Loading...
05-2937 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00002937 Property Address: 80859 VIA PUERTA AZUL APN: 762-240-003-81 -300962- Application description: POOL - RESIDENTIAL Property Zoning: MEDIUM DENSITY RES Application valuation: 15000 T,&t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: REMBOLD, WAYNE 80-859 VIA PUERTA AZUL LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/15/05 Contractor. D Applicant: Architect or Engineer: FAMILY POOL CONSTRUCTION WCC: STATE FUND C1 WC: 1344032-2005 03/0 0 SEP 15 o A 17 C;1 O CSLB: 658996 11/3 01005 ' V , w CIN OF I -A QUINTA ----------------- LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business d Professionals Code, and my License is in full force and effect. License C ss License No.: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I m exempt from the Contractor's 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 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 (5500).: (_ 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 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 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.). I—) 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: LQPERAIIT ----------------------------------------------— 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 pe*1,Pe ce of the work for hich this permit is issued. My workers' compensation insurance carriericy number are, Carrier C53-HICPoli Number - - - - - - - - - - -- - - - I certify that, in theance o work for which this permit is issued, I shall not employ any arson in any mas t come subject to the workers' compensation laws of California, nd yyyyyy,,,���,,,,,,������Illrrrree [hat, id subje to the workers' compensation provisions of Section 7t ofthe Lab, I s II orthw' comply with those provisions. Applicaik: WARNIN . F LURE TO SECURKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CPENA TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). INADDIO THE OST 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 whose request and for whose benefit work is performed under or pursuant to any permit i ued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, . emnify and hold harmless the City of La Quinta, its officers, agents and employees for any act omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application beco s null and void if work is not commenced within 180 days from date of issuance of such it, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that th b ve information is correct. I agree to comply with all city and oun ordi nces and state laws relating to b struction, and hereby authorize representatives of thi ter upon the above-mentioned property io purposes. te. Signature (Applicant or Agent): M Application Number . . . . . 05-00002937 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date . . 1/11/06 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ------------------------------------------------=--------------------------- THOU BLDG 2,001-25,000 117.00 Permit . . . MECH POOL Additional desc . Permit Fee 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . 0 Expiration Date 1/11/06 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 Expiration Date . . 1/11/06 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 . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 SPA ONLY. ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number . . . . . 05-00002937 ---------------------------------------------------------------------------- Special Notes and Comments PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ----------------- ---------- Permit Fee Total 258.00 Plan Check Total 129.30 Grand Total 387.30 LQPERMTT Paid Credited ---------- ---------- .00 .00 .00 .00 .00 .00 Due 258.00 129.30 387.30 l9lockWdl P// 4 'lockWdl ti A WAYNE Pjffl"l0OLr,) PE_'51r,)FNGF 8O8°S� Via Pueod a AZU1 Pued a Azul Gommund y Lol 81 A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOT Oa THE SITE FOR A SCHEDULED INSPECTION. NO EXCEPTIONS! CITY OF LA QUINTA BUILDING $ SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE ? f(s! O 5 BY GS �fqq/ �y 1/8"-1' M/ J� alnzlbl�p -61JD &O. -IL Construction f00% Spate �ounfain� C7G0>�G�-3G5� L.ic, #658996 Bin # Permit # ps Project Address: A. P. Number: Legal Description: r Contractor: p Address: City, ST, Zip: Telephone: � i State Lic. # : �� Arch., Engr., Designer: . Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 CaIcs. Flood plaid plan Grading plan Subcontactor hist Grant Deed II.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinti.. Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 922S3.(760) 777-7012 Building Permit APPlication and Tracking Sheet ' Owner's Name: lit ------------ Address: I City, ST, Zip. l' • Telephone: Project Description: �% A- Lic. #: APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd Plan Check submitted Reviewed, ready for corrections Called Contact Person Plans picked'up Plans resubmitted 2"' Review, ready for correclionsrssue Called Contact Person Plans picked up Plans resubmitted ' Revicw4eady for correctionstissue Called Contact Person Date of permit issue PERMIT FEES % { Item Plan Check Deposit Plan Chick Balance Construction Mechanical Electrical Plumbing s.nLl. Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount .