05-2349 (RPL)P.O. BOX 1504 ^'
78-495.CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: f05-00002349 Owner:
Property Address: 51341 VIA SORRENTO LEDERER LLOYD'
/CPN: 772-250-997-91 -31349 - 51-341 VIA SORRENTO
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000 1"\
Applicant:
Architect or
--------------------------—-----------------------
LICENSED CONTRACTOR'S DECLARATION
1 ereby affirm under penalty of perjury that I am licensed under provisions of��hapter 9 (commencing with
ction 7000) of Division 3 of the Business and Professionals Code, and myXicense is in full force and effect. -
✓✓✓✓✓✓
Licepse ss: I L1�i nsee No.: �cl
`bate Contractor:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 703,1.5, 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 Contractor's 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 (5500).:
(_) 1, 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 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.).
(_) 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason -
.Date: Owner:
CONSTRUCTION LENDING AGENCY
-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: -
LQPERMIT
Contractor:
PICASSO POOLS, INC
WCC: STATE FUND
WC: 1709395
CSLB:' 810111
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)777-7153
12/01/05
07/31/06
------------------
WORKER'S COMPENSATION DECLARATION
Date: 6/15/05
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.
X 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: ,
rrier B C27 C53 Policy Number - - -------- - - - - --
_ 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 b come subject to the workers' d' pensat'ion provisions of Section
3700 of the Labor Code, sUm
y vJit s provigions.
ate: Applicant: _
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE AGE 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.
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, andthe 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.
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. 1 agree t omply with all
city and county ordinances and state laws relating to Zildicons,ruclion, and hereby auth 'z re esentatives
of this ' o my o enter upon the above-mentioned pr ction ur 11
Da Signature (Applicant or Agen
Application: Number . . 05-00002349
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee 162.00 Plan Check
Fee
105.30
Issue Date Valuation
15000
Expiration, Date 12/12%05
Qty Unit Charge Per
Extension
BASE FEE
45:00
13.00 9.0000 THOU _BLDG 2,001-25,000
117.00
Permit . . . MECH POOL
Additional desc
`
Permit Fee 26.00 Plan Check
Fee
6.50
Issue Date . . . . Valuation
0 .
Expiration Date 12/12/05
Qt y• Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.00
Permit ELEC.POOL PERMIT -RES
Additional desc
Permit 'Fee 45.00 Plan Check"•Fee
11.25
Issue Date Valuation
0
Expiration Date 12/12/05
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
Issue Date Valuation
. . .
0
Expiration Date 12/12/05
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 3.00"0.0 EA PLB GAS PIPE.1-4 OUTLETS
3.00
-------------------------'---------------------------------------------
Special Notes and. Comments
-
" POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
,•
I «,- Application Number 05-00002349
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•• _ �'
Special Notes and Comments , .
�•
-. BE IN PLACE PRIOR•'TO PRE- PLASTER
t
INSPECTION. 'EQUIPMENT; ENCLOSURE NOT
-}INCLUDED IN PERMIT_
Fee summary. Charged Paid
Credited'
- Due
t, Permit Fee Total 266.00 .00
00
266.00
7 Plan Check Total 131.30_ .00
00
131.30.
'
Grand Total 397.30 .00
00
397.30
i
a
• LQPERAfff .. '
•• .. - .. '
J.
.. - -
Bin #` Ot t'�f La Quint2
`Y
Btiiltimg. Safety Division
P.O. Box 1304, 78-4-95. Ca1Je Tan7pirn .
Permit # La Quints, CA 922.3 - (760) 777-7012
Buildin; Permit Application and Twkinlr Shee•
Projea Addmrs: �l .vz;, .� pil[�o �jiter's 1�amc
A� P. Ntunber. Address:
Lega1.Descrivtion: Cin•. ST. Zip: 7
14C,Cotttractor 1 elephone: p2� o.� 9
Address: 0 eO l
Project Description:
Cm,. ST. 75
Telephone:
ne:
Pa o
�c State Lie 8 01 ` I Cin Lim r: C?—)D
.Arch_"_ Dcsiontr.
Adult=s:
Ctn•. ST_ Zip: .
_;;.:gin;::;€:<": c: :7cu aim
Telephone: p„E:$:.: - Consuuetion Typt:
F
State Lir ; : - `'%3 =''' - Project n c (circle one): )`ren• Add'n Ali --r RCP*.. Demo
:.....
1�ameiof Cotttaa Person: $q. FL: r StoriesL'ritc �_
clephone # of Contaci Person: — 4 �p�® Estimated Value of P pica:
APPL•1CANT::DO NOT WRITE BELOW THIS LINE
R +
Submitral, I
Req'd I
Ree'd
TR4CKJNG I
. EMIT FEES
Plan Sets (
Plan Check submitted I6hsl
Item I
Amount
Structural Cares I
Reviewed. ready for corrections I
Plan Check Dcposs �I
Truss Caps. �
Called Contact Person.
Plan Check B;.lance
Title 3'9 Cales �'
I
Plans picked up I
Construction
71bod plain plan
I
Pians resubmined I
Mechanic=1
Grading, pian (
2., Rnicw. rtadv for corrcctionsitssue I
Electrical
Subeontaetor List
I
Called Contact Person
Plumbing
Grant Deed,
Plans picked up'
H O .Approval
I
'Plans rrsubmined
I
-Grading
HOUSE:-
I
'"Review. ready for correcriorm-issue
Developer Impact Fee
Planming Approval "I
Caked Contact Person
A-1.P•P•
.Pub. Wks. Appr
Date of permit issue
School'Tt s
-
1
Total Pc. -mit Fees