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07-1140 (RPL)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: 4/19/07 Application Number: 07-00001140 / Owner: Property -Address: -----,-4 7850 VIA ZURICH BAILEY RESIDENCE APN: 643-140-061-84 -26152 47-850.VIA.ZURICH Application description'. POOL RESIDENTIAL D b QUINTA, . CA 92253 Property Zoning: LOW-DENSITY RESIDENTIAL Application valuation: 30000 - SPR OOl. ontractor. .. Applicant: Architect or' Engineer: CITY 0F LPINE POOL' S ' &. SPA'S .INC - PBW ��lil6�i� P.O. 'BOX 4687 , PALM DESERT .CA 92261 Vt LC. No.: 786324 -- - - - - - - - - - - - - ----- - - - -- - - - - - - - - - - - ----- - - - - -— • .LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - I`hereby affirm under penalty of perjury one of the following declarations: - - - Section 7000) of Division 3 of the Business and Professionals Code, and: my License is in full force and effect. - s I have and will maintaina certificate of consent to self -insure for workers' compensation;as'provided License Class: ' C 5 3 - License No.: 78632.4 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ - issued.'. %Date: Contracto - ' _ I have and will maintain workeis',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 - - `�` OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury than am exempt from the Contractor's State License Law for the - - Carrier STATE FUND- .. Policy Number 0023236-2007 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 become 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 become subject to the workers' compensation provisions of Sections- - - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cod I s It rthwith 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 . L - _ 'any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500).:- -Date: /nim , Applicant: - (_ C 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 HUNDREDTHOUSAND -and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). W 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 .. ( ) 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 contractsfor the projects with_a contractorls) 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 a result of this application, (_ 1 1, am exempt under Sec. , BAP.C. for this reason - - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City - - ' of La Quints, its officers, agents and employees for any actor 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 isnot 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 herebyaffirm 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 above information is correct. I agree to comply with all. • work for which this permit is issued (Sec. 3097, Civ. C.). `Cityand county: ordinances and state laws relating tobuilding construc io and hereby authorize representatives .. ofthis county enter upon the above-mentioned property for ' p urposes. 'Lender's Name: - 7 /]� - - Date: f T Signature (Applicant or Agent) - '.Lender's Address: tel. LQPERMIT .. Application Number .' 07-00001140- .-Permit BLDG POOL PERMIT Additional desc .. . Permit.Fee' 284.50 Plan Check Fee 184.93 Issue-Date Valuation. 30000 Expiration Date 10/16/07 Qty Unit Charge- Per _Extension BASE FEE 252.00 5.00- 6.5000 THOU. BLDG 25,001-50,000 32.50 'Permit ELEC POOL-PERMIT-RES Additional desc . Permit Fee 45.00 Plan Check Fee.. '11.25. Issue Date, . . . Valuation 0 Expiration Date . 10/16/07 Qty Unit'Charge Per Extension BASE- FEE_ .: 1.00` 30_0000 EA ELEC`PRIVATE:SWIMMING POOL- 30:00 Permit . . :' PLUMBING, Additional desc .. Permit..Fee . : 24.00 Plan Check F.e&_., 6.00 Issue Date Valuation 0 Expiration.Date .. 10/16/07 Qty "Unit Charge Per ; -Extension BASE FEE 15.00.- 1.00' 6.0000 EA ,. PLB FIXTURE 1.00 3.0000 EA PLB WATER' INST/ALT/REP '. .3':00 - - -- - -- - -- - --- tes and Co Special`Nomments - - - ----- POOL. ALARMS/BARRIERS SHALL BE .IN PLACE P.T PRE-PLASTER INSPECTION.EQUIPMENT ENCLOSURE"NOT-INCLUDED Fee summaryCharged Paid Credited Due -------------------------- Permit:Fee Total 353.50 .00 -- 00 •353.50 Plan Check Total' 202.18_. .00. .00 202.18 ` 'Grand-Total 555.68 .00 .00 555.68 Bin # City of LaQ uinta Building U Safety Division M. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ..Building Permit Application and Tracking Sheet Permit .# Project Address:' 7 - 95D V.4 Owner's Name:.. A. P. Number: Address: 5 4 ✓n Legal Description: Contractor: ,•UE Poo ` S W5 -City, ST, Zip: Telephone:, Address: PQ &V 4& 7 -Project Description: �(- City, ST, Zip: Y'lv, C o e/�- Telephone: State Lie. # : (o SrqCity Lie. Arch., Engr., Designer: C/ Address:. (i A,�/ City., ST, Zip: Telephone: State Lid.. #: Name of Contact Person:. w �; Construction Type: 9Occupancy: Project type,(circle one): New Add'n . Alter Repair Demo. Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: > G 0 9.7 - 7P 4 Estimated Value of Project: J© OQ O APPLICANT: DO NOT WRITE BELOW THIS LINE . . # Submittal . Req'd: Recd TRACMG . PERMIT FEES Plait. Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan. Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan . Plans resubmitted Mechanical Grading, plan . 2"d.Review, ready for eorrectiouslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- m Review, ready for eorrectionstissue. Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees