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13-0088 (RPL)P.O. BOX 1504 1 r� \ VOICE(760) 777=7012 78-495 CALLE TAMPICO J FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 - BUILDING PERMIT Date: 1/29/13 Application Number: 13-00000088 _ Owner. Property Address: 78520 VIA SONATA' LOOMIS RESIDENCE APN: 646-290-012- - - 78520 'VIA SONATA- Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL --- - Application valuation: 21500 Contractor: n Applicant: Architect or Engineer: AZURE POOLS .AND SPAS �� `� J Zl�[3 �T�C' P.O. BOX 10641 !1 /� PALM DESERT, CA 92255 CITY OF LA QUINTA (760) 322-7665 FINANCE DEPT Lic. No.: 802919 ------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business aanndddProfessionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided License Class C53-�c�'�"�"""' license No.: 802919 for by Section 3700 of the Labor Code, for the performance of the•work for which this permit is issued. Date:): �.i -.'/3 Contractor: � � , ' _ 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 OWNER-BUILDER DV11.110. - insurance carrier and policy number are: - I hereby affirm under penalty of perjury that I am exempt from the Contiactor's State License Law for the Carrier SOUTHERN INS Policy Number PWC002199-12 following.reason (Sec. 7031.5' Business and Professions Code: Any city or county that requires a permit to - _ I'certify that, in the performance of the work for which this permit is issued, I shall not employ any - construct, 'alter, improve,.demolish, or repair any structure, prior to its issuance, also requires the applicant for the .person in any manner so as to become subject to the workers' compensation laws of California, permit to file a'signed statement that he or she is licensed pursuant to the provisions of the Contractoi's State and agree that, if 1 should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business: and Professions Code) or 3700 of the Labor Coda,- t forthwith comply withthoseprovisions. 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).: `Date:A,2�-4g Applicant: - (_) I, as owner ofthe 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 WARNING: FAILURE TO SECURE.WORKERS' COMPENSATION COV AGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN ' improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706, OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . 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.). -APPLICANT ACKNOWLEDGEMENT (_ ). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a, permit subject to the _ 7044, Business and Professions Code: The Contractors' State License Law-does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this -application is made,each person at whose request and for pursuant to the Contractors' State License Law.). - whose benefit work isperformed under or pursuant to any permit issued as a result of this application, - (_ 1 I am exempt under Sec. , B.&P.C. for this reason - 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. - Date: Owner: 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 - CONSTRUCTION LENDING AGENCY - permit to cancellation. _ - I.hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this. application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec, 3097, Civ. C_.1. - - "city and county ordinances and state laws relating to building co truction, and hereby authorize representatives, .. of this county to enter upon the above-mentioned property.f pection purposes. Lender's Name - - - • - - Date/ �� Signature (Applicant or Agent): Lender's Address: - - Application Number 13-00000088 Permit . . MECH POOL Additional desc . Permit Fee 35.00 Plan Check Fee 8.75 Issue Date Valuation 0 Expiration Date 7/28/13 Qty Unit Charge Per,Extension -BASE FEE 15.00 1.00 .9.0000 EA MECH FURNACE <=100K 9:00 '. 1.00 11.0000 --------=----------------------------- EA • MECH FURNACE >100K --------------------------- 11.00 ----------- Permit BLDG POOL PERMIT Additional desc . Permit Fee 225.00 Plan Check Fee 146.25 Issue Date . . . . Valuation 21500 Expiration Date 7/28/13 Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 THOU BLDG `2;001-2.5,000', ----------------------- :180.00 Permit ELEC POOL PERMIT -RES Additional desc Permit Fee. 45.00 Plan Check Fee 11.25 Issue Date Valuation 0 Expiration Date,. 7/28/13 Qty Unit Charge Per. Extension BASE FEE i5.00 1.00 30..0000 EA. ELEC PRIVATE SWIMMING.POOL 30.00.. . --------------------------- ----------'------ ------------ 7-77----------- Permit . . . PLUMBING Additional desc Permit Fee . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 ' Expiration Date 7./28/13 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 ------------------------------ _----Special Notes and Comments ' POOL,SPA; ALARMS./ BARRIERS SHALL BE IN ' LQPERMIT _ Application Number. 13-00000088 �. ----------------------------------------------„---- Special Notes and Comments PLACE AT PRE -PLASTER_ INSPECTION - EQUIPMENT_,ENCLOSURE NOT INCLUDED 2010 CODES. . ----------------------------------------------- - Other Fees . . BLDG STDS'ADMIN (SB1473) 1.00 Fee summary Charged ------------------------- ------------ ---- Paid Credited -------------------- Due ---------- Permit Fee Total "' 338.00 .00 00 338:00. Plan Check`Total' 174.`50 .00 .00 174.50 Other Fee Total 1.00 -.00 •._00 1.00 Grand Total 513.50 .00 '.00 513..50 Bin # Permit # Project Address: A. P. Number. City Of U Quinta, Building & Safety Dlvision P.O. Box 1504, 78-495 Calle Tapico La Quiilta, CA 92253 - (760)77* 7-7012 Building Permit Application and Tracking Sheet h/� I'l9 Owner's -Name: Address: City, ST, Zip: Contractor.. /7,)'-,? U G� OGLS Address: U / G City, ST, Zip:pk X-/ Telephone: ,(/-3 z Z 7& ( State Lic. # (j 9 City Lic. # Arch., Eagr., Designer: Address: City; ST, Zip: Telephone: State�ic. #: Name of Contact Person: Telephone # of Contact Person: '11 nn ') -1 Y # Submittal I Plan Sets Structural Cale. Truss Cale. Energy Calcs. Flood plain plan Grading.plan• Subcontactor Litt . Grant Deed R.O.A. Approval IN ROUSE, Planning Approval Pub. Wks. Appr School Fees Project Description: TIO -0-1-1 . Construction Type: Occupancy. Project type (circle one): New ' Add n Alter Repair Demo_ Sq. Ft.: #S # Units: Estimated Value of Project: APPUCANT: DO NOT WntTE BELOW THIS UNE Recd TRAC KIkG Plan Check submitted Reviewed, ready for corrections Called Contact Person ----------------- Plans Oicked.up Plans resubmitted 2" Review, ready for correctioneusue Called Contact -Person Plans picked up Plans resubmitted Review, ready for.correctionelssue Called Contact Person .Date of permit Issue PERMIT FEES Item Amount Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Grading Developer Impact Pet A.I.P.P. Total Permit Fees