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05-1319 (RPL)- i� C&tyl 4 4 a" BUILDING & SAFETY DEPARTMENT �. Box 1504 (7-60).777-7012 -495 CALLE TAM'PICO FAX (760) 777-70'11 QUINTA, CALIFORNIA 922.53 INSPECTION REQUESTS (760) 777-71;53 BUILDING PERMIT Application Number . . . . . 05-00001319 Date 4/07/05 Property Address . . . . . . 4534:5 DEERBROOK CIR APN: 604-4.04-0.07-2.6 -2`3995 Application description description . . POOL - RESI-DENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation . . . . 22000 i Owner Contractor ----=,--=--'=------------- PETANUCK PARZINSKY POOL, INC., RICH . 45345 DEERBROOK CIR P.O. BOX 89.7 LA QUINTA CA 92253 PALM SPRINGS CA 92263 ('760) 324-5827 WCC: STATE FUND WC: 1739.513 08/15/05 CSL&: 431055 10/31/06 CCC: C8-05:3 ' Permit . . . . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 225.00 Plan Check Fee 146.25 Issue Date . . . . Valuation . . . . 22000 Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 THOU BLDG 2,001-25,0.00 180.00 .Permit . . . . . . MECH POOL Additional desc . Permit Fee . . . . 24.00 Plan Check°Fee 6.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension. BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00• Permit: . . . . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . . . . PLUMBING Additional descc . . Permit. Fee 33.00 Plan Check Fee 8.25 Alp P.O. Box 1504 •� VOICE (7.60) 777-7012 -78-495 CALLS TAMPICO FAX (760) 777-7011. LA QUINTA, CALIFORNIA 92.253 INSPECTIONS (760) 777-71.53 BUILDING. & SAFETY DEPARTMENT Application Number: Q.S— /3 ` Date: Applicant: I Architect, or Engineer: Applicant's Mailing Address: Co (`! t -k,4 GTO Architect or Engineer's Address: Lie..No.: BUILDING PERMIT DECLARATIONS 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 Professionals e, and sis in full force: and effect. -�f A io ss �nse Class !!F> CG`.53 License N -Contractoryy GA YAQ2;PJSW Poo /3 OWNER43UILDER DECLARATIQN I"hereby affirm under penaltyof perjury that I am exempt from the Contractors' State License Law.forthe following reason (Sec. 7031.5, Business and Professions"Code: Any city, or county that requires a permit to constrict, atter„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 Contractors' 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).); U I, as owner of the property, or my employees with wages astheir sole.compensation, will do the work, and the -structure is not.intended or offered for sale (Sec. 7044, Business and PmfessionsCode: The, Contractors! "Stale License Law does not apply to an owner of property who but ds.or improves thereon, and who does the work himself or herself or through his or her own employees, provided thatrthe 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.).. U 4 as owner of the property, am exclusively contracting"with licensed contractors to construct.the project (Sec: 70441, 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..). (--) lam exempt:under Sec. , BA RC. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I"hereby affirm ,under penalty of pedury'one of the following declarations: I have and will maintain a certificate of consent:to self -insure for workers' compensation, as provided forby Section 3700 of the Labor Code, for the performance. v 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 otthe work for which this permit is Xg issued. M workers' mpensafion'insurance camerprd:policy number are: Tier Sr;fo.--e ...�. Policy Numbery _ I certify that, in the perfornance.of the work for which this,permit is issued, I shall, notemployany person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if l should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (1 (� l Dais moi/ �I �5 Applican<c ry Fera �Zi w► to If -4 Ybo ! sJ 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'FHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION'LENDING AGENCY I hereby affirm under penalty of perjury that there Isa construction lending agencyior the performance of.the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address 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 personat.whose request and for whose benefit work is performed under or pursuant to anypermit 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 foe any act or omission related to the work being performed'under or following issuance of this permit. 2. Any permit:issued as a result.ofthis 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,thatthe above information is correct, I agree to; comply with all city and county ordinances•and state laws relating to building construction, and hereby authorize representatives of this county to enter uponihe above-mentioned property for inspection purposes. I95te ►ID_S Signature (Applicant or Agent)(�� Fee summary Charged Permit Fee Total '327.00 Plan Check Total 171.75 Grand Total 498.75 Paid Credited Due .00 .00 327.00 .00 .00 171.7.5 .00 .00 498.7,5 Page 2 Application Number . . . . .. 05-0000.1319 Date 4/07/05 Issue Date Valuation . . . . 0 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 3.000.0 EA PLB GAS PIPE 1-4 OUTLETS 3.00 Special Notes and Comments POOL & SPA. ALARMS/BARRIERS SHALL BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Permit Fee Total '327.00 Plan Check Total 171.75 Grand Total 498.75 Paid Credited Due .00 .00 327.00 .00 .00 171.7.5 .00 .00 498.7,5 SCALE: 1/8" = V CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE j /4 /0 S- 13v GM Rich Parzinsky Pool Const. Designed by: 05-025 Mike Petranck P.O. Box 897 Phone: 760-324-5827 Steve P. Designed 45-345 Deerbrook Cir P.S. CA 92263 Fax: 760-324-7287 4/5/2005 for: LQ T Round spa g to. match existing