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04-6746 (RPL)BUILDING..& SAFETY DEPARTMENT. cw4 P'.0., Box.1504 (760).777-70.12 tOF 9 78-495 CALLS TAMPICo 'FAX (760) 777-7011 LA QUINTA, CALIFORNIA.92253 INSPECTION REQUESTS (760) 777-7153 . BUILDING: PERMIT . Application Number : 04 -0.00-0674,6 ? Date 10/12/04 - Property' Address...-... 8 0110 ,V -IA VALEROSA . APN.: 7727250-999-11 -30357 - Application description POOL .-*.RESIDENTIAL Property .Zoning LOW DENSITY RESIDENTIAL Application valuation -19000' -. Owner... Contractor, TOLL CA V CALIFORNIA POOLS & SPAS C/0 KEVIN..D DUERMIT P.O. BOX 1280 8901. E' MOUNTAIN VIEW -2.00 COACHELLA CA 9.2236 �.-9222.SCOTTSDALE A. WCC.: STATE FUND 204 04600:061168 01/01/Q5e CITY A .LA QIiINTA CS LB 6 5 612 8 10/31/04- ' FINAN�^�E.DEPT. CCC. C8 -G27 -C29-053 Permit MECH POOL, Additional desc Permit.. Fee 24.00 Plan Check Fee 6.00 Issue Date Valuation 0 10 Qty' Unit Charge. Per Extension' BASE FEE 15.. 0-0,,1:00 9.0000 EA MECH FURNACE .<=100K `'. 900 -------- --- ---- --- ---=----- ----------------' Permit BLDG POOL PERMIT Additional desc Permit Fee 198:00 Plan Check Fee 128'.70 Issue.Date Valuation. 19000 Qty.- . Unit 'Charge Per Extension-. ...BASE FEE 45.00 17:00. .9.0000 THOU BLDG 2,001-25,000 153.00 Permit : ELEC POOL PERMIT=RES Additional desc Permit Fee 45.00 Plan. Check, -Fee• 11.25 Issue Dater Valuation 0 Qty Unit Charge Per Extension BASE .FEE 15.00: P.O. BOX 78-495 CALLSLLE TAMPiCO TA..:.. LA QUINTA, CALIFORNIA 92253 Application Number. Applicant: BUILDING & SAFET=Y DEPARTMENT -y, ;1w5w. i VOICE (766) 777-7012 FAX (760).777-7011 INSPECTIONS (760) 777-7153- Date: 77-7153 Date: Architect or Engineer: Architect or Engineer's Address: Uc. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of Pertarty that 1 am licensed under provisions of Chapter 9 (conmricing with Sedan 7000) of Division 3 of the Business and Prbfessionals Code. and my Llcen is h full force and effect. License Classp� License No. (a (o TJ Date ` d©D b` Coihtrartor • OWNER -BUILDER DECLARATION I hereby affirmunder penalty of perjury that I am exempt from the Contractors' State License law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a pemdt to constrict, alter. knprove. demolish. or repair any structure, prior to its isauano% also requires the applicant for the. permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contm t W State L100n" Law (Chapter 9 (corrxnencing with Sedan 7000) of Division 3 of the Business and Professions Code) or.thPenalty for she is exempt therefrom of a the baste for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to al penalty of not more than five hundred dollars (5500).); U 1. as owner of the property. or my employees with wages as their sole compensation, will do Ore work, and the structure is not Intended or offered for sate (Sea 7044, Business and Professions Code: The Contractors, State License Law does not appy 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 seta H, however: the budding or kmprovement is sold withiin one year of Completion, the owner-brilder will have the burden of proving that hear she did not build or Improve for the purpose of sale). U 1, as owner of the property. am exclusively contracting with licensed contractors to construct Ore paled (Sea 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 the Contractors' State License Law.). contracts for the projects with a contractor(s) licensed pursuant to U I am exempt under Sea B.6 rA. for this reason Date Owner,. WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury One of the following declarations:. t have and.vNll maintain a certificate of consent to selfdnsure for workers' can pen sellon, an provided for by Section 3700 of the Labor Code. for the performance of the work for which this permit is Issued.. 1 -have and will maintain workers' compensation Insurance, as required by' action 3700 of time Labor Code, for the peAonnance of the work for which this permit is eeQ� My wo rs. con ensation.ihsurance carrier and por aro: Canter _. f P 1. , Policy Number_ 1.CeMty that, in the performance of the work far vmch this pemdfts issued. I shall not employ any person in any manner so as to become subjectio the workers' Compensation laws of California. and agree that. If I should become subject Io the workers' compensation provisions of Section 3700 of the Labor Code. I shall kdhw th comply with thosepro'mns. WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), iN.ADDmON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that them Is a construction lending agency for the performance of the work for which this permit Is Issued (Sam 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, indemnify and hold harmless the City of La Quirts, Its offioers, agents and employees for any actor omission relat4the.'F-under or following issuance of this permit:2 Any permit Issued as a result of thhis application becomes nucod within 180 days from date of issuance of such peffnk or cessation of work for 180 dayswill subject pemdt to caroelta1 certify that i have read this application and state that the above In fmay with all city and county ordinances and state Sawa relating to building construction.. andd�hhereby authorize representatives of this count' ellePeM inspection Pumte /")lid ` d SI natureg (Applicant orAgent): t t A . Page 2 Application Number . . . . . 04-000'06746 Date 10/,12/04 - Qty Unit Charge Per Extension+..' } - 1.00 30.0000 EA ELEC PRIVATE SWIMMING -POOL 30.00 Permit PLUMBING Additional desc '+ Permit Fee, =3.00 Pian,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 3.000.0 t -- EA PLB GAS PIPE 1-4 OUTLETS - 3.00 - --- - - - -- - - - - -- - 7-7 - - - - -- -- - - --- --- - - - ---- Special Notes and Comments -- - - - - -- - - - -- ' POOL & SPA. BBQ ANSI Z31-58.1995'. ' ' ALARMS/BARRIERS SHALL BE IN PLACE PRIOR i. TO PREPLASTER INSPECTION. Fee summary Charged --------.-- - ----------------- Paid Credited `' ..Due ' ' Permit Fee Total --------------------, 300.100 .00 00 ---------- 300.00 Plan Check Total 154.20 .00 0-0 154.20 . Grand Total 454.20. .` 00 .• .00 454.20 _ .. f - - - NO OF JETS :> , ., - BIL E TRIM QU ARTER I�P�UN U GHT , TIl� RAISED SPA t_ .} 1 PIL'WAY TYPE � L L �' I. saeaAL NO s w� r N _ DECK G� � I G , EXCAV-AfiI N S T� „ . , { TYPE FfNPSM aCSSKRpAS EXPANSION _J ONT T � ELEVA TION C CANTILEVER ms DEEPDECK .:END 'AMP.. DRAINS -SEAT DECCO DRA IN -, REMOVAL CONCRETEs l S CURB CORE .. �.. 5013 REMOVAL, TREE REMOVAL e e R MOV Y , �. L P A J 5TE F` CE