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05-0609 (RPL)Tihf 4 . 44" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 - (760).777-7012 78-495 CALLE TAMPICO _ FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . (6-5-06-00-0-609-7 Date 2/16/05 Property Address . . . . . . 52865 LATROBE LN APN: 770-340-004- - - Application description. POOL - RESIDENTIAL Property Zoning . . . . . ... LOW DENSITY RESIDENTIAL Application valuation . . . . .30000 Owner Contractor - - - - - - - - - - - - - - - - - - - - - GORDON ROSS - - - - -.- - - - - - - - - - - - -•- - AINSWORTH POOL CONSTR, - .. ROBERT 52-865 LATROBE LANE 40900 GLENMORE DRIVE LA QUINTA CA 92253 PALM DESERT CA 92211 (760) 568-4993 WCC: VIRGINIA SURETY WC: 005-0024833 01/01/06 CSLB: 598681 07/31/06 --------------- CCC: C53 . . . . . . BLDG POOL PERMIT Additional desc Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation .. . . . 30000 .Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 -,32.50 ---------------------------------`-- ----j------------------L---------------- 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 45.00Pla heckjee 11.25 Issue Date ValL on . . . . 0 Qty Unit Charge Per • FEB 2 8 2005 tension BASE FEE 15.00 1.00 30.0000 EA', ELEC PRIVATE SW MMII(1N�O QUINTA Grl or 30.00 Permit . . . PLUMBING Additional desc Permit Fee . . . 33.00 Plan Check Fee 8.25 IFb dr P.O. BOX 1504 VOICE (7 60) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: V5- — o6 v `j' Applicant: Applicant's Mailing Address: . oNik,4cToe Date: �8--- Architect or Engineer: Architect or Engineer's Address: Lic. No.. 1311JILDING 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 /ode, and my LicpnA I in full force and effect. License Class L. License ate L {-Q Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 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 or 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.). U 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(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 is ed. My w rkers' corn ensation insurance carrier d.policy umb��a;e: Carrier f1. Policy Number �� _ I certify that, in the performance of the work for which this permit is i"ssLed, I sh noit employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, 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 APPlicany y��✓Q I (� Pled L S 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 THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 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.). Lenders Name ,t Lender's 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 person at whose request and for whose benefit work is performed undeY or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defendjademnify 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 following issuance of this permit. 2. Any permit issued as a result of this application bec s null and void if work is not commen within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit can ellation. I certify that I have read this application and state that the ab ve inf ation is correct. I agree comply with all city and county ordinances and state laws relating to building construction, and hereb authorize representatives of this c unty to nter upon the above- tioned property for inspection purposes. ✓ �Y 6 Signature (Applicant or Age t): / Page 2 Application Number . . . . . 05-00000609 Date 2/16/05 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- 3.0000 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 Paid Credited ----------------- Due ------------------------------- .. Permit Fee Total 386.50 .00 .00 ---------- 386.50 Plan Check Total 210.43 .00 .00 210.43 Grand Total 596.93 .00 .00 596.93 IF'Or A A P �.l ir ... ....... to I _ltl ' a. 15 . 72 a_.._ ----- - �,, 60 - . 36 44- - - — ...T 32 ..............................:....... :.. 28 .. i ... _ • BUILDING & SAFETY DEPT. p 20 '............... b.;.........:::.'. ......................._._. OR - - _ -- _ - F CION TFUCTION : • Q� .... . 16 1 - ........... \\� ... .......... 1 £ { _ � l .• • .iii ` ..... ...... r• y�/ �4 ............. _ t . _.. _,. f.. _.._ ... i..�-.-. .._Lr. �_ J)Fk Nbr fi ' �to v �-' .....�___ _.. ._!... i.-. }_.-.,._� . ••;-- .., j l .�,a� ty>� . ± a b�. �- _ 4 � 7i1• s �j _ J 4,-0 Yr JCS. &' _._�...�_...__`_ I .� { ' 1.:4. A ` t, 1• L •r �rT"i^ C �r5 POOL Ya nifV�C tf EQUIP. ly ., it 4r ,p� LY♦ 1 v u - ` �� 1 ti �f4'7Y .+.. H g �� u 1 t f:t i'. t t�C ' :1 ♦ ro ♦ �. , r1 :' -}• '1 .: * �4 (� � 1�i� � .,eJ -. 14 �• \�� s .Y W�•..4 n i � ,,�a} 1 ; `4 y �. )Y� a; "::'' •� L. 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