06-0271 (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:
06-00000271
78401 DEACON DR W
770-210-021- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
75000
Architect or
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LICENSED CONTRACTOR'S DECLARATION
T -Q
it!t 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
- b
k
JpN 19 2006
CITY OF 1A QuINTA
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section7 001 of ivision 3 of the Business and rofessionals C de, and my License is in full force and effect.
License
ads 53 icense No.: 518742
—Date'! I Contracto .
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 70001 of Division 3 of the Business and Professions Codel 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 0500).:
(_ 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 1, 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(s) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/18/06
Owner:
MCGAUGHEY WILLIAM
Contractor:
AMERICAN POOL CONSTRUCTION INC
P.O. BOX 11996
PALM DESERT, CA 92255
(760)340-2588
Lic. No.: 518742
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 STATE FUND Policy Number 0001188-2005
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 California,
an agree that, if I should become ubject to the workers' compensation provisions of Section
/, 3
700 of the Labor Code, I shall thwith cnmeVawith those provisions.
Date• 7 Applicane!
WARN NG: AILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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
city and county ordi ances and state laws relating to building constr coon, and hereby authorize representatives
of �th/is/�ou_ y to a er upon the above-mentioned property for in tion pUQiosac.—�
Dace: /q ignature (Applicant or Agent(
Application Number . . . . . 06-00000271
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
527.00 Plan Check
Fee
342.55
Issue Date . . . .
Valuation
. . .
. 75000
Expiration Date . .
7/17/06
Qty Unit Charge
Per
Extension
BASE FEE
414.50
25.00 4.5000
--------------------------------------------------------------
THOU BLDG 50,001-100,000
112.50
-------------
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
7/17/06
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 . .
7/17/06
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
7/17/06
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
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Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERMTT
Application Number . . . . . 06-00000271
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 631.00 .00 .00 631.00
Plan Check Total 368.55 .00 .00 368.55
Grand Total 999.55 .00• .00 999.55
LQPERMIT
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Palm Desei 82255
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City of La Quinta
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dr P.a BOX 1504, 7849$ CA Tlunplco
La Qtdn(4 G 922$3 - (760) 777.70 f 2
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