05-4492 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:—CO5_-000044.92
Property Address: 53504 VIA BELLAGIO
APN: 772-510-067- - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 40000
Tit!t 4 e(A Q" -
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 pno,olessionais Code, and my License is in full force and effect.
License Class: License No.:
✓Date!J_/a> Contrac r:
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 _ 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_) 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:
NRI CCP I
81100 AVE 53
LA QUINTA, CA 92253
VOICE (760) 777-.7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Y.
D5
rcr 10 2005 IDI
OF L QU t4 AYAY
A a##% - — —
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 be a subject thto the workers' compensation laws of California,
and agree that, if I should beco ubject to e workers' compensation provisions of Section
,{ 3700 of theLabo/r Code, comply with those provisions.
Da Applicant`
WARNING: FAILURE TO SE E 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 L
city and county ordinances and state laws relating to building con ion, and hereby authorize representatives
of this
/county to enter upon the above-mentioned grope v'for' s cti purposes.
Qat : /O Signature (Applicant or Agent).
Application Number . . . . 05-00004492
Permit
BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 349.50
Plan Check Fee
227.18
Issue Date
. . . .
Valuation
40000
Expiration
Date 4/04/06
Qty Unit Charge Per
Extension
BASE FEE
252.00
15.00
-----------
6.5000 THOU BLDG 25,001-50,000
:
97.50
. . . MECH POOL
Additional
desc,.
Permit Fee
. . . . 26.00
Plan Check Fee
6.50
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date 4/04/06
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 •4/04/06
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 4/04/06
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
-J
LQPERMIT
Application
Number . . . . . 05-00004492
----------------------------------------------------------------------------
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 453.50 .00
--------------------
.00
453.50
Plan Check
Total 253.18 .00
.00
2'53.18
Grand Total
706.68 .00
.00
706.68
'�
10/06/2005 10:03 1784920 GATTUSO POOL CORPORT PAGE 01
Bin 0City
of La Quinta
}
Building a Safety Division
P.O. Box 1504
-
Nennh #78-1495
Calle Tampico
r
�f
La Quinta, CA 92253
.
Building Permit Application. and Tracking Sheet
'
Project Address: 53 5U i// 97U_A CW o
Owner's Name: �{Wllilrr C -00-49
A. P. Dumber:
Address: 78100 DO /iVC q 'jtvl—if
Letsat Dcsviprion:
City.ST, zip:
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OL.
Address: C •U ( R
Project Descripuou'
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Telephone:s
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Ciry Lie. #: Q 2B I Le
4,0v
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Arch.. Engr-. Designer: (, S
Address: '7,3 k /%
City. ST. Zip, Rk/__M QP54F GAS Z Z,(PO
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Telcphone: 7 a L5
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in
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circle tine New
Demo
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