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04-6436 (RPL)ceiiv� 4 4.41"', BUILDING & SAFETY DEPARTMENT (760).777-704 2 CAMPICO FAX (760) 777-7011. LIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT p .04-00006436 _ Date 9/24/04 Property Address . . . . . . 5336'0 DEL GATO DR APN: 770-350-017- - - Application description POOL - RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 20000 Owner Contractor AVERILL DAN'L MCINTYRE POOLS & SPAS., ;INC.. P' -.O BOX 275 P ,O . BOX 1,79:1 B'IGFORK MN 599;11 LA QUINT- CA. 92:253 (760) 34.2-3612 WCC: HRH INS WG: 17691.1104 01/01/05 _ CSLB: 614611 0.9/30./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 9.000,0 THOU BLDG2,00:1-25,000 162.00 -------------- Permit. MECH POOL Additional desc . Permit Fee ., 24.. 0O Plan Check Fee .: 6.00 Issue Date . . . . Valuat°ion 0 Qty Unit Charge Per Extension BASE FEE! 15.00 1.00. :9.000'0 EA MECH FURNACE <=100,K 9.00 Permit . . . . . . .ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.0.0 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 P.O. BOx. 1504 VOICE 17601 777-.701: 78495 CALLS TAM�PICO' FAX {760) 777-7.011 LA QUINTA, CALIFORNIA 92253. INSPECTIONS (760.) 777-715,3 BUILDING & SAFETY DEPARTMENT Application Number: �% Y ' �J� (O Date: Applicant: I Architect;or Engineer Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION [hereby affirm;underpenalty of perjury that l am licensed under provisionvoif Chapter 9 (commencing with Section 7000)W Division 3 of the Business and :Professionals Code, and my =e/nand effect: �Gcense Class �j/►1/�[�''�nse No.. 'Date /Contractor_ 'C -y l— J^► �+ ��" �c� S OWNER43UILDER DECLARATION I Hereby affirm under penalty of perjury, that I am,exempt trom the Contractors' State License Lawlor the fol loving reason (Sec. 7031:5, Business and Professions Code: Any aty orcountythat requires a permit to construct, alter, improve; demolish ...or repair any structure, prior to Nsieauance, also requires the applicant for Ihe,permit to Rio a signed statement that he orshe 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 heor; she is exemplAherefrom and the basis --for the alleged exemption. Any violed of Section 7031.5 4, any applicant for a venni! subjects the applicant fo`a civil penalty of, not more than five hundred dollars (5500).): () I, as owner Of the property, or my employees with wages as their sote compensation, will do.Ute.work, and the,sbucture 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 orirriproves theroon, 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 sate:• If ;'however, the, building orimprovement,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 ftpurpose of sale.). U Ii as owner of the property, am exclusivelycontracting with licensed contractors to construct the. project (Sec. 7044,;Business and Professions Code; The Contractors' State License Law'does,not applyto an owner of property wtm,builds or impmvesthereon, and who oonbracfs for the pmocts with a contractors) licensed pursuant to the, Contractors' State License Law.). U 1:am exempt under Sec., , B:& RC: for this,reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: t have and will maintain a certificate, cf consentto self4nsurwforworkere compensation, as provided.for by Section,3706 of -the Labor Code; for the performance �of the Wo* for which thispemtit is issued. , I have and will maintain workers' compensati " insurence, as required bySec is m;3700 of the Labor Code, for the performance of the,woirh for,W** this pemdt is rkers' oompeneation i nca carrier etnployskny person In any mannerso as to become sut>)aefto the workers' compensationlaws of California, and agree.that If, I should become subject to the workers' oorripensatlon provtsions..of Section 3700 of theLabor.Code. I shall fortlWAthcomplywith those provisions. WARNING: FAILURE'TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO'OWE'HUNDRED THOUSAND DOLLARS ,(3100,000): IN ADDITION TO THE COST OF COMPENSATION, DAMAGEt A&OROViDED•FOR' IN SECTION 3708 OF THE LABOR,CODE. INTEREST, AND.ATTORNEWS FEES. CONSTRUCTION LENDINMAGENCY I hereby affirm under penalty, of perjury thatthere is a construction.lending agency for the perfomtenoe of the woArfor which this Pemwt is issued, (sec. 3097, Civ, C:). Lender's Name Lender's Add ress• APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is herebymade to the Di rector of Building and'Safety fora permit subject to the conditions and restrictions set forth on this application. I. • 'Each person upon whose behalf this application is made, each person at whose request and for whose benefit work,is"perfomted under orany pursuord,to a , permit issued as a result of thisapplication.1he owner, and the.appficarkeach agrees b: and shall,, defend, indemnify and hold, harmless the City of La Quints. its officers, agents ;and employees for •any act or omission,releted to the,work.being performed under or, following`issuance of this permit. 2. Any permit issued as wresultof ttus=application.becomes:puµ;and`vctd H work isnot commenced within 180 days ham data of issuance of "such Permit, or cessation of work for 180 days will subject permit to cancellation. I. certify that;!; have,read this application And state that the above information is correct'. "t,89 a to comply with 811 city and courdy"nanceg and state laws rstating to bul" construction. and.heTC .authorize representatives of this coun enter upon ft above-mentioned // property for inapectionpurposes. Datej/ez- nature licant or • (APP Agent):; Page 2 Application Number . . . . 04-00006436 Date 9/24/04 Permit. . . . . PLUMBING Addit.ionaldesc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date .. Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.010 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 Special Notes' and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT' ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due Permit Fee Total 109. 0,0 .0,0 :'0;0 30.9.00 Plan Check Total 1.60.05 .00 .Go 160.05 Grand Total 469.05 .00 .0°0 469.05