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05-4335 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 1(05=0000433 78390 CLARKE CT 643-170-999-17 -31348 POOL - RESIDENTIAL LOW DENSITY RESIDENTIAI '18000 Architect or Ta�1440" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT vv L - LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof i s Code, and my License is in full force and effect. License Class: Li nse No.: Date: X7)0 66 /Contractor 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 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 (55001.: (_ 1 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 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 I, 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 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 (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/27/05 Owner: PH RANCH LLC 78370 HIGHWAY 111 STE 200 LA QUINTA, CA 92253 Contractor: GATTUSO POOL CORPORATION WCC: STATE FUND WC: 1615074 01/01/06 CSLB: 672850 06/30/07 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. 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 policy number are: Carrier C53 Policy Number --------------- 1 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 b espawSTWt to the workers' compensation laws of California, and agree that, if I should be a subject the workers' compensation provisions of Section 3700 of the Labo ode, all forth comply with those provisions. ad te'l� Applicant: WARNING: FAILURE TO SEC/WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TOINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN A DITION 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 as 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 informati n is correct. I agree to comply with all city and county ordinances and state laws relating to building constr , and hereby authorize representatives of this county to enter upon the above-mentioned propert or i pe r purposes. Date��/� L A Signature (Applicant or Agent): Application Number . . . . . 05-00004335 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . . . Valuation 18000 Expiration Date 3/26/06 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 --=------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . - Valuation 0 Expiration Date 3/26/06 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 3/26/06 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 3/26/06 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 LQYERN TT Application Number . . . . 05-00004335 ---------------------------------------------------------------------------- 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 293.00 .00 .00 293.00 Plan Check Total 148.85 .00 .00 148.85 Grand Total 441.85 .00 .00 441.85 11 LQPERMIT 09/27/2005 12:13 1784920 GATTUSO POOL GORPORT Dz, rn7NT ya2�J z5 . � 3'JV!lVOp�Lylt[�ttD��. � Q.••, t 2y� x �y POOL 3 Dom, �. � � I Aal wooaaae : o rf ► M A -P/ L. OT 0 163gO G�a21��, r LA QVus7'A,, c -p, QAnU901'Wk mavp+AMN 007 EUGENE ROM 8399 PALM 9PrMAS, CA 92204 I rw�os a�ueeM�n 13 I (T9yr . ' ONINIC � � 301dd0 4-o P , I � I I - cl g , FLLtlB �� y.+'e u I ' 2ld1S dW i 140 ' Y W0Oa039 I + r I - PAGE 02 Z;,W/- yr}ltv CITY OF: LA Q U I N I A BUILDING & SAFETY DEFT. APPROVED FOR CONSTRUCTION DA ?fd / r BY LL I