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04-6421 (RPL)C&f °F 44" P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number . . . Property Address . . . . APN: Application description Property Zoning . . . . . Application valuation . . Owner IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC 7979 IVANHOE AVE STE 550 LA JOLLA CA 92037 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00006421 Date 9/24/04 77858 GREY WOLF TR 658-140-999-94-29436 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL ENSIT ContractorT. ------------- [� -------- - CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA CA 92236 (760) 398-9222 WCC: STATE FUND WC: 04600061168 01/01/05 CSLB: 656128 10/31/04 CCC: C8-C27-C29-053 ---------------------------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc . . Permit Fee 180.00 Plan Check Fee 117.00 Issue Date Valuation . . . . 17000 Qty Unit Charge Per Extension BASE FEE 45.00 15.00 9.0000 THOU BLDG 2,001-25,000 135.00 ---------------------------------------------------------------------------- Permit . . . . ELEC POOL PERMIT-RES Additional desc Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 P.O. Box 1504 Tait ��/�� FAX (760) 777-7011 78-495 CALLS TAMPICO f� VOICE (760) 777-701 LA QUINTA, CALIFORNIA 9225344 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: p -. Date: Applicant: ArrhitPrt nr Fnninnar- Applicant's Mailing Address: 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 Code, and my License is in full force and effect. License Class License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penally 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 Pike 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 penally of not more Ihen five hundred dollars ($500).): (_} 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. 70K Business and Professions Code: The Contractors' State Licensa Law does not apply to an owner of property who builds ar 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. 11. however, the building or improvement is sold within one year of comPledon, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (j I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 70", Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who oonlracts for the projects with a contractors} The pursuant to the Conlractors' State License Law.), U I am exempt under Sec. , B.9 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 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 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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date 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. 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 IMPORTANT Application is hereby made to the Director of Buildin and APPLICANT ACKNOWLEDGEMENT 9 Safety PermI subject to the conditions and restrictions set forth on this application. t issued as a resu t of this applicatitons a ownlion is er, ands the applicant each agreh person at es 10, and shale request l defen�d,se ben Brit work 15 Pe ndemnify and hold hafrn ass the Cunder ity of La Qu ntends��rt officers, agents and employees for any act or omission related 10 the work being performed under or following issuance of this perm 1. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 Jaya from date f issuance o[ such permit, or cessation of work for 180 days will subject permit 1a cancellation, I certify that I have read this application and state that the above information is correct. I agree 1a comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above -mentioned property for inspection purposes. Date Signature (Applicant or Agent): Page 2 Application Number 04-00006421 Date 9/24/04 Qty Unit Charge Per Extension 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 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 OUTLETS 3.00 --- ---------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 240 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA . 15 LF 4' BLOCK WALL CITY STND. ALAMRS BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. Fee summary Charged --------------------------- Paid Credited -------------------- Due ---------- Permit Fee Total 297.00 .00 .00 297.00 Plan Check Total 142.50 .00 .00 142.50 Grand Total 439.50 .00 .00 439.50 sin # Pell Clof La Quinta Buffdlr g Bt Safety Division P.O. Box 1504, 78-495 Calk Tampico b Quinta, C4 9220 - (760) 777.7012 Building Permit Application and Tracking ,sheet' Project Address: •: — 6- 5 lel-l-V ltkiir % �}I 79 Owner's Name' S (] A.P.Number: —, Address: Legal Description: — City, ST. Zip: --� Contractor. 4Spq,3 Telephone: Address: PO 2.90 Project Description: ;' A City,ST,1��, .: '=Te1�-h_aiiet :� — � :- ,ter.• _ � �-�'�?��:�_--_ � .. _- ...._ .:.. __ .__-. -. - ... =�;= -- 7 State Lic. #' : to i City Lie. #: - Arch., Engr.. Designer. rY rAddress: , Zip:ne: : Construction Type: • rruot Occupancy: Project type (circle one): tiv Add'n' Alter Repair Demo ---�ontact Person: DArj• Sq. FIL- # Stories: # Units - # of ContactPerson: rITeitphoie 2-7. ] d Value ofPra ect: 0 a 0 APRLICANT: DO NOT WFEITE BELOW THIS I. NE #. Submittal :• .; ' , Req'd• Rec'd TRACIQNG PERMITFEES Plan Sets Plan Check submitted L92 Item Amount _.._� • �ci�rai^ales� — — __.-._.. —_—.—__ Ite-viewed -rah 1or.torcerhQ — �c�])e nit— �-__.._-..__._-.._. _...._._ _..-. AI Truss Cslcs. Called Contact Person Plan Check Balance: Title 34 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted I -Mechanical Grading plan V Review; ready. for•correctionslissue Electrical SubcoutactorL'ut Celled Contact Person Plumbing Grant Deed Plans picked up 5.7 M. ILO.A, Approval Plans resubmitted Grading IN HOUSE:- '`d Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person. A.I.PT. Pub.'Alks. Appr Date of permit issue -School Fees Total Permit Fees