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04-5488 (RPL)1 Taf 4.40 Q" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 93,2J3 INSPECTION REQUESTS (760) 777-7153 IT ' D V Application Nu ��0� 0 , 0 00548.8_ - Date 7/14/04 Property Addres Q . `�. .�'3'69 DEL GATO DR APN: �O��Q177 -370-007-106 -28867 - Application descr a trio . O� ��.�� POOL - RESIDENTIAL Property Zoning �e�p�+ LOW DENSITY RESIDENTIAL Application valuati n . . . 35000 Owner Contractor ------------------------ ------------------------ CERF ALAN L AINSWORTH POOL CONSTR, ROBERT 1137 VIOA DI SALERNO 40900 GLENMORE DRIVE PLEASANTON CA 94566 PALM DESERT CA 92211 (760)-568-4993 WCC: AU INS SRVC WC: 00500018173 01/01/05 CSLB: 598681 07/31/04 CCC: C53 -------------- Permit. . . . . BLDG POOL PERMIT Additional desc Permit Fee 317.00 Plan Check Fee 206.05 Issue Date . . . . Valuation . . . . 35000 Qty Unit Charge Per Extension BASE FEE 252.00 10.00 6.5000 THOU BLDG 25,001-50,000 65.00. - --------------------------------------------------------------------------- Permit . . . . . . MECH POOL Additional desc Permit Fee 24.00 Plan Check Fee 3.75 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 Fees. 11.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE •15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL. 3.0.00 11 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 ff Ot INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: IJIA Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensedundee rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C.ade, and my Licgnbe . in full force and effect. License Class ``(. `I License No. 1 U cU /Da `1 (1 Q --Contractor k NS�,,Qnjrt Poo L5 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 1, 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 1, 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 Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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. 41 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 isedMy ?Is'op�nsation i y ce carrier _ I certify that, in the performance of the work for which this permit is issued, I shall hot 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. ,V!) "gi-4 V60 t! �, 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. 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 j�� Lenders Address f^ 1 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 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 toellation. certify that 1 have read this application and state that the abov, nin&atiop Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and rPherebyaruthorize representatives of this coun to nter p the above-mentioned property for inspection purposes. at � JV 4 �Tignature (Applicant or Agent): Page 2 Application Number . . . . . 04-00005488 Date 7/14/04 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee 33.00 Plan Check Fee 8.25 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 ---------------------------------------------------------------------------- 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 419.00 .00 1.00 ---------- 419.00 Plan Check Total 229.30 .00 .00 229.30 Grand Total 648.30 .00 1.00 648.30 I 0 Lj LAI 'C _ (ED. / 11 •• • w v � chi 1 •. Q • . `� �� Q- �3 ' k+ •r' � r �- • • QL IT .. o • it'd,O . }•�•� ° lu 1 p _ C ° I• ' i� . • : e , • �' • r0 • �.+ �' � . ° Jam.+ N+�'a • r+' A N a b/Z abed NVOZ:OI b0-Vl-Tnf `OvOOOOe09L `SIOOd H1dOMSNrd :A9 juaS Sent By: AtNSWORTH POOLS; 7602000040; Jul -14-04 10:20AM; Page 3/4 CH 4. r 1,4 a • , � •�� '� fwd' �c.r' , ' � .D `fir � l Ste' •o. � o •e p o• (/ on affur 111ppm milli I SUN 'm RON