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05-0648 (RPL)Lou BUILDING & SAFETY DEPARTMENT P—.O--B 1504 (760).777-7012 78-495C�ALLE TAMPICO FAX (760) 777-7011 LA QU�iNA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 �� 242D05 BUILDING PERMIT o� L, f1�Q!Acen��. Appli.ca .-ion Number . : . . . 10_5=00000.648, : Date 2/22/05 Property Address 80520 VITALAVERA APN: 772-250-999-124 -30357 - Application description, POOL — RESIDENTIAL Property Zoning . . LOW DENSITY RESIDENTIAL Application valuation 17000 Owner Contractor ------------------ ------------------------ TOLL.CA V CALIFORNIA POOLS & SPAS C/O KEVIN D DUERMIT P.O. BOX 1280 8901 E MOUNTAIN,VIEW'200 COACHELLA CA 92236 SCOTTSDALE AZ 85258 (760),398-.9222 WCC: SEABRIGHT INS WC:_ BB1050510 01/01/06 CSLB: 656128 10/31/06 CCC:- C8-C27-C29-053 Permit BLDG POOL PERMIT Additional desc Permit Fee 15.00 Plan Check Fee 9.75 Issue Date Valuation . . . . 80 Qty Unit Charge Per Extension BASE FEE 15.0 0 ---------------- 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 . . . . BLDG POOL PERMIT Additional desc Permit Fee 1,89.00 Plan Check Fee 122.85 Issue-Date . . Valuation . . . 17920 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 THOU BLDG'.2,001-2.5,000 144.00 ------------------------------------------------------------------- Permit . . . . ELEC POOL PERMIT-RES - Additional desc Permit Fee 45.00 Plan Check Fee 11.25 P.O. BOX 1504 • '�� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Application Number: A5_` Z Date: Z-2-5--5 Applicant: I Architect or Engineer: Applicant's Mailing Address: /Y TiP,n C TO K Architect or Engineer's Address: `C%1' Lic. No.: t$UILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm undpenalty of perjury that I am licensed un ovisions of Cher 9 (comr0encing with Section 7000) of Division 3 of the Business and Professionals ode, and my Lice i! ^' force and effect. x//66 License Class J L ens No. ` ,Xate Z 7` C)S Contractor -, OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt fro a 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date 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 Lof the work for which this permit is issued. I have and will maintainArkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is U worker5%dompensation insurance carne � o n r� �arrier (�i11 Policy Number ��16 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 t t, i hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall �� forthwith comply with those provisions. trate � A,,plicant WARNING: FAILURE TO SECURE WORK RS' COMPENATIO COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA 00,000), 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 A/ZT Lenders Address 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, 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 vFte-mentioned ot 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 e to comply with all city and county ordinances and state laws relating to building Ycconnstructio/nn,, and hereby authorize representatives of this county, to ter /upon property for inspection purposes. /Date Signature �� Signature (Applicant or Agent li Page 2 . Application Number 05-00000648 Date 2/22/05 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 Issue 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 Special Notes and Comments POOL & SPA. S L.F. 4' BLOCK WALL,, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED ,IN PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 306.00 .00 .00 306.00 Plan Check Total 158.10 .00 .00 158.10 Grand Total 464.10, .00 .00 464.10