05-1351 (SOTB)awcu
` a BUILDING & SAFETY DEPARTMENT
P.,O. Box 150.4r
(760),.777-7012
® `�0 78-495 CAL.LE TAMPICO - FAX (760)'777-7011
C
A
LA QUINT, ALIREQUESTS (7607-7153FORNIA 92253 INSPECTION ) 77
_, . . ► .
o � _ BUILDINGRERMIT
Application Number 05=00001351., Date 4/,11/05
Property Address 78935 VIA•VENTANA
APN: 646 -330 -026 -,-
Application description' . .""STRUCTURES OTHER THAN BUILDINGS
Property Zoning LOW DENSITY -RESIDENTIAL
Application Valuation L' 500
Owner Contractor .'
---------------------- ----------.--------------
QUAD D A LTD PARTNERSHIP �y CALIFORNIA POOLS & SPAS
5 PEPPERWOOD.DR P.O: BOX 1280
SANDY UT 84092 COACHELLA.CA 92236
y (760)- 398-9222
WCC': S'EABRIGHT INS '
• - WC: BB1050S10 -01/01/06
CSLB: 656128 10/31/06
CCC:' C8 C27 C29 C53
Permit BUILDING PERMIT
Additional desc
Permit Fee 15.00 Plan Check Fee , 9.75
Issue Date Valuation 500
Qty. -Unit Charge Per Extension
BASE FEE - 15.00
----- - - - --- - - - - a- -7---,-7-77 ------------------------------
Permit , ..PLUMBING
Additional desc
Permit Fee 18.00 . P1aH Check Fee 4.50
Issue Date t'_`. Valuation , ` 0
Qty Unit Charge `Per "' 'Extension
BASE'FEE - 15.00
1.00, 3.-0000 EA PLB GAS PIPE'1_4 OUTLETS 3.00
--------------.--- ------,---------- --_-------- ---- ----------=------n------- --- ------
Special Notes and Comments
FIREPIT. AGAL #496
Other Fees ENERGY ENERGY REVIEW FEE .98
Fee summary, • Charged Paid Credited, Due
- Permit Fee Total -33 00 .00 - - -- :-' -� - - ---_ - -' :00 -----33.00
Plan Check Total 14.25 00 ..00 14'.25
Other Fee: Total tj 98.:, .00 .00 98.
Grand Total '48.23 .00 .00 48:'23
P.O. sox 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: 05' 3 S / . Date: "�2 --o's—
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
00" T/ ?, AGTOK
Architect or Engineer's Address:
Lic. No.,
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
force and effect.
hereby affirm under penalty of perjury that I am licensed un er provisions of ChaptQQr 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
C e, and my Lie I
IcenSe Clas L en a No
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 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).):
L) 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
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 ave will mainfin workers' compensation insurance. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
v_ er is wr ar
arr cd _iI SLSL_l AL�rJa{e�'
! /1
Policy Numb r
_ 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fort with comply with those pprovi 'ons.
Applicant
WARNING: FAILURE TO SECURE WOR RS' COMPENSA COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND 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
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 oi� 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 v i rk 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 above info ation is c ect. agree to comply with all city and county ordinances and state laws relating to building
construction,/ d her by authorize representatives of this county to n er u on t e e -mentioned property for inspection purposes.
Date,
Signature (Applicant r
9 ( pp o Agent tp