04-5420 (RPL)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-70112
J8.--495 CALLE TAMPICO FAX (760) 777-70.11
Q LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
l�'
JUL -141004 BUILDING PERMIT
C1Av'g1- fWty`on Number X04 0=0.0.05 20,r. Date 7/12/04
Prope-r-ty Address 78345 VIA TUSCANY
APN: 604-032-999-55 -305212-
Application description-: POOL,- RESIDENTIAL
Property Zoning LOW DENSITY RESIDENTIAL
Application.valuation 17000.
Owner Contractor
LENNAR HOMES OF.CALIFORNIA /-CALIFORNIA POOLS & SPAS
78401 HIGHWAY 111, STE C P.O. BOX 1280
LA QUINTA, CA COACHELLA CA 92236
LA QUINTA CA ,92253-' (76.0) 398-9222
WCC STATE FUND
WC: 04600061168' 01/01/05'
CSLB: 656128 10/31/04
CCC: C8. -C27 -C29-053
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Permit . . . BLDG POOL PERMIT
Additional,desc
Permit Fee. 180.00 Plan Check Fee .117.00
Issue,Date Valuation 17000
Qty Unit" Charge Per. Extension
BASE FEE 45.00
15.00 9.0000 THOU BLDG 2,001-25,000 -135.00
----------------------------------------------------------------------------
Permit MECH POOL
Additional .desc
Permit Fee . . . . 24..00 Plan Check Fee 6.00
Issue Date 'Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1 00` 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. Box 1 504• �� VOICE (760) 77' 4012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: (2y - $z%ao Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
1A
BUILDING PERMIT DECLARATIONS
LI ENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under p ov' " s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
and my Lice s� anheffft
License Class Li ns No.
Ll�/Date /q/0V--Contractor
I— .,— NER-BUILDER DECLARATION
1 -hereby affirm under penalty of perjury that I am exempt from a Cont Actors' 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,l, 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, 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.).
U 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 I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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 maintai workerscompensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is ued. worke compensation i nce carrier �n¢.golicy qumb�r 77,
�er 5 � 'Policy Number D �/ (,n00 t ]jl
_ I certify that, in the performance of the work for whic hi it 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 th t, I hould come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
/
forthwith comply with those p v sions.
date < `1 Applicant
WARNING: FAILURE TO SECURE WO ERS' COM A 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.
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.).
Lenders Name //��
Lenders Address A
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.
I. 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 t all, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work bei performs under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and jabo
ot com1.1y
ced 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 i rmation ise to co with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this count to enter uponti 'of
property for inspection purposes.
Signature (Applicant or Agent) '
Page 2,
Application Number 04-00005420
Date '7/12/04
Qty Unit Charge• Pet
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
12.00 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, FIREPIT (496AGAL)`.
ALARMS/BARRIERS SHALL.BE IN PLACE AT
PRE -PLASTER INSPECTION.EQUIPMENT
ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited-
Due
Permit •Fee Total 282.00 .00 .00
282.00 -
Plan Check Total 142.50 ..00 .00
142.50
Grand Total 424_.50 .00 .00
424.50
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