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BPOL2016-0054fl"11 . 78-495�ALLE,T jiM PICO LA QUINTA, CALIFORNIA 92253 Application Number: BPOL2016-0054 Property Address: 52679 MERIWETHER WAY APN: 767690030 Application Description: RUSTOM / POOL Property Zoning: Application Valuation: $118,000.00 Applicant: PRECISION POOL SERVICES INC P 0 BOX 2181 PALM SPRINGS, CA 92263 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 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 Professions Code, and my License is in full force and effect. . License Class: C53 License No.: 869069 Date: _ Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of 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 any applicant for a permit subjects the applicant to a civil penalty of not more than 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. 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 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.). (1 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.). ( I lam exempt under Sec. . B.&P.C: for this reason Date: Owner: 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 Lender's Address: Owner: FARES RUSTOM 55 NE BROADWAY PORTLAND, OR 0 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: ,COMA 'PRECISION POOL SERVICE: P 0 BOX 2181 PALM SPRINGS, CA 92263 (760)365-6248• Llc. No.: 869069 Date: 4/26/2016 A4 R � " CITYOFLA QUINTA IT DEVELOPMEWDEPARThIENT 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 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:_ PolicyNumber. _ - 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes.. Date: Signature (Applicant or Agent): 'PRECISION POOL.SERVICES, INC. _ ; ,, CHECK R15035 1629 ASE ..Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:, . $5 00 $5.00 �� E R�QN COUNT QTY . AMOUNTS PAID PA D D GAS SYSTEM,'.1-4 OUTLETS ' ' ' 1.01- �: 101=0000-42401. 0 $12.09 . " ` DESCRIPTION ��CUNT I1�w. Qfy�YF AMOUNT -, �� PAID PAIDxDATE z ' ,. Bumm SAS SB1473 FEE ' 101-0000-20306 0 ; .' " $5.00 •' $5:00 4/26/16 ' . +. :..r.P✓�� D;: '�x .:..ry.v`k.. siist#�C g"r VOIII�.,..a nnFrunm - ac"r,,rior. .. `rurr�r�tr� PRECISION POOL' SERVICES, INC Mr�nv ,815035 'PRECISION POOL.SERVICES, INC. _ ; ,, CHECK R15035 1629 ASE ..Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:, . $5 00 $5.00 �� E R�QN COUNT QTY . AMOUNTS PAID PA D D GAS SYSTEM,'.1-4 OUTLETS ' ' ' 1.01- �: 101=0000-42401. 0 $12.09 . " ` $12.09 ". 4/26/16IBM � � �� rMETHOD RECEIPT# CHECK# CLTD. BY S 31. ' . +. :..r.P✓�� D;: '�x .:..ry.v`k.. siist#�C g"r Lb- 1 - PRECISION POOL' SERVICES, INC . ;CHECK�. ,815035 -:1679 ; RSE" ' 'D CM PTIQN�y' NT 'PAIO�� P`gm w."� z AC CO, 'moi s' s v5 ,53U .,�. TY AI1flOUNT e Q , PAMOATE GAS_SYSTEM, I-0 OUTLETS�PC `:,101-0000-42600=�$24 17 - x$24.17 4/26/T6 aPBY �`,; s �EiHOORECEIPT #w CHcK# CLTD BY.. PRECISION,POOLSERVICESINC- `_ CHECK :,;; 815035 '1679 -'R E, ' Total Paid for PLUMBING FEES '� $36.26 : $36:26 �_ .� �DESC IPTION�� g0Pn b 00UNT Qn( AM'OUNT PALO " PAIDA E; SWIMMING :POOL/SPA . ` 101-000Q42404 , 0. $181.29 > -.$181.29 4/26/16 PAID BY METHOD M RECEIP �# ACHE Kii I C BY PRECISION POOL SERVICES INC -CH ECK ' ` , R15035 1679 'RSE DESCRIPTION ' ; ACCOUNT QTiY AMOUNT PAID`" PD'ATE x,,N�, �"..ak �' .,Xw'^iY lk ` $S'i2,.?Ysk.� >fi 3i&fW9�1'Y' . SWIMMING:POOL/SPA PC y'101 0000-02600" • 0 '' '$98.62 , $98.62 4/,26/16 "Amb, �� PAID BYMETHOD ��ffin y EC PT # CH CK # �CLTD BY PRECISION POOLSERVICES INC �;' CHECKf:;,` 815035.. 1679 ARSE • DE IPTION .�a� ACCOUN T 4� AMOUNT PAID �!PAIO�DAT£µ WATER FEATURE 301-0000-02404,; `0" $725.16 _m $725:16 _4/26%16- PAID BY , RCT# CHECK=# CLTDRBY ` ,aME�TIisOD PRECISION POOL SERVICES INC : "• CHECK - 8150351679 ':. RSE !t S T N ACCO: T QTII AMOUNT x PAID D AT �. WATER FEATURE PC 101-0000-02600 0 ` '. $394.48 $394.48 4/26/16 E PAID BUY RE E PT y CHECKa# =0, PRECISION POOL.SERVICESINC`. CHECK, 815035 167.9 'RSE_ ' Total Paid for POOL`/ SPA. $1;399:55 $1,399.55 • ' i f . - R Description: RUSTOM / POOL Type: POOL Subtype: Status: APPROVED Applied: 4/26/2016 RSE Approved: 4/26/2016 RSE Parcel No: 767690030 Site Address: 52679 MERIWETHER WAY LA QUINTA,CA 92253 Subdivision: TR 33076-2 Block: Lot: 38 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: , Valuation: $118,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories:'0 No. Unites: 0 Details: Applied to Approveda I + Printed: Tuesday, April 26, 201610:29:08 AM 1 of 2 SYSTEMS BOND INFORMATION ATTACHMEN ' . ^ ' ^ ` ' ^ Printed: Tuesday, April 26,2O161O:Z9:O8AK4 2ofZ . . CBFWSYSTEMS GAS.SYSTEM, 1-4 101-0*000-42401 0 $12.09 $12.09 4/26/16 R15035 1679 CHECK PRECISION POOL R�E OUTLETS SERVICES INC GAS SYSTEM, 1-4 101-0000-42600 0 -$24.17 $k17 4/26/16 R1503S 1679 CHECK PRECISION POOL RSE OUTLETS PC I I I SERVICES INC Total Paid for PLUMBING FEES: $36.26 $36.26 PRECISION POOL SWIMMING POOL/SPA 101-0000-42404. 0 $181.29 $181.29 4/26/16 R15035 1679 CHECK. RSE SERVICES INC SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $98.62 4/26/16 R1S03S 1679 CHECK PRECISION POOL RSE PC SERVICES INC PRECISION POOL WATER FEATURE .101-0000-42404 0 $725.1 6 $725.i6 4/26/16 -111503S 1679 CHECK RSE SERVICES INC PRECISION POOL WATER FEATURE PC 101-0000-42600 0 $394.48 $394.48 4/2.6/16, R1S03S 1679 CHECK RSE, SERVICES INC Total Paid for POOL/ SPA: $1,399.SS $1,399.SS BOND INFORMATION ATTACHMEN ' . ^ ' ^ ` ' ^ Printed: Tuesday, April 26,2O161O:Z9:O8AK4 2ofZ . . CBFWSYSTEMS