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05-3227 (RPL)P.O'. BOX 1504, VOICE (760) 777-7012" 78-495 CALLE TAMPICO FAX (760) 777-7011 LA.OUINTA, CALIFORNIA 92253. BUILDING & SAFETY- DEPARTMENT. INSPECTIONS (760) 777-7153 BUILDING PERMIT rit�.:.:Date 7/27/05 Application Number: — .0 5.7 UOUU322 Owner: - Property Address:.56905 VILLAGE DR JOHNSON .APN: 764-050-030 - 56-905 VILLAGE DRIVE Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000. Q Contractor: Applicant: Architect or Engin INS: Owner r CI?YOF�QUINTA--------------------------------- FINANCE OEC' a LICENSED CONTRACTOR'S DECLARATION I hereby . affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Professionals Code, and my License is in full force and effect. ' .License Class: License No.: - Da Contractor. \ � OWNER -BUILDER DECLARATION I hereby affirm under penaltyof perjury that I am exempt from the Contractor's 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 Contractor's 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 f any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1,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 }, 4 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.).T - ( X' 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7J/T 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: 2. Do Owner: CON RUCTION 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: - - - - LQPERMIT 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 FL for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 number are: - Carrier' Policy Number - 1 certify that, in the performance of the work for which this permit is issued, I shall not employ anyY person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section - 3700 of the Labor Cod shall forthwith comply with those provisions. Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. 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-tothework 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to buildin construction, and hereby authorize representatives ' of this court y t90 ter port the above-mentioned p/rop%rty f r i pe tion purposes. Dat, l Signature (Applicant or AgarR1: Application Number . . 05-00003227 Permit . . . . BLDG POOL PERMIT Additional desc . Permit,Fee 162.00 .. Plan Check Fee 105.30 Issue Date Valuation 15000. Expiration Date - 1/23/Ob _ - •_ , Qty Unit Charge Per Extension' BASE -FEE 45.00 13.00 9.10000 THOU BLDG 2,001-25,000 117.00- ----------------------------------------------------------------------------- Permit MECH POOL - Additional desc . Permit.Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 _ Expiration Date 1/23/.06 - Qty Unit Charge Per Extension BASE FEE, 15..00 1.00 11.0000 EA MECH FURNACE >100K ------------------------------------- 11.00 -Permit ELEC POOL PERMIT -RES " -Additional desc - Permit Fee 45.00 Plan Check Fee..- 11.25. Issue .Date -. ,Valuation 0' Expiration Date 1/23/06' Qty Unit Charge Per Extension r 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 .. 5.25 Issue Date Valuation 0 Expiration Date,.. 1/23/06. Qty Unit Charge Per Extension' _ BASE FEE 15.00 2.00 6.0.000 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 -------=---------------------------------------------------------- Spe�ial Notes -and Comments -------- POOL & SPA ONLY. ALARMS/BARRIERS SHALL LQPERMTT ." Bin, -. • r`, • . CIS of • , �' La Q urn to Pennic # • v Building tat Safety Division 22 P.O. Box 1504, 78-495 Calle Tampico La Quint', CA 2 92253 - (760)'777-7012 `J Project Building Permit Application and Tracking Sheet. Address:. 5 (, — C�,OS! V 1119 Or - A' P: Number: � Owner'sNart . JO�...S0"1 ' - -L Legal .Description: wAddres S �S v V� _e Contractor: U r1V. 2 _ d Address: ress: - :-- Telephonc`. 7 6 G (� 'i �6 S City, ST, Zip: `Project Description - -- Telephone: . State Lic. # . City Lic. #: ' Arch., Engr., Designer:. Address:` City.. ST, Zip: Telephone: L• C n s tructt onT• , Type: Oc cu Pa n C - '--- _ .. Name of Conta ct Person: y� e �� r 1 r a _. •e c J t) circle on P e)=' Ne�� Add'n Alter ' Repair P r Demo ,`, Telephone-# of Contact -Person:' i> Sq: Ft.: #Stories:. #Units;. Estimated Value of Project. APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Re9'd Recd TRACKING . Plan Sets PERMIT FEES Structural Plan Check submitted Item Calcs, Reviewed, ready for ` Amount • TrussCalcs. 1, corrections Plan Check'Dcposi't .Called Contact Person Title 24 Cala. i. Plan Check Ralanet . r Flood plaiin plan Plans picked'up Construction Plans resubmitted Grading plan 2"4 Revien-, Alechanical Subcontactor List read} for corrections/issue Eltctrical• Called Contact Person " . Grant Deed ' Plans picked. up I:lunibing. , H.O.A. Approval + Plans. resubmitted IN HOUSk.- Grading PlanningA ppro ral '"' Review ead% for corrections/issue Developer Impact Fee Called ContactPerson Pub. \Vks. A PPr' A.LP.P: Date of permibissue School Fees ,. "T -Total Pcrmit Fces ' 4 t < ' JOB ADDRESS'Sb-9otC-{j 1 CITY 0171A. QUINT -A, LIST ( Ibis form 'PERMIT' NUMBER - OWNER `fin '' `BUILDER - ' D�� ' a . shall b ed on 1 e job t .._� � - , 'n __- uil on this job. Any changes to this list ! e Card allsin c e. Only persons appearing on this list or their employees are authorized to work must be approved by the Building Division prior to commencement, of work. Failure to comply will result in a stoppage of work andlor the voidance {. of building ermtt For each ap Itcable trade all rnformatton xil`Yd(�!}�t($fi%C�'tlgbay bxs'fx 7: ! 'v•�arra re nested betovrmust be completed by a plicarit. 'On File" is riot an acceptable response. .. - tii`r s r'. y i a'• c. :Nc .. .l.a .. - ...,<»rk....t:iOt;},kx.....t;.•.."K',.rtS.hy •3bP.f.0xf'i7''<k:. <'<;�.' rMYBfFr ��6inY LyIQ -Y' �C #x. .^ t4aa.x. 2 :-..cExa'x_. s -Aa -.<:4. :�YG.; ` Y.,.Yr2A .:Rtx..#cLA'-:'• - xi.A �l a .xx1k^S.rrr::.�t 3< L+Rt aYat:,3,]4ey2a't`::„. > •`kf it<.x,.A. :•.yiC" X -a - � �x<; :. xs 6y3 aY ➢ )uY &x&fAx's, r ..x)>s.i xk Sa'.•....•L-nFLa:i �S%. .v a.IC�"' x jtx : Co -pant. Name'Class[ ata;z t , i. 4b4aa .aA, Y xj. Classifiation License Number. Exp. Date' Carrier Nam! POKcy Number Exp. Date license Number Exp. Date �• - ~ m a t,��tYyx k :+ (e.g. A. B,.0-8) txxxxxx) txxlxx/xx) (e.g. State Fund, CalComp) + tFornwt Valdes) t (xxlxxlxx) "(xxxx) Ixxlxxlxx) - ¢ -a•� YS FAL- m / d S'o;. ?15) fill;'' N LD - t Y t`. -`a i��x•+�k _" S • •tt (t. -� t` • �� ,-tl ti •\ ct .__ �'{ �', - 'tM5�?tiGx'5a G td 2 52 . a7 G�G FoarO d -q?O 3a • _ -qs 3 � J, ^A• lt^ C�GiZ1j alGx t �. • fxms A;,.�2.?ii�YY.£'d,xyp�2+. - 7 ti -,G% •L �l (vi�. •` (Win)- _ . 'L�4a iz Q x.l m 77--7 w LO APS .. .. ' . •i'- • .. t N ✓I wk/�t J xtKt 2 91 p 1w ll1:l STy.�N. �S5i - k .. ' a J ■■��y ��}yS' xx... (b'diili - - s C if , r' • -'S ' J «• r , J 4 r '��• '+Vti.�^4 ' Y .r`, " .Z - . � ♦` > x . <,• ' - V ' ^