plc.nt: t/ 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL . Contractors' State License Law does not apply to an owner of property who builds or improves thereon,, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND " and who does the work himself or herself through his or her own employees, provided that•the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ 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.). APPLICANT ACKNOWLEDGEMENT (._ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. _ IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of - conditions and restrictions set forth on this application. ' property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to'any permit issued as a result of this application, (_ 1 I am exempt under Sec. , BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City Date: Owner: r CONSTRUCTION LENDING AGENCY 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT 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. 1 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 ou to enter upon the above-mentioned pr rty r inspection es /pure ature (Applicant or AgentL'tw V ' �� LQPERMIT Application Number . . . . . 07-00001025 Permit . . . BLDG POOL PERMIT INV FEE Additional desc . Permit Fee 414.00 Plan Check Fee 134.55 Issue Date Valuation . . . 20000 Expiration Date 10/01/07 Qty. Unit Charge Per Extension BASE FEE 90.00 18.00' 18.0000 THOU BLDG 2,001-25,000 324.00 Permit . . . MECH POOL Additional desc- escPermit PermitFee. . . 26.00 Plan Check Fee 6.50 Issue Date . . . Valuation 0 Expiration Date 9/30/07 Qty Unit Charge Per Extension BASE FEE' 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 Permit . . . ELEC.POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan .Check•Fee, 11.25 Issue Date Valuation 0 Expiration.Date 9/30/07 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 'Fee :.: 8.25' Issue Date Valuation . . . . 0 Expiration Date : 9/30/07 Qty Unit Charge Per Extension BASE FEE 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. ALARMS/BARRIERS SHALL BE IN LQPERMIT Permit # r� �O -- L 1f Project Address: A. P. Number: Legal Description. X Contractor: P-z•7t i� Address: A A City, ST, Zip: —.F7ry Jbb X Telephone ��Z '— �QL A State Lic. Arch., Engr., Designer: Address: City. ST. Zip: Telephone: State Lic. !J: 1C Name of Contact Person: 'ME -- X Telephone it of Contact Person: p Submittal Plan Sets Structural Coles. Truss CAICL Energy Coles. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval M HOUSE: - Planning Approval Pub. Wks, Appr School Fees City of Lauin Q to Building 8 Safety Division P-0- Box 1 SO4, 78-49S Calle Tampico La Quinta, CA 922S3 - (760) 777.7012 Building Permit Application and Tracking Sheet ' Owner' ' s Name: Address: �U VIA ` City. ST. Zip: mac• , .�.A� �� ,�� ;Telephone: -• :-.r. Project Description: Lic. q: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:q Stories: N Units: -04, stimated Value of Proiec AreU%-ANT: DO NOT WRITE BELOW THIS LINE Reed TRACKMG Plan Check submitted Reviewed. ready for corrections Called Contact Person Plans picked up Plans resubmitted Pi Review. ready for correctionsAssue Called Contact Person Plans picked up Plans resubmitted 3w Review. ready for correctionsAssue Called Contact Person Date of permit Issue PERMIT FEES Item Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing ------------ S.�t.l. Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount r� 1 ,'