05-1457 (BLCK)9&t
U
BUILDING & SAFETY DEPARTMENT
P.O x 1504 (76.0),773-7012
OFTt�91 8 208- CAiLE TAMPICo FAX (760) 777-7011
LA UI TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53
CIT` OF Lp' O1UIP1T0► - .
FINo►NCEOE�' BUILDING PERMIT
Application Number 000-0-014.57 7 Date 4/18/05
Property Address 78495 VIA SEVILLA -
APN: 604-212-010=54 -23971
Applica"tion description . . . WALL/FENCE
Property Zoning . . LOW;DENSITY RESIDENTIAL
Application valuation 4"55 s
Owner Contractor
POPE JIM LEE CONSTRUCTION, MICHAEL
78495 VIA.SEVILLA 539.30 AVENIDA MADERO
LA QUINTA, CA 92253 LA QUINTA, CA 92253,
(760) 333-8690
WCC,: EXEMPT
WC: EXEMPT 06/30/.05
CSLB! 602947 02/28/07
CCC C53
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 - INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number. Date:
Applicant: Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:'
Lic. No.:
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
Code, and my License is full fo nd effect. - / O U
License -Class G F� 2 License No. (i
Date D Contra /ice/
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forlhe'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 1, 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 carrier and policy number are:
Carrier Policy Number
I certify that, in the performance of the work for which this permit is issued, I shall of 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 subjec the workers' compensation provisions of Section 3700 of the Labor Code, I shall.
forthwith comply with those provisions.
l t 1 --
WARNING:
-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 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 Ouinta, 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 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 permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and he eby authorize representatives of this county to er upon the above- ntioned properly for inspection purposes.
�A /C
Date 3 �D ���Signature (Applicant orAgent): 4—V
„.Application Number 05-00001457
Permit WALL/FENCE PERMIT
Additional desc
Permit Fee . . . 15.00
Plan Check
Fee
.00
Issue Date
Valuation
455
Expiration Date 10/15/05
Qty Unit Charge_ Per
Extension
BASE FEE
15.00
Special Notes and Comments
21 LF 5' BLOCK WALL PER CITY STANDARD
`
Fee summary Charged Paid
Credited
Due
Permit Fee Total 15.00
.00
.00
15.00
- Plan Check Total .00'
.00
.00
.00
Grand Total. 15.00
.00
.00
15.00
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Gold quartzite file line- °" -36'. �?` Drain
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Boulder spillway`
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Beach Entry:
. / Planter • r 1' { •. t ` �' I �,
' Area 1900sgft of stamped color concrete .•
_ Skimmer & Auto -f 11 _ I :•. -f —�� —.i — "—I' `� I
%n I 'Balcony, �} r+'� ._� �. > il•
New
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�,� , _ t 700sgft grey broom concrete
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No. Jets. 5 . No. -Li hts ' 1
S a raised -'"18" Spillway Type_ Boulders
S ecial'notes
Tool spec: a
Size. 16'.: x+34'_ "Area 453'x'" Per. Y99' ^Y
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R.B.B. no
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Excavation: Type Bobcat
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Size:. Filter' '402.0-c. ; _ Heaters 40d'000
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Type of controls Aqua lodgic 8
Fountains/sera heads none
No. of Skimmers -1 Lights 2
Decking: 1900sq_ Finish Stamp
Coloi Deck drains yes
Steps-- per plan. Notes .
Tile: Type . Quartzite
Step trim None Type -
Masonic : - Coping type Cantalever�: '
Access wall per plan Equip wall °. none
Fire pit 'none - BBQ length
Pebble. yes., Plaster' o '
Color- TBD . Size
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_ .BACKVARD'RESORTS •.
` By Michael Lee Construction '=
Office •(760)777-9838
n 7 - �•'I
' fax -(760)771-9676
s' Licensed since 1"0
03-602947r..
r
Name: Jim Pope
Street:i 78495 Via Seville
City: La Quinta
- Job Address: SAME
Phone Office: Res.
Lot Tract Page - Book -'
Scale 1/8"=1'' Date
Spa spec:, F
Size. 6' ' x- 8' Area. 42Per. 24'
Spa dam wall width 18"• S
No. Jets. 5 . No. -Li hts ' 1
S a raised -'"18" Spillway Type_ Boulders
S ecial'notes
Tool spec: a
Size. 16'.: x+34'_ "Area 453'x'" Per. Y99' ^Y
Depth Min. 3'6" Max: 5" `
R.B.B. no
Love seat per*plan .. . Extra steps no
Tannin 'Led a Rock pockets no
Excavation: Type Bobcat
Elev. Deep end ram "
Removal:- •wall yes Sod t •yes'
Plumbing:- Hayward Equipment
Size:. Filter' '402.0-c. ; _ Heaters 40d'000
Pum ,2ph ' 2nd pump 2h 3rd pump' 4
Type of controls Aqua lodgic 8
Fountains/sera heads none
No. of Skimmers -1 Lights 2
Decking: 1900sq_ Finish Stamp
Coloi Deck drains yes
Steps-- per plan. Notes .
Tile: Type . Quartzite
Step trim None Type -
Masonic : - Coping type Cantalever�: '
Access wall per plan Equip wall °. none
Fire pit 'none - BBQ length
Pebble. yes., Plaster' o '
Color- TBD . Size