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04-5894 (RPL)TIMf 4 4 a" x 1504 :ALLE TAMPICO TA, CALIFORNIA 92253 BUILDING PERMIT er . . 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 04-00005894 Date 8/10/04 77900 GREY WOLF TR 658-140-999-91 -29436 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 17000 Contractor CALIFORNIA POOLS & SPAS P.O. BOX 1280 COACHELLA CA 92236 (760) 398-92.22 WCC: STATE FUND WC: 04600061168 01/01/05 CSLB: 656128 10/31/04 CCC: C8-C27-C29-053 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 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 . . . . 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 VOICE (760) 777-7012 78-495 CALLS TAMPICO �1/ FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: n 4 1 Date: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS ON 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 C de, and my Lice e i II force and effect. /f cense Class i nse N —C�i _Date Ze, c ntractor OWNER•BUILDER DECLARATION I herebyaffirm under penally of perjury that I am exempt fro Contractors' State License Law for the fallowing reason (Sec, 7031.5, Business and Professions Cade: 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 a 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 nat more than five hundred dollars (S500).): L 1 I, as owner of the property, or my employees with wages as their sole compensalion, Wit 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.). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions CDde: 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 contractors) licensed pursuant to the Contractors' State License 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 1-have and will maintain rkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is iss ed. workers' mpsnsat on irtrence a rrY?1 pOligy r3,j ar�Tay�� rrier _ I olioy Number_ _/�i LAG @ I certify Iha , in the performance of the work for w ' his permit Is issued, I shall noti�y any person in any manner so as to become subject to the workers' compensation laws of California, and agree r , If I oufd become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r f►J WARNING: FAILURE TO SECURE WORKERS' CCMPENSAI[D� 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.) Lenders 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 rk being performed under or following issuance of this permit 2. Any permit issued as a result of this application becomes null and void f of 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 cc act. I a to comply with all city and county ordinances and state laws relating to building construction, and hereby autorize representatives of this county l niter upo t abov ntioned property for inspection purposes. '-_Signature (Applicant or Agent): Page 2 Application Number 04-00005894 Date 8/10/04 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 ------------------------------------------------------------------------- Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Permit Fee Total 282.00 Plan Check Total 142.50 Grand Total 424.50 Paid Credited Due .00 .00 282.00 .00 .00 142.50 .00 .00 424.50