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07-2531 (RPL)r P.O. BOX 1504 r; . �^' VOICE 760.777-7012 78495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CAL'IF&RNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 >x - BUILDING PERMIT Date: 9/13/07 Application Number: 0_7-+00002531M T Owner. Property Address: - 53175 VIA VICENZEW PURYEAR RESIDENCE APN: 77.2-520=008- - 53175 VIA VICENZE _ Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 30000 , :�• .. _ !!fi�nn _ r Contractor: Applicant: t Architect or Engineer: MCINTYRE„ POOLS ,& L „ ' 83695 AVENUE 45 ••� - . z. INDIO, CA 92201 p fd, iA QWIN"IA (,760)342-,3612 r7W - Lic_ No. 614611 ---------------------.------------.--------------.--------,- -----.---------=------------ - -- - -- - - - -LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION r• ^l.. _ I hereby affirm under penalty of, perjury that I am licensed under. provisions of Chapter 9 (commencing with w. 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 • Lice ass: C53 License No.: 614611 - for by. Section 3700 of the Labor Code, for the performance of the work for which this permit is r - issued , Date: •fContractor. �,J /, - _ I.have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor, . l!v lll... . 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: • ' . - Ihereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the . Carrier MAJESTIC INS CO Policy Number • C20060333602 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a. permit to _ 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 become 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 Labor , I shall forthwJ'�h c Iw' o provisions.. F ' • % - ' that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by. - - PP' - , I sh M/s/.Ep rovisi�__ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500):: Date: .� / If lican171 �`•'- 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 WORKERS' 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 PENALTIES AND CIVIL FINES UP TOONE 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. - i _ • 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.). - - _ APPLICANT ACKNOWLEDGEMENT. I, as owner of the property, am exclusively contracting with licensed contractors to -construct the project (Sec: IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code:- The Contractors' State License Law 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. I. 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 I am exempt un_ der 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 is not 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 1 certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ.. C.). city an u ordinances and state laws relating to build* nstruction, and hereby authorize representatives - - - of .th' n to enter upon the above-mentioned grope fon pection purposes. _ - _ Lender's Name: Date a Signature (Applicant or Agent): - -- Lender's Address: LQPERMIT. - Application Number ... . . 07-00002531 'a Permit . . . . . BLDG'POOL.PERMIT Additional desc . Permit Fee 284.50 .Plan Check Fee. - •184.93 Issue Date. Valuation 30000 Expiration Date 3/11/08 - Qty Unit Charge Per Extension BASE FEE 252.00 5.00. 6.5000 THOU BLDG_25,001-50,000 --------------- 32.50 Permit MECH POOL Additional 'desc ; Permit Fee 26.00. Plan Check•Fee 6.-50 Issue Date Valuation 0 Expiration Date 3/11/08 Qty Unit Charge 'Per Extension BASE FEE 15:00 = . 1.00 ,EA : MECH FURNACE >100IC ------------------- 11.00 - PermitELEC.POOL PERMIT -RES - Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date ". Valuation 0 Expiration Date 3/11/08 - Qty Unit -Charge Per Extension.. BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE,SWIMMING-POOL 30.00 :..-----=----------------------------=------------------=---------------------. Permit . . . . . ._• PLUMBING a, Additional desc Permit Fee - ,45.00 Plan Check -Fee 11.25 :•, Issue.Date - - Valuation 0•, Expiration Date:. :3/11/08 Qty Unit.Charge..Per _ Extension BASE FEE 15.00 4:00 6.0000 EA PLB FIXTURE 24.00- 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,: ALARMS/BARRIERS SHALL BE IN LQPERMIT r Bin # Permit Project Address* :J A. P. Numbs: Legal Description: X x A Contractor Address: City. ST, Zip�� X Z� A X Telephone,. State Lic. q : l Arch., Engr., Designer: Address: City. ST. Zip: Telephone: State Lic. il: Name of Contact Person: Telephone # of Contact Person: N Submittal Req'd Plan Sets Structural Cala. Truss Calcs. Energy Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE:. Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building, at Safety Division P.O. Box 1504, 78-495 Calle Tampico U Quinta, CA 92253 --(760).777-7012 Building Permit Application and Tracking Sheet TAddrcss:. — ( I ST, Zip:hene• Dcsaiption: City Lic. q: Construction Type: Occup ancy Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:� # Stories; # Units: slimated Value of Proiect: Q� APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACKING PERMIT FEES Plan Check submitted Amount Reviewed, ready 1111111,c rrectionsCheck KPlan Deposit Called Contact Person Check Balance Plans picked up Construction Plans resubmitted Mechanical 2'' Review, ready for correctionslissue Electrical Called Contact Person --------------- Plumbing Plans picked up 5.111.1. Plans resubmitted Grading 3'4 Review, ready for correclionsriissue Developer Impact Fee Called Contact Person A.1.P.P. Date of permit issue Permit Fees �� IL 1 eY L�� EJf �Ol� fin- Cd2R-ter<�