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06-3788 (SOTB)r, P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tiht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 06-00003788 Property Address: 80270 VIA TESORO APN: 772-250-019-25 -30357 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5000 Applicant: �/ We I hereby affirm under penalty of perjury th am Section 7000) of Division 3 of the Busine s and License Class:/C8 C27 C29 ate: ntractor: Architect or Engineer: a'0 ----------------------------- ONTRACTOR'S DECLARATION ense rider provisions of Chapter 9 (commencing with fessiona Code, and my License is in full force and effect. cense No.: 656128 OW ER -BUILDER DECLARATION I hereby affir under penalty of perjury that I am ex pt from the Contractor's State License Law for the following reason (Sec. 7031.5. Business and Professns Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any stn- ture, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is lice sed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 70001 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).: 1—) 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 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.). 1 _ 1 1, 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: LQPEPNIIT Owner: TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE, AZ 85258 Contractor: CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/24/06 ----------------------------------------------- WORKER'S 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 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 n ber are: Carrier SEABRIGHT i Policy Number BB1060510 I certify that, in the performaA work for which this permit is issued, I shall not employ any person it any manner so sme subject to the workers' compensation laws of California, and agree that, if I sho d bubject to the workers' compensation provisions of Section 3700 of the La r Co r4 hwith comply with those provisions. I --,- a: licant: WARNING: F URE TO SECURE WORK SUBJECT AN MPLOYER TO CRIMINAL I DOLLARS ($100,000). IN ADDITION TO SECTION 3706 OF THE LABOR CODE, IN ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN TEST, 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, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Ouinta, 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 abjitrtr�' n is correct. I agree to comply with all city and co my ordinances and state Il9ws relating to build' n, hereby authorize representatives of this intj to enter upon the a_4ov -mentioned propert fo purp as. (Applicant or Agent): It Application Number . . . . . 06-00003188 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 5000 Expiration Date . . 4/22/07 Qty Unit Charge Per Extension RARE FRF 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 ./22/07 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 . . 4/22/07 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 BBQ - Z21-58-1995 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68 STRONG MOTION (SMI) - RES .50 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 5.18 .00 .00 5.18 Grand Total 168.04 .00 .00 168.04 LQPERMIT