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RPL (04-7038)T,Vf 4 4. 4" BUILDING & SAFETY DEPARTMENT P.O.. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . 04-00'007038 Date 11/02/04 Property Address . . . . . 81995 MOUNTAIN.VIEW L-"�— APN: 767-480-001-1 -26769 _,/,'„ n Application description . . . POOL - RESIDENTIAL Property ZoningLOW DENSITY RESIDENTI -Application vauation . . . . 33000 �'� O Z��i Owner Contractor CI FINANCE ------------------------ ------------------------ FRANK HONOROF GATTUSO POOL CORPORATION 81995 MOUNTAIN VIEIW 667 S: EUGENE ROAD LA QUINTA CA 92253 PALM SPRINGS CA 92264 (760) 327-7592 WCC: STATE FUND WC: 161507404 01/01/05 CSLB: 672850 06/30/05 CCC: C53 ------------------------------------------------------------=--------------- Permit MECH POOL Additional desc Permit Fee . . . . 35.00 Plan Check Fee 8.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per. Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 ---------------------------------------------------------------------------- Permit . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 304.00_ Plan Check Pee 197.60 Issue Date . . . . Valuation 33000 Qty Unit Charge Per Extension BASE FEE 252.00 8.00 6.5000 THOU BLDG 25,001-50,000 52.00 -------------------------------------------------=-------------------------- 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 . I%% P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: //— Architect or Engineer: Architect or Engineer's Add r s/ UTI 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 Licen a is i I force and effect. / License Class License No. &1Z Date °'04 Contractor&WZ1S0 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).): U 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 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 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 sued. My ternrkers�' Compensation insurance carrier ayrd, pol'ySrwmb� Z Carrier- Policy Number /(2 _ I certify that, in the performance of the work for which this permit is issued, I shall not bmploy any person in any manner so as to become subject to the workers' compensation laws of California,a gree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those p isions. Date I . L( v WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10 ), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTO EY 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 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 Ouinta, 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 i ation 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 to en r upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent): r Page 2 Application Number . . . . . 04-00007038 Date 11/02/04 Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 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 ONLY. ALARMS/ BARRIERS SHALL BE IN PLACE PRIOR TO PREPLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN, PERMIT. Fee summary Charged Paid Credited Due Permit Fee Total 411.00 .00 .00 411.00 Plan Check Total 224.35 .00 .00 224.35 Grand Total 635.35 .00 .00 635.35 G0( 0PAD kicFF r,%,) i i FRANK AND CAROL TIONOROF 82995 MOUN"TALN VYEIV LANE LA QUINTA, CA 92253 GATT[TSO POOL CORPORATION 667 EUGENE ROAD PALM SPRINGS, CA 92264 760-327-7592 LIC 4 672850 i GITY OF tA�QUINTA BUILDING & SA ETY DEPT. APPROVED FOR CONSTRUCTION m N