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06-2975 (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: a� T4ht 4 4 Q" 06-00002975 80872 VIA PUERTA AZUL 762-240-003-3 -300962- POOL - RESIDENTIAL MEDIUM DENSITY RES 18000 00 Architect or Nia LICEN6EI CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT AUG 2 8 2006 I hereb *-5 enalty of perjury tta�yf licensed under provisions of Chapter 9 (commencing with Secti n on 3 of the Busi an Professionals Code, and my License is in full force and effect. Lice se License No.: 658996 Date:Contractor: OWN -BUILDER DECLARATION I hereby affirm under penalty of perjury that I a exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Pr essions 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 ($500): (_) 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 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 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 Owner: HALL 80872 VIA PUERTA AZUL LA QUINTA,.CA 92253 Contractor: FAMILY POOL CONSTRUCTION P O BOX 283 LA QUINTA, CA 92247 (760)564-3655 Lic. No.: 658996 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/11/06 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 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 performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy n er are: Carrier STATE FUND Policy Number 1344032-06 I certify that, in I ance of the work for which this permit is issued, I shall not employ any person in an as to become subject to the workers' compensation lawsof California, and agree - become subject to the workers' compensation provisions of Section D00 of the I shall forthwith comply with those provisions. Date: �•ApplicaWARNIN : FA URE TO SEKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,000). INATHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABINTEREST, 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 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 Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. ' 2. Any permit issued as a result of this application becomes null void if work is not commenced within 180 days from date of issuance of such permit essation of work for 180 days will subject p mit to cancellation. I certify t at I h ve read this application and state that th a information is correct. I agree to comply with all city unty rdinPnces and state laws relating to onstruction, and hereby authorize representatives of ' Qr upon the above-mentioned prope tion purposes. Date: Signature (Applicant or Agent): I Application Number . .'. . . 06-00002975 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . Valuation . . . 18000 Expiration Date 2/07/07 Qty Unit Charge Per Extension BASE FEE" 45.00 16.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 Permit . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expirs_tion Date 2/07/07 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 2/07/07 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 2/07%07 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 -------------------------------------1-------------------------------------- Special Notes and Comments POOL ONLY/BARRIERS SHALL BE IN PLACE AT LQPERMIT Application Number 06-00002975 7----------------------------------------------------------------7---------- Special Notes and Comments PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 287.00 .00 .00 287.00 Plan Check'Total 147.35 .00 .00 147.35 .Grand Total 434.35 .00 .00 434.35 LQPERMIT Bin # Permit # City of La Qutn a . Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta,.CA 92253 - (760) 777-7012 Building Permit Application .and Tracking Sheet Project Address: Q. �{ �� A. P. Number: Owner's Name: Address: Q/ 2 8 Legal Description: Contractor: L \f Address: 3 _I ' City, ST, Zip: L eA �ZS3 Telephone: Project Description: City, ST, Zip: Telephone State Lic. #.: ` City Lic. #: Arch., Engr., 'Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: TNL Name of Contact Person: Telephone # of Contact Person: a� 3 Sq. Ft.: # St ies: # Units: W Estimated Value of Project: _ APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIONG . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan 21d 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:- '"' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P.. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees V eiockWdl MAWIESr V eiockWdl vr/j IJzv� /4'-C'„ OO 1 V ei�wdr rod Equlpaeid K, V P/adwdi A REINSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND jOB CARD ARE Np�VE THE SITE FpR q SCHEDULED U INSPECTION. LED NO EXCEPTIONS! CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE A Ia l0yo BY _ Construction P00% 5pa� lourdain� C7G0��-3G�5 Lic, #6558996