05-5384 (RPL)s
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00005384
Property Address:
52905 CLARET COVE
APN:
770-330-004- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
25000
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I e licen i1 under provi ions of Chapter 9 (commencing with
Section 7000) o Division 3 of the Business a 'Profess nals Code, d my License is in full force and effect.
License
�jCl s: 53 License8681
/6. e: ! ontrac r:
NER-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 penalty of not more than five hundred dollars ($500).:
1 _ 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.).
(_) 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(sl licensed
pursuant to the Contractors' State License Law.).
( 1 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
Owner:
GILBERT
52-905 CLARET COVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/09/05
Contractor:
AINSWORTH POOL CONSTR, ROBERT
40900 GLENMORE DRIVE n
PALM DESERT, CA 92260
(760)568-4993
Lic. No.: 598681 pEC 2 0 21005
-- - - - - - - - - - - - - - - - ---- ---PENS--
WORKER'S COMATI RATION
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. ,
/V 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 VIRGINIA SURETY Policy Number 005-0024833
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 be tile
to the workers' compensation laws of California,
and agree that, if I should beco a subjec to the wor rs' compensation provisions of Section
700 of the Labor h fort i comply wit rovisions.
D e: �pplicant.
WARNING FAILURE TO SECURE WORKERS' OMPENSATION 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 informati is rrect. I agree t comply with all
city and county ordinances and state laws relating to building construct' , a d h eby authorize presentatives
of thi my enter upon the above-mentioned pro pert io pur se .
Date: �:Signature (Applicant or Agent):
Application Number
. . . . 05-00005384
Permit . . . BLDG POOL PERMIT
Additional desc..
Permit Fee 252.00 Plan Check Fee 163.80
Issue Date Valuation . . . . 25000
Expiration Date 6/07/06
.Qty • Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG 2,001-25,000 207.00
----------------------------------------------------------------------------
Permit . . . MECH POOL -
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date Valuation . . . . 0
Expiration Date 6/07/06
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 6/07/06
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 6/07/06
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 . . . . . 05-00005384
----------------------------------------------------------------------------
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 356.00. .00
----------
.00
356.00
Plan Check
Total 189.80 .00
.00
189.80
Grand Total
545.80 .00
.00
545.80
LQPERMIT
CITY OF LA
BUILDING & S
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