The URL can be used to link to this page

04-5019 (RPL)P: O. BOX 1504 BUILDING' & SAFETY DEPARTMENT OE.78-495 CALLE TAMPICO (760).777-7b 12 LA QUINTA, ,CALIFORNIA 92253 FAX (760) 777-7011 INSPECTION REQUESTS (760)• 777-7153 BUILDING PERMIT c Application Number 04.-00005019 Property Address 50225 VIA-SIMPATICO- Application IA. SIMPATICO Date 6/17/04 APN: 772 -400 -019 - Application description . POOL -,RESIDENTIAL Property Zoning . . LOW.DENSITY'RESIDENTIAL Application valuation . 15000 Owner -----=------------ETI Cont-r--actor R J T HOMES -`----1425 E UNIVERSITYDR RJTI1HOMES LLC PHOENIX 4 1.425JE. UNIVERSITY DRIVE AZ 8_PENdIXAZ 85034 A QUI�tiF�i DEI''EWCC c STATE FUND WC: 1583906 10/01/04 CSLB: 690645 06./30/04 CCG: A -B ------------------ -----= - ------ P.ermit - -------- Additional desc MECH POOL ------------ Permit Fee 24.00 Issue Date an PlCheck Fee . 6.00 Valuation 0 . . .Qty Unit Charge Per BASE. FEE Extension - --; --- 9-0000 EA MECH-FURNACE z=100K 15.00 ----------- .Permit.. ------------------- 0 BLDG POOL PERMIT ----- Additional desc Permit, Fee 162.00 Plan Check Pee . Issue Date 105.30 ' Valuation 15000. 4ty� Unit Charge Per BASE FEE Extension 13.00. 45.00 -9_0000-THOU.•BLDG 2;001=25,000 - -----------=------ --�=----------117-00_ Permit ------- ---------------------- POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check Fee . Issue Date ,: 11.25 ' Valuation 0 Qty Unit Charge Per BASE FEE Extension 1.00 30.0000 EA ELEC PRIVATE.`SWIMMING.POOL 15.00 30.00 P.O. Box 1504 t!'f�Gv 78-495 CALLE TAMPICO 4 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: . Applicant's Mailing Address: Architect or Architect or Lic. No.: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 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 Li nse r n full force and effect. ago t i License Class License No. a `(' i Date C9 Contractor b� OWNER -BUILDER DECLARATION 1 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 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 Owner . WORKERS' COMPENSATION DECLARATION a 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 �r _VssyediMy wo compe sation insurance carrier and policy nurq are: Cartier C�1".� -P �,�/� Policy Number Z_as a mss` 8 _ i certify that- in the performance of the work for which thiCorittif is ssu d, 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, I shall forthwith comply with those provisions. Date Applicant 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, indemnity 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 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. 1 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 hereby authorize representatives of this county to enter upon the abo� ventioned property for inspection purposes. Date67 uc"Z111 Gly Signature (Applicant or Agent): Page 2 Application Number '04-00005019Date 6/17/04 Permit . . . . ... PLUMBING Additional desc.... Permit Fee 31.00 Plan Check Fee 8.25 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 PIPE 1-4 OUTLETS 3.00. Fee'summary Charged Paid Credited Due Permit Fee Total 264._00 .00 .00 264.00 ". Plan Check Total 130.80 .:00 .00 130.80 Grand Total 394.80 .00 .00 394.80 v v`' - n,4*, • ,n�r r ,:rW. 7r o. -: y{ ` Y '4,7 n. •. `r b d I N14 . O3 7 FFA f a 39,00 249 G '?? J SQ TyP4 00 co .. �. VL- A.. � J 2e J P4170 le Je P40, 0 4;70 V14 CA ,�• `��i� Sz05 3�� ny � IF� a► e a 68 NPj0 Ss�OX. At R E- I N_C101�1-$" W�tCE CHARGED IF THE APPROVED D DIN 5�� p� NS AND ` CARD ARE NOT ON y�? ' SITE"' 4 SCHEDULED _ .. ' F® CCT/ON INSPECTION... NO EX TPTIO�! �,TE pY — — A-4 0��:. 8 ��