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06-1126 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 06-00001126 51749 VIA SORRENTO 772-250-997-74 -31349 STRUCTURES OTHER THAN BUILDINI LOW DENSITY RESIDENTIAL 5000 1 Architect or Engineer: A, A., BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner. r ROSSELET 51-749 VIA SORRENTO LA QUINTA, CA 92253• contractor: 2ALIFORNIA POOLS & SPAS P.O. BOX`1280 20ACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/20/06 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 and Professionals 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: C8 C27 C29 License No.: 656128 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is VZC1!P' issued. ate: Contract6r: �( 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 DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier HRH INS Policy Number BB1060510 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 Contractor's State and agree that, if I should bec a 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 Code, I sh forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by R/ ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Dal€: X 20 Applicant: - (_ ). 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 WARNING: FAILURE TO SECURE WORKER ' COMPENSATION COVERAGE 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 -however, DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, 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 is performed 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 -Icertify 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.). city and county ordinances and state laws relating to building construction, and hereby au thorize•representatives - ' of this county to enter upon the above-mentioned property for ins urposes. Lender's Name: _ Date ? Signature (Applicant or Agenil! Lender's Address: LQPERMIT Application Number ... .". 06-00001126 Permit .` . . . BUILDING PERMIT Additional desc.. Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . Valuation 5000 - Expiration Date 9/16/06 Qty Unit Charge Per Extension BASE FEE .45.00 3.00 9.0000 THOU BLDG 2,001-25,000 ----------------------------------------------------------------------------- 27.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation 0 Expiration Dat -z! 9/16/06 " Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- 2.25 Permit PLUMBING Additional desc . Permit Fee 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . 0 Expiration Date 9/16/06 Qty Unit Charge Per Extension BASE'FEE 15.00 1.00 3.0000 EA ° PLB GAS PIPE 1-4 OUTLETS 3.00 - ----------------------------------------------------------------- Special Notes and Comments BARBEQUE (Z21-58-1995). ------------------------------------------------- Other Fees . . . . . . . ENERGY REVIEW FEE 4.68 .Fee summary. Charged Paid Credited Due -- ---------- ---------- ---------- Permit Fee Total 107.25 .00 .00 107.25 Plan Check Total 55.61 .00 .00 55.61 Other Fee Total 4.68 .00 .00 4.68 Grand Total 167.54 .00 .00 167.54 ' LQPERMIT .. 'Bin it ' - City of. La Quints Building U Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit -Application and Tracking Sheet Project Address: S/— y9 V So Owner's Name: , A., P. Number: Mo e Address: -,7- /_ V Vick p Legal Description: City, ST, Zip: . au i v. Contractor`s- 1 ` Telephoner Address: �� © (2-3 CP Project Description: ' City, ST, Zip(q C! Telephone: State Lic. # -.'6105 Z - City Lic. #: • Arch., Engr., Designer. Address: City, ST, Zip: Telephone: : Construction Type: Occupancy: .. P Y State'Lic. #: Project type (circle one): Add'n Alter Repair Demo - . Name of Contact Person: -, C) Sq. FL: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project:. j '5- O 0 O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMUr FEES, Plan Sets Plan.Check submitted j Item Amount ' Structural Calcs. Reviewed; ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction GOT8, Flood plain plan Plans resubmitted Mechanical Grading. plan' r' Review, ready for corrections/issue Electrical - 3 Ft ueeS Subcontactor List Called Contact Person - Plumbing _ pp7(�ZS ,Grant Deed Plans picked up .- '• S.M.I. . . H.O.A. Approval Plans resubmitted Grading i .IN ROUSE:- ''" Review, ready for corrections/issue- Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees C OF LA Q U l nl BUI ING8 SAFETY.DEPT. Total Permit Fees I DATE BY% ' 1 11 1 —L 1 11 12" 141 32" J3 1/2" 71 G-) =mo7- cry m r- r - m ;a rn > I — frt"1 m --1 --71 m -u > m It-\= C� . * n 71 �n P: M > F m m C) 70 0 -o > —A > 0 z C) 0 Om E: Z c 0-7 S2 < > MT) > cf) 7-- L 0 Z m .:.1: bA� 0 U) > co:: F— --j— ^�� rnm o 11>3 (-) n M:K nx o> 0 ;:u 70 F-4 0 N m z C) z m m r 70-n, m m Cl) to �.-j VARIES r 70 J 76 m I D > CC z z 02: 0 1 , 0 ;;o G-)7 I6° VARIES 6"l �70 0 0 I I Ic � I .. C: oi 1 0 . I 0 000- m0 M z 0 7C InVARIES D O r- . n m - G) Ln o N m m cn m co N\ > co ;urn -U -n -n < m m C/) <7(nu > 0 > z m < G-) =mo7- cry m r- r - m ;a rn > I — frt"1 m --1 --71 -u > n P: M -14 F m m C) 70 0 -o > 70-n, m m Cl) to �.-j VARIES r 70 J 76 m I D > CC z z 02: 0 1 , 0 ;;o G-)7 I6° VARIES 6"l �70 0 0 I I Ic � I .. C: oi 1 0 . I 0 000- m0 M z 0 7C InVARIES D O r- . n m - G) Ln o N m m cn m co N\ > co ;urn -U -n -n < m m C/) <7(nu > 0 > z m < n Uy Cf) Iz m J10 VARIES m 11/2 [T r- Co > --i z C: cn VARIES > C� C N t:VARIES M ,--cn r- QOO 0 mn M X:c --i 0 0 rr-) (-)::j (-Y-)i Or- G-) =mo7- cry m r- r - m ;a rn > I — frt"1 m --1 --71 -u > n P: M -14 m m C) 70 0 > P F cn > 0 C) 0 Om E: Z c 0-7 KL-7777�1 MT) > cf) 7-- L 0 n Uy Cf) Iz m J10 VARIES m 11/2 [T r- Co > --i z C: cn VARIES > C� C N t:VARIES M ,--cn r- QOO 0 mn M X:c --i 0 0 rr-) (-)::j (-Y-)i Or- �2 C) (f) Z--i =mo7- Mm> 7Z — Z m r- r - m ;a I m (D cn q l '