05-0119 (RPL).r
BUILDING & SAFETY DEPARTMENT
c - O. Box 1.504 (760),777-7.012
495 CALLS TAMPICO FAX (760) 777-7011
QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
JAN is
,, n� d aUIPlT@�
BUILDING PERMIT
umber
Property Address . . . .
APN:
Application description..
Property Zoning . . . . .
Application valuation .
05-0000011 Date 1/12/05
77340--CALLE DURANGO
773-1.61-023-12 -0000&Q-
POOL - RES'IDENTIAL
. COVE RESIDENTIAL
17000
Owner Contractor
.BENOIT CALIFORNIA POOLS & SPAS
.77340 DURANGO P.O. BOX 1280
LA QUINTA, CA 92253 COACHELLA, CA 92'236
(760)398-9222
WCC: SEABRIGHT I'NS
WC: BB10.505'10 01/01/06
CSLB: 656128 10./31/06
CCC: C8 -C27 -C29-053
P.O. BOX 1504 Ot VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (7:60) 777-7011
LA QUINTA, CALIFORNIA 922`53 INSPECTIONS (760) 777-7153
-BUILDING & SAFETY DEPARTMENT
Application Number: S- lily Date:
Applicant: I Architect or Engineer:
,Applicant's Mailing Address; _
PERMIT
Architect or Engineer's Address:
Lic: No.
LICENSED -CONTRACTOR'S DECLARATION
I he by affirm under penalty of perjury that I, am licensed u rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals.
e, and'myticen is force and effect.
cense Class i ns No. [1 (tel ZJS
/ata OS -Contractor
OW NER-BUILDER. DECLARATION
I hereby affirm under penalty of perjury that 1 am exemptirom the Contractors' State License Law for thefollowing 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 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 anyapplicant for a permit,subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U J, as owner ofthe property, or my employees with wages as their sole compensation, will do the work, and the sure is not Intended or oftered,for sale (Sec: 7044,
Business and Professions Code: The •Contrectors' State License Law does not apply to an owner of property who, builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or tmprovement'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 I, as owner of the property; am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor;'
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 pursuantto
the Contractors' State License Lash.),
U I am exemptunderSec. ; BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
l.hereby"afrn Underpenalty of perjury one of the following declarations:
Ihave and will maintain a certificate of consent to self -insure for workers' compensation, as provided for bySection 3700 of ft Labor Code, for the performance
of the work.for which this permit is issued..
I have and will maintain rkers' compensation insurance, as required;bySection :3700 of the)Labor Code, for the performance of.the work'forwhich this permit is
h worke mpensationinsurance carrier a p tcy numb are:
Carrier Policy Number ifill/%�� f (�
_ 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 subject to the workers'
compensation laws of Califomia, and ag if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date ,0 /Applicant
WARNING: FAILURE TO SECURE"WdRKERS' 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, DAMAGESAS' PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
Lendees Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to -the Director of Building and Safety for a permit subject to the condfions 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, indemnity and hold harmless the. City. of Le Quints, its
officers, agents and employees foranyactor omission related'to.the work being:,perfomted 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,cartify thatl have read this application and state thatthe abovelinformation ' co I agree;to comply with all city and county ordinances and'statelaws:relating to building
�construction, and hereby authorize representatives of this coun nter u the boveanentioned property for inspection purposes.
Date 0 'Si nature.(, licant or A ent :
9 APP 9 )
r
Application Number . . . . . 05-00000119
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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 9.0'000 EA MECH FURNACE <=1O0K 9.00
------------------------------------------------------------------------------------
Permit . . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 180.0.0 Plan Check Fee 117.00
Issue Date . . . . Valuation . . . . 17000
Qty Unit Charge Per Extension
BASE FEE 45.00
15.00 9.0000 THOU BLDG 2,001-`25,000 135.0.0
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 3.0.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
Permit PLUMBING
Additional desc .
Permit Fee . . . . 33.0,.0 Plan Check Fee 8.25
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 TNST/ALT/REP 3.00
1.00 3.00.0,0 EA PLB GAS PIPE 1-4 OUTLETS 3.00
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
BE IN PLACE PRIOR TO PREPLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
Permit Fee Total 282.00 .0.0 .00 2.82.00
Plan Check Total 142.50 :00 .00 142.50
Grand Total 424.50 .00 .00 424.50
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