06-1662 (SOTB)•A
TA
P.O. BOX 1504 VOICE (760) 777-7012jI'
78-495 CALLE TAMPICO FAX (760) 777=7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
y BUILDING PERMIT
Date: 4/27/06 '
1' Application Number: 06-00001662 ® Owner. s
` Property Address: 8023"5— VI A-MIRASOL 'PALLEY i•,
_ APN: 772-430-007- - - 86-255 VIA MIRASOL
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5000
1 Contractor:f
Applicant: Architect or Engineer: p� CALIFORNIA POOLS, & SPAS f
44 -O. BOX 1280
O COACHELLA, CA 92236 '
.' (760)39879222'
r. t. Lic. No. .656128
r..
•` - •• LICENSED CONTRACTOR'S DECLARATION t WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with ' , I-hereby affirm under penalty of perjury one of the following -declarations:
_� • Section 7000) 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 _-
' LicenseClass: C8 C27 C29 License No.: 656128 -for by Section 3700 of the Labor Code, for.the performance of the work forwhich this permit is ..
issued. ;
Date: `rC. Contract. r.. .r • 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: -
I hereby affirm under penalty of perjury thLlrofessions
am exempt from the Contractor's State License Law for the. Carrier SEABRIGHT Policy Number `BB1060510 -
following reason (Sec. 7031.5, Business Code; Any city or county that requires a permit to - r _ 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 b ome 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 - 3700 of the LaborC orthwith'comply with those provisions..f '
• 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).: Date: /YL2- 6> Applicants
'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 WARNING: FAILURE TO SECURE WORKE S' 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 P�NALTIES 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 notbuild or i- -
improve for the purpose.of sale.). - - - APPLICANT ACKNOWLEDGEMENT - • `
I, as owner of the property, amexclusively contracting with licensed contractors to construct the project (Sec. ' . IMPORTANTApplication is hereby made to the Director of Building and Safety for a perrnit subject to the • -
7044, Business and Professions Code: The Contractors' State License taw 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 contractor(s) 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 _'1 I am exempt under Sec. B.&P.C. for this reason 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.
Date: Owner:. 2. Any permit issued as a result of this application becomes null and void if work isnot commenced
- within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject -
_ - CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of. the I certify that I have read this application and stat4tbove information is correct. I agree to comply With all
work for which this permit is issued (Sec. 3097, Civ. C.). - - city and county ordinances and state laws relatinconstruction, and hereby authorize representatives
of thiscount to enter upon the above-mentionesection purposes.
Lender's Name: . _Date:�Signature (Applicant or Age
Lender's Address: -
LQPERMIT `
Application Number
. . 06-00001662
Permit
BUILDING PERMIT
Additional desc .
Permit Fee
72.00
Plan Check Fee
46.80
Issue Date
Valuation
5000
Expiration Date
10/2.4/06
Qty Unit Charge
Per,
Extension
BASE
FEE
45.00
3.00 9:0000
THOU BLDG
2,001-25,000
27.00
Permit . .
ELEC-MISCELLANEOUS
Additional desc
Permit Fee
17.25
Plan Check Fee
4.31
Issue .Date . . .
Valuation
_
0
Expiration Date
10/24/06
Qty Unit Charge
Per
c
Extension
BASE
FEE
15.00.
3.00 .7500
PER ELEC
DEVICE/FIXTURE 1ST 20.
2.25
Permit
PLUMBING
Additional desc .
= Permit Fee
18.00.
Plan Check Fee
4.50
Issue Date . : .
Valuation
0'
Expiration Date
10/24/06
-. Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00. 3.0000
EA -..PLB GAS PIPE 1-4 OUTLETS
3.,00 •.
-----
Special Notes and Comments
BARBEQUE ONLY (Z21-58.-1995)
..
-----------
Other Fees ,-.
ENERGY REVIEW FEE
4.68
Fee summary Charged
Paid - Credited
Due -
Permit Fee Total
107.25 -
00 .00
107.25,
Plan Check Total
55.61
:00 .00
55.61
Other Fee Total.4.68
.00 00
4.68. -
Grand Total
167.54
00 00
167•:54
• LQPERMIT
- .
StateLtc' '
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Arch., Engr., De§igner:
:
Address.
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Telephone
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Construction Iype
Occupancy
State Ltc #
� Project type (circle one) Add'n Alter Repan Demo
Name of Contact Person
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#S nto es #Units
One.# of Contact Person
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mta value o
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APPLICANT
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Structural Calcs
Reviewed, ready for corrections
Amount
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`Called Contact Person
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Plan Check Balance
Energy Gales.�77
PI ans p►cked up
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onstruc on �O7g
Blood plan plan
_
Plans resubmitted
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Mechanics
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Gradmgplan �;
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ryElectrical �.
Subcontac;or List .:: . ;
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yCalled GontactPerson .''
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Plumbing
Grant Deed =� z_— Plans picked up SMI
HOA ApprovalPlans
resubmitted
Grads
IN HOUSE -'
'^' Re ►ew, ready for corrections/issue -
v :...,
:Developer Impact Fee
Ylanm .9 Approval
Called Contact Person
i
AIPP.
Appr
Date of permit, issue
9
School Fees31
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LA
',Total`Permit Fees
FOR, CONSTRUCTIO !
'DATE