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05-1596 (BLCK)z BUILDING & SAFETY DEPARTMENT BO 1504 (760),777-7012 78-49 ALLE TAMPICO FAX (760) 777-7011 LA Q A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 APR 2 9 105 BUILDING PERMIT CITY OF LA QIIINTA Property Address . . . . . . APN: Application description Property Zoning . . . . . . . Application valuation . . . . 05-00001596 Date 4/27/05 53395 VIA STRADA 772-540-033- - - WALL/FENCE LOW DENSITY RESIDENTIAL 5818 Owner Contractor --------------------------------- ----- --------------------------- DECKER GARY L & JANE J CALIFORNIA POOLS & SPAS 43611 OLD HARBOR DR WCC: SEABRIGHT INS BERMUDA DUNES, CA 92201--0 WC: BB1050510 01/01/06 CSLB: 656128 10/31/06 CCC: C8 C27 C29 C53 ---------------------------------------------------------------------------- P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Mailing Address: NO / V Fc , 6 l( Architect or Engineer: Architect or Engineer's Address: Lic. No.: AbIt BUILDING PERMIT DECLARATIONS CENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed un r pr isions of Chapter 9 (co encing with Section 7000) of Division 3 of the Business and Professionals ode, and my Lice s. is 42:f force and effect. ��/ / �� icense Class • 7 Li se o. (C7l Date �G 0S Contractor OWNER -BUILDER DECLARATION I 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 70.00) 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 contractor(s) licensed pursuant to the Contractors' State License Law.). L) I am exempt under Sec. , BA P.C. for this reason Date Owner. WORKERS' COMPENSATION DECLARATION I 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 d will mainI , workers' compensation insurance, as required by Section 3700 of the Lab r Code, for the performance of the work for which this permit is ork ompensation insurance carrier I' umber r artier Policy Number ((p _ I certify that, in the erformance of the work for w ' this mi is issued, I shall not employ,dny person in any manner so as to become subject to the workers' compensation laws of California, and agree t I. if I shou become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall %ffoorJthwi comply with those pr ' ions. D �Applic int WARNING: FAILURE TO SECURE ERS' COMPEN N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND 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 A 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, ea h 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 o erformed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and if work is no mmenced within 180 days from date of issuance of such pernit, 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 info ation i rrect. I agr o comply with all city and county ordinances and state laws relating to building construction, anh�er'eby uthorize representatives of this county to er upon ibo entioned property for inspection purposes. Date" l/6 Signature (Applicant or Agent): ---------------------------------------------------------------------------- } Application Number . . . . . 05-00001596 ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 81.00 Plan Check Fee .00 Issue Date . . . . Valuation 5818 Expiration Date 10/24/05 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001-25,000 36.00 ---------------------------------------------------------------------------- Special Notes and Comments 30 L.F. 5' BLOCK WALL & 120 L.F. 36" BLOCK WALL, CITY STANDARD. 150 L.F. 51 - BLOCK WALL, ORCO SYSTEM. Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 81.00 ---------- .00 ---------- .00 81.00 Plan Check Total .00 .00 .00 .00 Grand Total 81.00 .00 .00 81.00 Bin # City Of La QUICK Building 81: Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: — 3% Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: C Li Fo MODLS Telephone ::.<•::.:::::.::;<>.• .:.::::....::•.,:•. Address: Box Z%( Project Description: City, ST, Zip: 60c, cke, 114 3 0 Telephone: s State Lic. # City Lic. #: Arch., Engr., Designer: • s —' d' 68 « � 0 LK L L— �'/� ✓�' �G' Address: City, ST, Zip:' St's c ��/l3Lv �/t✓� ®l�� Telephone: State Lic. #: .y:: >•M1:` �:,•::v:4r,`;'i#;::� '::i: inti:`;:':.:;:c;:;:; ,::;:•<<»>:>;>:>::::<<•>:rirr::>:<.:>:s,.< Construction Type:Occupancy: Project type (circle on Ne Add'n Alter Repair Demo Name of Contact Person: boi s'dK54:5" Sq. FL: # Stories: # Units:. Telephone # of Contact Person:.2'�5"-114 G.-75'—O,;t Estimated Value of Project:' v APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan-Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°d Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing I • I Grant Deed I I I Plans picked up I I S.M.I.. I I H.O.A. Approval Plans resubmitted Grading IN HOUSE: 7rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr I • I I Date of permit issue I I I School Fees Total Permit Fees