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05-4330 (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: 05-=00004330 78350 CLARKE CT 643-170-999-21 -31348 POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 18000 Re = Architect or c&ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------------------------------------- LICENSED CONT CTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lice dun r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P fessio s Code, and my License is in full force and effect. License Class: License No.: Date-1nspIO 1Contractor: 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 ($500).: (_ 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 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 contractors) 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 - - - - - - - - - - - - - -- _ 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 becomes�Iect t the workers' compensation provisions of Section �3700 of the Labor Code, I sh IYforthwi omply with those provisions. at'e: J0_/'�/Applicant,/ WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR MINAL 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 info, correct. I agree to comply with all city and county ordinances and state laws relating to building con rxion d hereby authorize representatives of this cou fy to,,entyer u/pon the above-mentioned prop ert for ' spect rposes. Date:��V_W Signature (Applicant or Agent): Application Number . . . . .. 05-00004330 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 1.60 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 ---------------------------------------------------=---------- 30.0.0 -------- - - - - -- 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 LQPERMIT Yl� LQPERMIT Application Number . . . . . 05-00004330 ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged ----------------- ---------- Permit Fee Total 293.00 Plan Check Total 148.85 Grand Total 441.85 Paid Credited Due ---------- ---------- ---------- .00 .00 293.00 .00 .00 148.85 .00 .00 441.85 09/27/2005 10:59 1784920 GATTUSO POOL CORPORT PAGE 03 I 4 P I I 1 A+ V TA BUILDING & SAFETY DEPT. APPROVED FORCONSTRUCT ON DATE �1�'lI°`S BY k met . I Cly .rw BEDROOM r VT � - ' 713 350 C-Llkzwe G+, la6 ) � OFFICE LA QU�t�F�� GLS g2ZS� � CL ET •. rivq r e� aa�wwa OArrM wool• CCRPCRAMN o61 EUGENE PW i 1A r PALM SPRINC4, CA A)Zfe DR1=39 1 KITCHEN GRJROOM I - r r — i :BEDROOM ' I NIDOi( I • i ' L.H DRYLj RYl T to UWEf1 Q 11 CoWAGI- � �wxn x�nYe Nimwm�� �c. 1 - 1 • 5' wail. \ -----.�_ . F C7 ,' 09/27/2005 10:59 1784920 GATTUSO POOL CORPORT PAGE 01 Bin City of La Quimta Building 8L Safety Division 1 P.O. Box I SO4 Permit # 78-49S Calle Tampico La Quintai CA 9ZZ53 ' Building Permit Application. and Tracking Sheet Project Address: "r t3 3 f�O Owncr s Name: A. P. Number. Address: 7 D o. Alve- 'S✓ a Z Leval Description: City.ST. Zip: 44 f3 � A 9 ?,Z f 5 Contractor. C=RmUSt, Pt>ot_ Cb RP Tcicphone: Address: EV (v.4q; NE R Projcct Description: Cit%,.ST. Zip: ?A GN JZ.ZIA tbAL Telephone: a7. 01 State Lic. ; : Co 5;0 City Lie, sv: p 019 1 La Arch.. Ener.. Designer. esS Address, 7 5!9 (o 40 60 cit.'. ST. zip: 1#7AI pl Dk-sE-,er cA zzcvg Telephone:— p 0.5 r:',, `' ; Construction Type: Ooeuppn¢y State Lic. - 3 ;<: -.._,:.>'. `: Project type {circle oxer New Add'n Alta• Repair Demo Same ofContaCt Person:C a�� Sq. Ft. aR Stoeies #Units: Tdcyhone = of Contact Person: 3 7-7 - 'j ZPsumated Yalta of Project: /s, tape . O ^;' a Submittal ;:Raged' s.f�CEd M 3rs:s�^ °.•,� Ny TB ;.sa"sy�2# ? 4:7.. plans, "C v'!. :iit:. 'va.r+:: :•1�iR1�':Y�. ,`M.�Cf{tr:Y;,yi'?1`F:y +�' ..RQ;x�; -I WORT "•:'ti:�:;.Afa SrrvcraratCrtla:: .: ��• ..,�� ' �^.x • , ,.. .,. ,;..,:.' "' ��. �:�•• • 7.:,-,'.k : ;Re�iewitlayeadyitor:re�s• ' s t;: • � i�+t+4r�`�`t: ;�,�:' � 1 . 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