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04-7415 (RPL)BUILDING & SAFETY DEPARTMENT `P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 it LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT A�p.p-l�cation Number 04-00'007415 Date 11/23/04 -property Address . . . . . . 50777 SANTA ROSA PLAZA APN: 770-020-031-6-000000- Application description . . . POOL - RESIDENTIAL Property Zoning . . . . . . . GOLF COURSE Application valuation . . . . 18000 Owner Contractor . SANTA ROSA PLAZA MCINTYRE POOLS & SPAS, INC. 7902 S DEPEW STE 120 P.O. BOX 1791 LITTLETON CO 80121 LA QUINTA CA 92253 (760) 342-3612 WCC: HRH INS WC: 176911104 01/01/0E CSLB: 614611 09/30/0E CCC: C53 ----------------------------------------------------------------------------- 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 189.00 Plan Check Fee 122.85 Issue Date Valuation 18000 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 THOU BLDG 2,001-25,000 144.00 ---------------------------------------------------------------------------- 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 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 -------------------------------------------------------------------------------- Permit . . . . PLUMBING Additional desc Permit Fee 39.00 Plan Check Fee 9.75 P.O. Box 1504 �N.V 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: Applicant: Applicant's Mailing Address: Date. Architect or Engineer: f Architect or Engineer's Ad[Architect or Engineer's ess. / 7 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 Code, and my License is in full force and effect License Class License No.��-� Date - 3--v-=C/Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Lawforthe following reason (Sec. 7031-5, Business and Professions Code, Any city or county that requlres 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 applloant fora permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): U 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 awn 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.). ( j 1, 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) Ilccensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.& P.C. for this reason 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 Poltcy 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. WARNING: FAILURE TO SECURE WORDS' COMPENSATfON 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safely for a permit subject 10 the conditions and restrictions set forth on this applicafion. 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 Oulnta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.. 2. Any permit issued as a result of this appiication becomes nu11 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 cancel]ation, I certify that I have read this application and state that the above information is correct- 1 agree to comply with all city and county ordinances and state Paws relating to building construction, and hereby authorize representatives of this county to enter upon th above-me�ntio propert or inspection purposes. DaWe Q T c7 Signature (Applicant or Agent;�� Page 2 Application Number . . . . . 04-00007415 Date 11/23/04 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 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 & 3 SPAS. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary ----------------- Permit Fee Total Plan Check Total Grand Total Charged Paid -------------------- 297.00 .00 149.85 .00 446.85 .00 Credited Due .00 297.00 .00 149.85 .00 446.85