BPOL2016-013178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-dr4.�wQ�rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPOL2016-0131
Property Address:
54945 AVENIDA RUBIO
APN:
774291022 -
Application Description:
CORONEL / POOL & SPA AT FRONT YARD
Property Zoning:
compensation laws of California, and agree that, if I should become subject to the
Application Valuation:
$20,000.00
Applicant:
comply with those provisions.
GATTUSO POOL CORPORATION
667 EUGENE ROAD
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
PAI.I'A CA 92264
permit subjects the applicant to a civil penalty of not more than five hundred dollars
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.: 672850
Date:" Contractor.
i
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 9/7/2016
Owner:
CORONEL ENTERPRISES INC
42760 MADIO STREET
INDIO, CA 92201
FA 10
Contractor:
GATTUSO POOL CORPORATION
667 EUGENE ROAD" JCh 7 2�iU i
PALM SPRINGS, C - .. 92264 —
(760)327-7592 COX''JA'7YCE:=
x..T
LIC. 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 the work for which this permit is issued.
A(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 polity number are:
OWNER -BUILDER DECLARATION
Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
BNUWC0134492
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
I certify that in the performance of the work for which this permit is issued, I
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall. not employ any person in any manner so as to become subject to the workers' .
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
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
Date: , — 1 Applicant: l_ ��
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
U I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). "IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(1 I, as owner of the property, am exclusively contracting with licensed contractors
1. Each person upon whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any.permit
State License Law does not apply to an owner of property who builds or improves
issued as a result of this application , the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' State License Law.).
employees for any act or omission related to the work being performed under or
(� I am exempt under Sec. B.&P.C. for this reason
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
Date: Owner:
work for 180 days will subject permit to cancellation.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building
the -performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize.representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Lender's Name:
Date: Signature (Applicant or Agent):
Lender's Address:
Date: 9/7/2016
Application Number: BPOL2016-0131
Owner:
Property Address: 54945 AVENIDA RUBIO
CORONEL ENTERPRISES INC
APN: 774291022
42760 MADIO STREET
Application Description: CORONEL / POOL'& SPA AT FRONT YARD
INDIO, CA 92201
Property Zoning:
Application Valuation: $20,060.00
Applicant:
Contractor:
GATTUSO POOL CORPORATION
GATTUSO POOL CORPORATION
667 EUGENE ROAD
667 EUGENE ROAD
PALM SPRINGS, CA 92264
PALM SPRINGS, CA 92264
(760)327-7592
Llc. No.: 672850
--------------------------------------------------------------------------
1wi. 'EQUiPM'EUT WALL T i''J�LUi:r-D.EQUIPrvit-Nl'SHALL BEINSTALLWI'W LZ601i6; INCE`' ITHMANUFACTURERSPECIFICANONS.
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
DESCRIPTION
FINANCIAL INFORMATION
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
1 SWIMMING POOL/SPA
101-0000-42404
0
$181.29
DESCRIPTION'
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
I
101-0000-42600
0
$98.62
Total Paid for POOL / SPA: $279.91
TOTALS:,0
1
I
08/31/2016 13:24 7607784920 GATTUSO POOLS PAGE 03/04
"'
City of La Quinta
Building a Safety Division
P.O. Box 1504
Permit #
78-495 Calle Tampico
La Qulnta, CA 92253
wilding Permit Application and Tracking Sheet
Project Address: C,
owners Name:
A. P_ ?cumber:
Address:
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City,ST_ Zip.
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Telephone_
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Project Description: lL:�I
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"telephone: 2—-J52.—
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it
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Address: -7 3 (9 (D i /�
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Circ'. ST, Zip: PALM Dtr-`5;'j�.eT G/A 7i�(00
Telephone:7 O)O5
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lcame ok Contact Person: C ���
Sq. Ft_: # Stories: # units:
Telephone = of Contact Person: 3Z-7— % Z_
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