05-4115 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T,iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
0 05 0004115
Property Address:
78.400 CLARKE CT
APN:
643-170-999-16 -31348 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
D
Application valuation:
20000 ,
Applicant:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011''
INSPECTIONS (760) 777-7153. ��-
- n
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE 200
n LA QUINTA, CA 92253
SESEP7 ontractor:
P 1 6 �oo� GATTUSO POOL CORPORATION
WCC: STATE FUND
WC: 1615074 01/01/06
C'e QU�NTa CSLB: .672850 06/30/07
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 Pr ionals Code, and my License is in full force and effect.
License Class: License No.:
Date Contractor:illy
'
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 70001 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 penaltyofnot more than five hundred dollars (5500).:
(_ 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.).
(_) 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.).
I—) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Date: 9/14/05
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.
'x I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T' Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier C53 Policy Number - - - - - - - - - - - - - - -
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become sub'ect to the workers' compensation laws of California,
and agree that, if I should become o the workers' compensation provisions of Section
3700 of the Labor Code, I shall ith those provisions.
QX. " Applicants
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 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 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 constr n, and hereby authorize representatives
of this 6nty�to center upon the above-mentioned property for i e rposes.
te: � /f Signature (Applicant or Agent)✓
Application Number . . . . . 05-00004115
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
207.00 Plan Check Fee ..
134.55
Issue Date . . . .
Valuation . . .
. 20000
Expiration Date
3/13/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit . . .
MECH POOL
Additional desc .
•Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date.
Valuation . . .
. 0
Expiration Date
3/13/06
Qty Unit Charge
Per
Extension
BASE FEE
.15.00
1.00 11.0000
------------------------------------------
EA MECH FURNACE >100K
----------------------------------
11.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc.. .
Permit Fee
45.00 Plan Check Fee
11.25
Issue Date.
Valuation . . .
. 0
Expiration Date
3/13/06 .
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
-------------------------------------------------------------------=--------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date
3/13/06
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 ONLY. ALARMS/BARRIERS SHALL
LQPERMIT
Application Number . . . . . 05-00004115
-------------------------------------------------=---
Special Notes and Comments
-------------
----------
BE IN-PLACE PRIOR TO PRE -PLASTER.
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid
---------------------------
Credited
----------
Due
----------
Permit Fee Total 311.00 .00
----------
.00
311.00 -
Plan Check Total 160.55 .00
.00
160.55
Grand Total 471.55 .00
.00
471.55
1
LQYERMIT - _
09/14/2005 14:01 1784920
it CA:
Oro EUGENE ROAD
PAW SPRINGS, CA M04
GATTUSO POOL CORPORT
� MR -
$WD
PAGE 08
CITY OF LA QUIrrr
BUILDING & SAFETY
APPROVED
FOR CONSTRUGI-4C)4d
DATkA/S /,)57 BY
09/14/2005 14:01 1784920 GATTUSO POOL CORPORT PAGE 05
Bin 0
City of La Quinta I�
Building a Safety Division a
P.O. Box 1504
Pew k
'78-495 Calle Tampico
La Quinca, CA 92253
Building Permit Application and Tracking Sheet
ProjectAddress: 78q06 CLQ.
Owner's Name: E4• LN IEF P0- 1
A. P. Number.
Address_ f 590C) 41%6 t f' . qui r L- /07_
Legal Description:
City.ST. Zip: Z -A .&jl tS ,4, 4
(kiRi5U POOL �U2
Telephone: 'Contractor. ?<`
Address:, U C? F x.11=
• u
Project Description:
Citg.ST. Zip; ?A 5 1J.(x GA. ZZ
6-a0. pA�
Telephone: x Z `c
Y
State Lie. = : U12 City Lic. #: C7 O
ff(
-S50
Arch.. Engr.. Designer:
Address: 7 3 (0
City. ST. Zip: 4M D i;zr ci4 Twtvo
Telcphonc:_ 0 �.5
Conitrtrcdon Type: Otxupancy
State Lic,= 33
Fr�oject type (circle one): New Add'n Alter Repair Detno
Name of Contact Person: t�2�
Sg, FL: # Stones: d Units:
Tcicphone = of Contact person:
Estimated Value of Project: 00D, D —
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