BPOL2017-0144C&�, 01( lv Quz
78-495 CALLE TAMPICO D "'iiL1Ct!
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPOL2017-0144
Property Address:
52230 AVENIDA MADERO
APN:
773242002
Application Description:
PEPE BUILDS / POOL & SPA AT FRONT COURTYARD
Property Zoning:
a
Owner:
Application Valuation:
$20,000.00
Applicant:
GATTUSO POOL CORPORATION
667 EUGENE ROAD
PALM SPRINGS, CA 92264
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
{commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: C53 License No.: 672850
Date: 3 ' IV -7 Contractor: IA3 O.Sii==n aAA` :�
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).:
(1 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.).
(_) 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 am 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 Na
Lender's Address:
(760)327-7592
Llc. No.: 672850
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 he or 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: MIDWESTEMPLOYERS CASUALTY COMPANY Policy Number:
_ I certify that in the performance of the work for which this permit is issued,
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: QL7 Applicaat,;_ ,. , , n s6 .� r�
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 behalfthis 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: Ot ' -1 ' r'� Signature (Applicant or Agent
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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Owner:
PEPE BUILDS LLC
52230 AVE NIDA MA19A
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LA CLU INTA, CA 9225 „
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Contractor: v
GATTUSO POOL CORA�RAT
667 EUGENE ROAD rX
PALM SPRINGS, CA 9JR64
(760)327-7592
Llc. No.: 672850
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 he or 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: MIDWESTEMPLOYERS CASUALTY COMPANY Policy Number:
_ I certify that in the performance of the work for which this permit is issued,
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: QL7 Applicaat,;_ ,. , , n s6 .� r�
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 behalfthis 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: Ot ' -1 ' r'� Signature (Applicant or Agent
Application Number:
BPOL2017-0144
Property Address:
52230 AVENIDA MADERO
APN:
773242002
Application Description:
PEPE BUILDS / POOL & SPA AT FRONT COURTYARD
Property Zoning:
Application Valuation:
$20,000.00
Applicant:
GATTUSO POOL CORPORATION
667 EUGENE ROAD
PALM SPRINGS, CA 92264
Owner:
PEPE BUILDS LLC
52230 AVENIDA MADERO
LA QUINTA, CA 92253
Contractor:
GATTUSO POOL CORPORATION
667 EUGENE ROAD
PALM SPRINGS, CA 92264
(760)327-7592
Llc. No.: 672850
Date: 8/31/2017
Detail: POOLAND SPA AT FRONT COURTYARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE AND BLOCK
WALLS. BLOCK WALLS HAVE BEEN PULLED BY A DIFFERENT CONTRACTOR. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2016 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306
0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$190.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
Total Paid for POOL / SPA: $293.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin #
Permit #
MOL -Vol -0144
Project Address:
A. P. Number.
Legal Description:
Contractor: �}
Address:(0 40 7
City, ST, Zip: P
&L
Telephonc..76 �/ T
State Lic. #
Arch., Engr., Designer
Address:22 — %z
City., ST, Zip:
Qty of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
] ) Owner's Name:
Address:
City, ST, Zip:
Telephone:
Project Description:
�'5u)1r/n 1"r,,11,',�'-
City Lic_ #0222 5M
'&V /3d_
Ml s//
Telephone) Q • �� �.��� Construction Type: Occupancy:
Skate Lic. #:� Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: f� Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE RR OW TPIR I IMF
#
Submittal
Req'd
Rec'd TRACKING PERMIT FEES
Plan Sets
PIan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Pian Check Balance
Title 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'i Review, ready for correctionslissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S-M.L
II.O.A. Approval
Plaus resubmitted Grading
Lel $OUSE:-
'"` Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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