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04-5419 (RPL)7 V14 BUILDING & SAFETY`DEPARTMENT i P.O. Box, 1504 } (76.0):777-70'12 OF 9 78-495 CALLS TAMPI:Co FAX (760) 777-7011 !% LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Applicati-onNumb�er 04 0-0"005.4=19 Date 7/12/'04 Prope-rty. P,ddr�ess 1t--444835 VIA MIRABEL APN:' 604-032:-999-587305.212- Application-de.sccription POOL'- RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL, Application valuation 17000 : Owner Contractor ------------------------ ------------------------ LENNAR HOMES OF CALIFORNIA CALIFORNIA POOLS &SPAS 7840.1, HIGHWAY- 1.11; STE 'C P.O. "BOX 1280 LA QUINTA, 'CA":. -COACHELLA CA 92236. LA QUINTA CA 92253 (760). 398=9222 WCC): STATE FUND, WC: 0460.0"061168 01/01/05 .. • CSLB • 6561.28'.-i -10/31/04 - CCC:... C8 C2.7 - C2.9 -.C53 Permit BLDG POOL PERMIT Additional desc Permit Fee 180.00 Plan Check. Fee 117.00 Issue Date Valuation_ 16760, Qty, Unit Charge Per Extension BASE FEE 45..00 15.0.01 9.0000 THOU BLDG .2,001-25;00.0..." 135.00 Permit . . MECH..POCL Additional desc". Permit Fee 24.00 Plan Check Fee 6.00 Issue Date Valuatibn 0 Qty Unit •Charge, Per Extension" BASE FEE" 15.00 1."001, 9.0000 EA MECH FURNACE <=100K 9.00 Permit ELEC 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 P:O.1504 • '�C'� �V 78-4955 CALLE TAMP ICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or Engineer's Address: Lic. No.. A BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under p ws ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals ;21 and my Lice, a is forceand effect. �^^—/ f ('� cense Class ( ^ 1<i n No.) 6 J 6 / �1j ( 9WNER-BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 am exempt from the�Cbntractors' 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, ttie 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 (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 1 am exempt under Sec. i , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 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 rkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is iss d. orkers' mpensation inks amts came r cy num r crier cS olitYcy Number / I certiy a , in the perforhance of the work for whi this permilJs 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 f I should become subject to the workers' compensation provisions of Section 3760 of the Labor Code, I shall fa comply with those p i ions. ,--Date G plicent WARNING: FAILURE TO SECURE WOR RS' CO REN COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH SAND 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 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.). Lenders Name Lenders Address 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, indemnity 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 4 n mmenced 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 torr ree to mply with all city and county ordinances and state laws relating to building construction, and he by authorize representatives of this coun o enter upon the v nti ed property for inspection purposes. ate 6 Sig pplicant or Agent): Page 2 Application Number 04-00005419 Date 7/12/04 Qty Unit Charge Per. Extension 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 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.:- Additional'desc Permit Fee .15.-00 Plan Check Fee .00 Issue Date . . Valuation . . . . .240 Qty Unit Charge Per Extension BASE FEE 15.00. Special Notes and Comments POOL/SPA, BBQ(ANSI Z21 -58A), 15.L.F. 48" BLOCK WALL CITY STANDARD ALARMS/BARRIERS SHALL BE -IN PLACE AT PRE -PLASTER INSPECTION. Fee -summary Charged Paid. Credited Due Permit Fee Total 297.00 .00 .00 297.00 ' Plan Check Total 142.50 .00 .00 142.50 Grand Total 439.50 .00 .00 .439.50 ' l i WA Al _ .r ✓. .- ... 4 v s ,n , .fir +�. .,d. i Y y , M ,: .... s ., .:, _. ,. .:.. ,.-♦. ,r 2.. Sz x s a w... .:. ,., , r. ,. .. `� x. : t.. ,„ .... 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