05-0575 (RPL)0�
• u�l�;i6v
BUILDING & SAFETY DEPARTMENT
O. Rox 1.5`04 (760).777-7012
05 -495 CALLS TAMPICO FAX (760) 777-7011
L QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
LAQUI14TA
CE - BUILDING PERMIT
Application Number .. . . . 05-00000575 Date 2/14/05
Property Address . . . . . . 819.34 COUPLES CT
APN: .764-060-.007- - -
Application description . . POOL - RESIDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation 200.00
Owner Contractor
GABRI`EL RES. MCINTYRE POOLS & SPAS, INC.
81-9.34: COUPLES COURT 83695 AVENUE 45
LA QUINTA CA 92253 INDIO CA 92201
(760) 342-3612
WCC: STATE FUND
WC: 176.9111 01/0.1/06
CSLB: 61461.1 09/30/05
CCC.: C53
Permit . . . . . . BLDG POOL PERMIT
Additional desc .
Permit. Fee 207.00 Plan Check Fee 134.55
Issue Date . . . Valuation . . . . 20000
Qty Unit Charge Per Extension
- BASE FEE 45.00
18.00 9.0000 THOU BLDG 2, 001-.25, 0'00 162.00
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 . . . . . . 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
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.Permit . . . . . . PLUMBING
Additional desc .
Permit Fee . . . . 33.00" Plan Check Fee 8.25
P.O. BOX 150VOICE (760) 777-7012
44
78-495 CALLE TAMPICO FAX (7'60) 777-701.1
LA QUINTA, CALIFORNIA 9.2253 FAX
(760) 777-7153.
BUILDING' & SAFETY DEPARTMENT
Application Number: Date: 7'O
Applicant: I Architect or Engineer'
Applicant's Mailing Address:
N 7_iC1% c, To �
Architect or 'Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that l am licensed under proy+'sion of Chapter 9 (commencing with Section 70030) of Division 3 ofthe Business and Professionals
5p—de, and my License is ,in full force and effect.
!cense Class License No.
Contractor ✓ V ��J�)�v1yK� C if l�
OWNER -BUILDER. DECLARATION
I hereby affirm under penalty of perjury that I am exempt fronf 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. Anyviolation of Section 7031.5 by any applicant for a pemrit subjects
the applicant to a civil penalty of not more.than five hundred dollars ($500):);
U I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered forsale (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 oonstruct 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.exemptunder Sec. , BA P.C. for this reason
WORKERS' COMPENSATION.DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have avid 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 willi mai itain workers' compensation insurance, as required by action 3700 of the Labor Code, for the performance of the.work for which this permit is
i rs' compensation: insurance carrier an
— r
Cater Policy Number
certify that, in the performance of the work for which this permit is issued, I s ail.not,e ploy any person in any manner so as to become subject to the workers'
compensation laws of Califomia, 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.
to,73/ r
W Applicant I�\�4'� —1 .LoA l�J�c
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 .37013 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.).
Lenders Neme._
IV
Lenders Address
APPLICANT. ACKNOWLEDGEMENT
IMPORTANT Application is herebymade to the Director of Building and Safety for a perp t 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 owners 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 permifissued as a result'of this,application becomes null and void if work is not commenced within 160 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
1 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
con ruction, and hereby authorize representatives of this county to�nter upon theabove-mentioned property for inspection purposes.
"Date J/
nature(Applicant or Agent):
Page 2
Application Number . . . . . 05-00000575 Date 2/14/05
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 6.0000 EA PLB FIXTURE 12.00
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
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Special Notes and Comments
POOL & SPA.. BBQ UL ##Z21581:995.
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 309.00 .00 .00 309.00
Plan Check Total 160.05 :00 .00 1.60.05
Grand Total 469.05 .00 .00 469.05
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01
-AI011,
-51-611
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA al L/O Y ST