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04-8027 (RPL)t C4 rV BUILDING & SAFETY DEPARTMENT 1504 OFTi'9 78-495 CALLE TAMPICO (760) 777-7012 FAX (760) 777-7011 LA QUINTA•, CALIFORNIA 92253 INSPECTION.REQUESTS (7 60) 777-7153 BUILDING PERMIT Application Number 04-00008027 Date 12/28/04 Property. Address . . . . . . 5122 `VI'A S -O RENTO APN:. 772-250-997-96 -31349 Application description POOL- RESIDENTIAL Property Zoning . . . . LOW DENSITY'RESIDENTIAL Application valuation 17000 - Owner `t Contractor ------- ------------------ -- - ---- -- ----- --- TOLL CAV CALIFORNIA POOLS'& SPAS C/O KEVIN D DUERMIT P.O. BOX 1280 8901. :E' MOUNTAIN VIEW 200 .COACHELLA, CA 9223.6 e SCOTTSDALE, AZ 8.5258 .(760)398-9222. WCC: STATE FUND WC: 04600061168 01/01/0.5 CSLB: 656128 10/31/06 CCC: C8 -C27 -C29-053 i DEG 2 91004 CITY OF IA QUINTA . FINAFdC� t3Ef�T. ' P.O. BOX 1504 • ��V�'►N 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: 0 4- aag 7 Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or Engineer: 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 rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C e, and my Li-pris,'n I force and effect. nse ClassC_ — J � cen No. o S W 2 / Date % 2 /?- /o Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for 116 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 contractors) licensed pursuant to the Contractors' State License Law.): U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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. Al have and will maintai workers' compensat' insurance, as required by Section 3700 of the Labor Code, for the -performance of the work for which this permit is iss ed. y worke compensation ' ranceprier fin. 'cyAmum r aje.e �� Carrier olicy Num CJ C/ (J _ I certify 1hit, in the performance of the work for ich permit is issued,.) shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t, if I s ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shad forthwith comply with those prmuistiins. WARNING: FAILURE TO SECURE WORKERS' CO NSATI N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN, EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D RS 00,000), IN ADDITION TO.THE COST OF COMPENSATION, DAMAGES AS PROV DED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 Lenders Address IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT afeA Safety aACKNOWLEDGEMENT 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 i w rk 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 co I gree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize re resentatives of this county to enter u n e -mentioned property for inspection purposes. Date �/v1 Signature (Applicant or Ager,0' 1c Application Number `. . . . 04700008027,. Permit BLDG POOL PERMIT Additional ,desc' . . Permit Fee 180.00 Plan Check Fee .. 11.7.00 . Issue Date Valuation 16760 Qty Unit Charge Per: Extension' BASE FEE' 45.00 15.00 9.0000 THOU BLDG 2,001-25,000 135.00 Permit . . . . . MECH POOL Additional.desc Permit Fee . . . . 24.*00 Plan Check•Fee 6.00 Issue Date" Valuation 0 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 3.75 Issue Date Valuation . . 0 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 . . . . 33.00 Plan Check Fee 8.25- Iss.ue 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 Permit . . . WALL/FENCE PERMIT . Additional desc Permit Fee 15.,00 Plan Check Fee .00 Issue Dame. Valuation 240 Qty Unit Charge Per Extension BASE FEE 15.0.0 Special Notes'and.Comments POOL & SPA. 15 LF OF 4'`BLOCK WALL*CITY STANDARD.. ALARMS/BARRIERS SHALL BE IN PLACE.PRIOR TO,PREPLASTER INSPECTION. Fee summary. Charged Paid Credited Due Permit Fee Total 29.7.00 00 .00 297.00 Plan Check Total 135.00 .00 A0 -.135.00 i I 11, 1! 11, 1 I _', __ - - L __ � , I � , , � , � - � - � � :1 _ - � ------------- - - - ._____________________. _____ ______ ------------- ___________________,.__ ----L------------- ______ _______L___,_ ____ ____,__ , - ------------- - , ____________._______ _______.__ - _______________,__ -_ _____ I .1 � I I I I I I . I 1. -_ I I � I � .1 -- -_ - --- , --- --- I � I . I I I . I � I I I I I I I - I � . .1 I � � � �. I I I - I I . I I I I . . I I I I I � � .1 t I I . I I I I . . I _� I I �_�� I I I I I I . . I � I I I I I I � � I 1. I � I - - � . � � I I � . I . � .. I I I . I I I . I I I - i I I � I I . I I . I I I I � I � I . 1, I . . I I . . I . � 11. I I � I � . - 1. 11 I �, - I � - . I . � I � I I I I I I . I I I .. � I I I � . I . I . I . 1. I I I . I I I � I I - � I I . I I I I I � -1 - . I . 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