06-2208 (SOTB)r 1,
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
-Date: 5/31/06.
Application Number: 06-00002208_ Owner:
Property Address: 080525 VIA TALAVERA'\ PURVIS
• APN: 772-250-999-144 -30357 - 80-525 VIA TALAVERIA
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5000 D d
Contractor:
Applicant: Architect or Engineer: CALIFORNIA POOLS & P S
P.O_ BOX 1280. JUN 0I 1006
COACHELLA, CA 92235,
(760)319.8-9222 CitypF�QUOAlT�1
_ Lic. No.: 656128
FJ QUINTA DE31'.
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• LICENS CONTRAndCTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am sed uer provisions of Chapter 9 (commencing with Ihereby affirm under penalty of perjury one of the following declarations:
Section 7000).of Division 3 of the Businqksand ro ionals Code, and my License is in fullforce and effect. ' I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided -
License Clas : C C27 C29 .License No.: 656128. for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
y issued.
Date: a//• Contractor:,' _ - - - _. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor -
M�- 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 SEABRIGHT • 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 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 beco subj t 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 LaborQdtlf, I shall oth 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 f --
any applicant for a permit subjects the applicant to a civil penalty of'not more than five hundred dollars ($500).: f Date S� _plicaApnt: i
(_ 1 1, as owner of the property, or my employees with wages as their sole compensation; will do the work, and C - - - L
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The' WARNING: FAILURE TO SECURE ORKERS' C NSATION 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 DOLLARS J$1 00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
improvements are not intended or offered for sale. If, however, 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 "
1 _ 1 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 result of this application,
• ( ) 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 I certify that I have read this application and state that the abo&urposes.
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 cauthorize representatives
_ of this cou ty to nter upon the above-mentioned pro for
Lender's Name: - _ -t-- - ^
Date: ' Y.� Signature (Applicant or Agen
Lender's Address: - --
LQPERMIT
Application Number
. . . 06-00002208
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
72.00
Plan Check Fee
46.80
Issue Date . . . .
Valuation
5000
Expiration Date
11/27/06
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 Date
11/27/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00 .7500
PER ELEC
DEVICE/FIXTURE 1ST 20
2.25
--------------
Special Notes and Comments
------------------------------,
BAR -B -Q ONLY PER APPROVED PLAN
Fee summary Charged,
------------------
Paid Credited
Due
--7
Permit Fee Total
------ ----------
89.25
--------------------
00 .00
89.25
Plan Check Total
51.11
.00 .00
51_11
Grand Total
140.36
.00 .00
140.36
LQPERMIT