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07-2953 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 /Application Number: 07-00002953 !Property Address: 53629 VIA DONA APN: 772-420-999-37 -298944- Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 57000 T4t!t 4 aCP Q" Applicant: Architect or Engineer: IV� n� IV BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- NSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of pe9thatm licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the d Prof ionals Code, and my License is in full force and effect. License CI ss: C53 LicenseNo.: 598681 Date: (� d Contractor: OWNER -BUILDER DECLARATION I herahy affirm under penalty of pem exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Burofessions 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 1$500).: (_ 1 1, 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 ISec. 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.). 1 ) 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 Owner: O'BRIEN RESIDENCE 53-629 VIA DONA LA QUINTA, CA 92253 Contractor: AINSWORTH POOL CONSTR, 40900 GLENMORE DRIVE PALM DESERT, CA 92260 (760)200-2800 Lic. No.: 598681 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/14/07 ROBERT ------------------------------ WORKER'S COMPENSATION DECI 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 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 _CALIF INS Policy Number 460030110103 I certify that, in the perf man of the ork for which this permit is issued, 1 shall not employ any person in any mann r so as t beco subject to the workers' compensation laws of California, and agree that, if I hould be ome bjact to the workers' compensation provisions of Section 3700 of the Labor ode, I s ith comply with those provisions. Date: "1 (- V Applicant: WARNING: FAILURE TO SECURE W RI' RS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI A 11 NALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIO 0 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 1 have read this application and state %theove formation ' correct. I agree to comply with all city and county ordinances and state laws relatingruction nd hereby authorize representatives of thisc myoto enter upon the above-mentioned io urPoses.Date:t / Signature (Applicant or Agent Application Number . . . . . 07-00002953 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 446.'00 Plan Check Fee 289.90 Issue Date Valuation . . . . 57000 Expiration Date 5/12/08 Qty Unit Charge Per Extension BASE FEE 414.50 7.00 4.5000 --------------------------------------------------------------------------- THOU BLDG 50,001-100,000 31.50 Permit . . . MECH POOL Additional desc . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date . . 5/12/08 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 5/12/08 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 . . 5/12/08 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 Application Number . . . . . 07-00002953 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged ----------------- ---------- Permit Fee Total 550.00 Plan Check Total 315.90 Grand Total 865.90 LQPERMIT Paid Credited Due -- - - - - -- ------ - - - - - - ---------- .00 .00 550.00 .00 .00 315.90 .00 .00 865.90 T Bin # City of La Quinta Building U Safety Division . P.O. Box 1504, 78-495 Calle Tamrico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tacking Sheet Permit # ►-I� Z�y3 Proj Address: Owner's Name: NVI IMI A A. P. Nu • er: 5 (0 2-q V lA PCNA . Address: Sl-6Sl-kL Uy Ohiffi- Legal Description: City, ST, Zip: LA CA Contractor: P-4N3W6MY N 2 111114 Telephone: Address: G R4 v t,-JIL r 7 R. Project Description? St'`�')M�" Q D 3SPAi City, ST, Zip: (_P dwi R GA Telephone: 106 _ If -08 State Lic. # : I City Lic. #: Arch., Engr., Designer: S I Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: , S 1 Estimated Value of Project: odd APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING . PERMIT FEES Plan Sets Plan Check submitted I) I3 Itemm Amount Structural Calcs. Reviewed, ready'for corrections Plan. Check Deposit Truss Calcs. Called Contact Person Plan. Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plu¢ bing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Gracing IN HOUSE:- ''d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.E.P. Pub. Wks. Appr Date of permit issue School Fees Tota_ Permit Fees ����� alae 5uye re�s.s �`""hl O K, 0 aVA6= tVid dlCW5CPuVa C 0ffjre pt.