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08-0326 (RPL)f P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: ProDerw Zoning: Application valuation: 1 08-000_00326 81842 VIA LA SERENA 767-200-011-14 -318742- POOL - RESIDENTIAL LQW DENSITY RESIDENTIAL 52500 T4ht 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Businessnd Profess Code, and my License is in full force and effect. License CI s: 3 License No.: 518742 �Oate: ractor: T-T-17ir 61 / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 ($500).: 1 _ 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 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.). (_ 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: LQPERAIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: VINCE & SISSY MLANDINICH 81842 VIA LA SERENA LA QUINTA, CA 922530 t� Contractor: AMERICAN POOL NS TI P.O. BOX 11996 C/Tj. 0 ��oo� 0��q PALM DESERT, CA 92 (760) 340-2588 qp�F pFpNTq Lic. No.: 518742 Date: 2/21/08 7/6 WORKER'S 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: Carrier LINCOLN GENERAL Policy Number CWC00043900 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 that, ifAshouldb subject to the workers' compensation provisions of Section 7�3100 ofthe Labrthwply with those provisions. 9ateY pplicant: WARNING: FAILURE TO SECURMPENSATION 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. 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 nulland 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 co nt o dinances and state laws relating to building construction, and hereby authorize representatives of this co ,tyy/,to nter upon the above-mentioned properly nspecti / oses. �e� w nature (Applicant or Agent)' ��— Application Number . . . . . 08-00000326 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 428.00 Plan Check Fee 278.20 Issue Date . . . . Valuation . . 52175 Expiration Date 8/19/08 Qty Unit Charge Per Extension BASE FEE 414.50 3.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 13.50 Permit . . . MECH POOL Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 8/19/08 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 8/,19/08 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 . . 8/19/08 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 Permit . . . . . . WALL/FENCE PERMIT LQPERAITT Application Number . . . . . 08-00000326 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 325 Expiration Date 8/19/08 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, DIVING BOARD, 15 L.F. 5' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE_AT PRE -PLASTER INSPECTION. Fee summary Charged Paid ----------------- Credited Due -------------------- Permit Fee Total 547.00 ---------- .00 ---------- .00 547.00 .Plan Check Total 304.20 .00 .00 304.20 Grand Total 851.20 .00 .00 851.20 LQPERA1IT Bin 11 City of La Qwnta HUMIng 8r Safety Division i .O. Box 1504, 78-495 Ca& Tampico !a Qtdnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet p Pro}ect Addsesr. Y�' (a d a .L i C- A. P. Number: Address: 4 U' 4- i/re 11;' Legal Description: City, ST, Zip: Lk}- ft V Cli Contractor: 7 ��, � �'IC�G TcicphonG �� Project Description: ^ /� ✓i /'P.Y� Address PO . i!—tT' fl I l City. Sl', Zip: )Pr= YL Z-` ss 15 �(/L • Vit.%ifi2'� ,'j � '� State Lia # : City Lie. #; Arch., Eogr., Designer: Address: J City, ST, Tap: Telepbonc. Construction Type: Occupancy: State Lie. #: Project type (circle one)r New Add'n Alta Repair Demo Name of Contact Person::�' L ( ! �� -�5 Sq. FL; # Stories: Umiu: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRA IONG PERMITTEES Plan Sets Plan Cheek submitted item Araoant structural Cain. Reviewed, ready for corrections Plea Cheek Deponit Tams Coln. Cailcd Contact Person Plan Cliuk Bahner 1iBe 24 Cates. Plans *kid upConIS nation Flood plain plan Pians reaabmiti.ed Meebautcal G--'&" pian 2-! Review, ready for cor rectioasliasae Eleebical 3nbcAatacbos Iiat Called Coulad Person Plumbing Graut Deed Plans picked up SMI. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Revkw, ready for correctionsfnsae Devcloptr impact Fee Planting Approval Called CoolactPerson Pub. Wks. Appr Date of pmwt issue Saba Fees Total Permit 5-. 3� 57,1 7 [•d 9CV6VL909L apn.ilsuoo food utoiaewy dIZ:ZO 80 OZ gad Bin # City of La Quinta �2Building 8E Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:' Owner's Name: A. P. Number: Address: Legal Descript• n: Contractor: Address: P,� �L fe., City, ST, Zip: &4— Telephone: Project Description: City, ST, Zip: Telephone.. -;4d State Lic. # : �j ���` Arch., Engr., Designer: City Lic. #: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Name of Contact Person: Project type (circle one): New Adc'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: ---7S Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIONG . PERMIT FEES . Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Checi Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Constructbn Flood plain plan Plans resubmitted Mechanical Grading plan 2"+ Review, ready for correctio issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer =mpact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue 0 School Fees Total Perm -t Fees `t'�f 3_ (�S O r<� • AMERICAN CONCRETE.`INSTITUTE This is to certify that n - D BARRY HALTMAN D has demonstrated knowledge and ability by successfully completing the ACI certification requirements and is hereby recognized as an ACI CONCRETE FIELD TESTINGTECHNICIAN M 1, GRADE .- . _ vertifs DaW 8!1810-1 -81161121 - A : Examiner of Record: Ms Deborah A `- lCl Maea� 'r� Direct6r o -- Priesf, gr g f, Cern catron �-` ' _ _ The: iutl�etztiery o this cern cgtian can: a veri zed at wwiv..flClCerti 'J f 'r . Y y. ~�•y �, a� .tip r.:�. ^.�Y. 7 1 411 ;!t =Y' _ F' �• t "c' z AL "f w,. fin"-�`. S `>t.f�`:v "£�=•F: _ _ -. e`>'�4 _<:~:->.;! ::n :f::"_'��"�i:",�-J '"•�=: AMERICAN CONCffl, : TE INSTITUTE This is to certify .that has demonstrated knowledge and ability by successfully completing the AC[erti c fication requirements and is hereby recognized as an ACI-SHOTCRETENOZZLE MAN, DRY MIX PROCESS, VERTICAL ONLY 1 * Cirt, r md Date: 5/4`07: Ei' i Q 1) res: V. 1. -A- SO W W- idl Kiaminer of ]Wec('b -top"he, r r