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05-4593 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application. Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 05-00004593 80758 VIA PUERTA AZUL 762-240-003-22 -300962- POOL - RESIDENTIAL MEDIUM DENSITY RES 20000 T,iht 4 4 Q" - Architect or Engineer BUILDING & SAFETY DEPARTMENT BUILDING PERMIT U NOV 18 Zoos CITY NFC2NrA ------------ - - - --- LIC - - --------------------- - - - - - - CONTRACTOR'S DECLARATION Ihereby affirm under penalty of perjury thattIhr1 licensed under provisions of Chapter 9 (commencing with Section 700) f Div'sion 3 of the Busine rofessionals Code, and my License is in full force and effect. Licens I License No.: D e: Contractor: ' NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am empt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Prof. sions 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 Contractor's 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 ($5001.: 1—) 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 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.). 1 _ 1 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/05 Owner: BETZ 80-758 VIA PUERTA AZUL LA QUINTA, CA 92253 Contractor: FAMILY POOL CONSTRUCTION WCC: STATE FUND WC: 1344032-2005 03/01/06 CSLB: 658996 11/30/06 ---------------------------7------------------- WORKER'S 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 maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perf ante of the work f hich this permit is issued. My workers' compensation insurance carrier d olicy numb e: Carrier C53-HIC olicyNumber--------- - - - - -- I certify that, in the p rfor a of the work for which this permit is issued, I shall not employ any person in anytrall ecome subject to the workers' compensation laws of California, (d agree thae subject to the workers' compensation provisions of Section 700 of the Lorthwith comply with those provisions. D ApplicaWARNING: ILURE TO SECPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TOLTIES 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. 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 hose request and for whose benefit work is performed under or pursuant to any permit iss as a result of this application, the owner, and the applicant, each agrees to, and shall defend, i mnify and hold harmless the -City of La Quinta, its officers, agents and employees for any act mission related to the work being performed under or following issuance of this ermit. 2. Any permit issued as a result of this applicati n eco null and void if work is not commenced within 180 days from date of issuance of s ch it, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that abo a information is correct. I agree to comply with all city a co ty ordinances and state laws relating to u' nstruction, and hereby authorize representatives of this ou to ter upon the above-mentioned operty , s ion purposes. D Signature (Applicant or Agent): Application Number . . . . . 05-00004593 Permit. . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date Valuation . . . . 20000 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 THOU BLDG 2,001-25,000 162.00 ---------------------------------------------------------------------------- Permit MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 ---------------------------------------------------------------------------- Permit . . . ELEC POOL PERMIT -RES Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 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 ` Expiration Date 4/12/06 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 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. ALARMS/BARRIERS SHALL LQPERMIT Application Number . . . . . 05-00004593 ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary ----------------- Charged Paid Credited Due Permit Fee -------------------- Total 311.00 .00 -------------------- .00 311.00 Plan Check Total 160.55 .00 .00 160.55 Grand Total 471.55 .00 .00 471.55 LQPERMIT J/ l e 5t tRLiffY pfrz 80758 V/0 Pued a AZU/ Lof 22 Pued a Azul COI'lStt^UCtl01'1 Pools Spate iounlaln5 C760"64 -36f6 L -/c, #6�8996 Bin# City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # OJT �5�3 Project Address:D Owner's Nam • e ,¢� A. P. Number: Address: 07-5'3 Legal Description: _A Contractor:h4mi�,4Telephone: City, ST, Zip: u Address: _ pp Project Description: City, ST, Zip: L Vk Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 6r—) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES ZPlan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees