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05-1334 (RPL)� oz U--- Ot = h BUILD.NG & SAFETY DEPARTMENT Cw4 P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 D 6 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT QF I,A QUINTA Clap, umber . . . . . 0.5.Date 4/20/05 roperty Address . . . . . . 80780 VISTA BONITA TR APN: 772-280-008- - - Application description POOL - RESIDENTIAL Property Zoning . . . . . . . VERY LOW DENSITY RES Application valuation . . . . 40000 Owner Contractor --------------------------------- --------------------------------- ANDERHOLT J JOHN VACATION POOLS INC 74770 HIGHWAY 111 NO 201 83900 AVE 45 STi; C INDIAN WELLS,.CA 92210 INDIO, CA 92201 (760) 775-0468 WCC: STATE FJND WC: 1795938-05 04/01/06 CSLB: 856835 04/30/07 CCC: C53 ------------------------------------------------------=--------------------- P.O. Box 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: D.7`�- 13x4 Date: 3,5 - Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: A) pq Lic. No.: BUILDING PERMIT DECLARATIONS 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 �ode, and my License is in 111,Il force and effect./ R� icense Class C_ 5- 1 icense No. �S(o v �� O for 1) /�G % -7-0 N 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) 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 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. have and will maintain workers' compensatio insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is NV s ed. workers' come isation i ante carrier and pol'cy nu ber a arner NV' -E E k r\.IrjC olicy Number 1: �� -3,4-0 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 thworkers' e compensation laws of California, and agree that, if I should become ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. O� .moi WARNING: FAILURE TO SECURE WORKERS'L'GMPENSAII`ION CO G IS UNLAIW�AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100.00 0), I DDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FE S. 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 Lenders 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 or omission related to the work being perfo d 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 c enced 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 cc ect. I a e to c ply with all city and county ordinances and state laws relating to -building construc tion, land hereby authorize represent tives of this county to enter u e ab - ention d or inspection purposes. ateCIV/0 Si nature (Applicant or Agent ---------------------------------------------------------------------------- Application Number . . . 05-00001334 ---------------------------------------------------------------------------- Permit . . . . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . BLDG POOL PERMIT 349,50 10/18/05 Plan Check Fee . . , . 227.18 Valuation . . . . 40000 Qty Unit Charge Per Extension BASE FEE 252.00 15.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 97.50 Permit . . . . . . MECH POOL Additional desc . . 4 Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/18/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 ---------------------------------------=------------------------------------ EA MECH FURNACE <=100K 9.00 Permit . . . . ... ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/18/05 Qty Unit Charge Per Extension 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 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/18/05 Qty Unit Charge Per. Extension BASE FEE 15.00 2.00 6.0000 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 OUTLET 3.00 Special Notes and Comments 7 ----------------------- POOL & SPA. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ---------- 451.50 -------------------- .00 .00 451.50 Plan Check"Total 252.68 .00 .00 252.68 Grand Total 704.18 .00 .00 704.18 � m 1 AWL'. 10 v Ia,.,� aatuia- ��u�ccunii�o.- � Iouc�Gw dy —7-7T--— if 11 LL c: Mi Al -PA 11 1111 II ------------ t�ties /' �Yl u �ii .c"v4/r wv1 V11- I P44-9'"MIX 199 Ave aa -o ��o, -��s. oy�g , fQ LANDSCAPE ARCHITECTS, NO. 74020 ALESSMDRO, StJrTE E PALM DESERT, CA 92260 (760) 568-3624 MAX (760) 773-5615 - E-MAU rgatrga-pdcorn I W.1 _0" SCALE 1, 8 GRAPHIC SPALi?1.0 rmm"9 rM9 SPECIFICAMONS sHEE-rG BOOK 13 Mal MGR. RP DFIAWN. RP CHECKED. - PROD. NO. - R 0452 DATES V/02/041 SCALE: 1/81-T-0. REAS!ONS: 0 0 0 0 0 CONCPT