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05-0760 (RPL)L/� R 5 BUILDING & SAFETY DEPARTMENT P BOX •1504 (760).777-7012 OF 9 5 CALLE TAMPICO FAX (760) ,777-7011 D l O INS L INTA,.CAL IFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 . MAR BUILDING PERMIT MC1SY O�c DEp?.A ication Number . . . ..0-0�0 '5=--C=0=0,7-6.0� Date 3/07/05 Property Address . . . 78435 VIA SEVILLA APN: 604-212--004-60 -23971 Application description POOL - RESIDENTIAL Property Zoning ,. LOW DENSITY RESIDENTIAL Application valuation . r'' 30000 f Owner Contractor ----------------- ----- ----- ----- ---------- STEVE & AMY LARSON CAIPO, GUILLERMO-W. 78-435 VIA SEVILLA 38077 CROCUS LANE. LA QUINTA - CA 92253 PALM DESERT CA 92211 (760) 20071000 WCC: EXEMPT WC: EXEMPT 07/31/05 CSLB: 816693 01/31/07 CCC:. B-053 ---------------------- Permit BLDG POOL PERMIT Additional desc Permit Fee . . . 284.50 Plan Check Fee 184..93 Issue Date . . . Valuation . . 30000 Qty Unit Charge: Per Extension {. BASE FEE - .252.00 5.00 6.5000 THOU BLDG 2.5,001-50,000 32.50 ---------- --------------.---.------------------------------------------ Permit MECH POOL Additional desc Permit Fee 24.00 Plan Check Fee .'6.00 Issue Date -Valuation 0 r` 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 I0 Qty Unit Charge Per Extension -BASE FEEL 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 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: o.�' o '% 6 O Date: Ap 96icane40-046' j#t��•/%//��'6 av f� Ap�iiT Mail PSC ress: Architect or Engineer:, ; 'f Architect or Engineer's Address: Lic. No.. A,1,A BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals G6deiem and ss Licer a is in fyll Prie and effect. � �/o /� � y icense Class `•f G f- License o. (S /01 Z drBT Contractef two/ Q OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 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 cam r and policy number are: Carrier Policy Numbe7 I certify that, in the performance of the work for which this permit 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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date <.pplicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.). Lender's Name Lender's Address APPLICANT IMPORTANT Application is hereby made to the Director of Building and Safety for 1. Each person upon whose behalf this application is made, each person issued as a result of this application, the owner, and the applicant, eac officers, agents and employees for any act or omission related to the 2. Any permit issued as a result of this application becomes null and void cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above informal is cor construction, and hereby authorize representatives of this county to e r u on the D�aattee Signature (Applicant or Agent)/ 6 ACKNOWLEDGEMENT permit subject to the conditions and restrictions set forth on this application. I whose request and for whose benefit work is performed under or pursuant to any permit agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its w rk being performed under or following issuance of this permit. work is not commenced within 180 days from date of issuance of such permit, or comply with all city and county ordinances and state laws relating to building ied property for inspection purposes. Page 2 Application Number 05-000.00760 Date 3/07/05 Issue Date . . . . Valuation . .. 0 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 PIPE1-4,OUTLETS 3..00 Special Notes and.Comments POOL & SPA. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE-PLASTER.INSPECTION. EQUIPMENT ENCLOSURE NOT INLCUDED IN PERMIT. ._ Fee summary. Charged Paid Credited Due Permit Fee Total 386.50 :00 .00 386.50 Plan Check Total 210.43 .00 .00 210.43 Grand Total. 596.93 00 .00 596.93 2'-6'x4 SPA UMBRELLA f 2' HOLE M. o � .. u _ L - POOL n, OOO, `[ • - ~ `,' „r BAR .-�-'' _ =' O ASCADE DECK AREA = 577 square ft. 11�111��1�111��111�11�1��1�111��11�r1�111m POOL INFINITY PA O S , �:. �mmmmmmmrnmmmrn�mn 6 4' * �mmmmmmr�mmmmr�m�rerr�mmmmmrmnm��n� •mmmmmmmnm�mn�mrmm m�mfmmm�n��mm�m�nrrrm�m 2'-6'x4 SPA UMBRELLA f 2' HOLE M. o � .. u _ L - POOL n, OOO, `[ Owner: STEVE 8t AMY LARSON 78435 VIA SEVILLA Project Location : LA OUINTA, CA. 92253 PHONE 760- 200-8655, 6,15 Mb Fdi W03 COm Sub W FS CA. 92M amp 9MMAN W2 ® + . rm Cn" ruamim ab CMA ao - �W NJ • - ~ `,' „r BAR .-�-'' _ =' O ASCADE DECK AREA = 577 square ft. POOL INFINITY PA O S , �:. 6 4' * Owner: STEVE 8t AMY LARSON 78435 VIA SEVILLA Project Location : LA OUINTA, CA. 92253 PHONE 760- 200-8655, 6,15 Mb Fdi W03 COm Sub W FS CA. 92M amp 9MMAN W2 ® + . rm Cn" ruamim ab CMA ao - �W NJ