06-2974 (RPL)low
Ott!
� VOICE760 777-7012
P.O. BOX 1504 O ( )'
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 " BUILDING & SAFETY DEPARTMENT- INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date:. 8/11/06
- -y Owner:
Application Number: 06-00002974
Property Address: 52920 -VIA DONA ANDREW PIERCE CORP..`
APN: 772-410-999-10 -298944- 52920 VIA DONA
Application description: POOL - RESIDENTIAL. O LA QUINTA, . CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (�
Application valuation: 45000 W c
D1 i TO Contractor:
Applicant: Architect or Engineer: P�� �P AINSWORTH POOL CONSTR, ROBERT
OGLENMORE DRIVE
O�C�O�� PALM DESERT, CA '92260
F�bP (760).200-2800
Lic. No.: 598681
----------——------ I --------------------------------
LICENSED
---------——-
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 an r sionals Code, and my License is in full force and effect. -
Licens la -s: C 5 3 License o.: 598681
Date: `1 trac[or:
OWNER -BUILDER DECLARATION
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 a 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 fora permit subjects the applicant to a civil penalty of not more than'five hundred dollars 155001.:
as oviner 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 _) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Seca
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.l.
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner: '
-
CONSTRUCTIONLENDINGAGENCY
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.I.
Lender's Name: '
.Lender's Address:
LQPERMIT
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 CALIF INS Policy Number 460030110102
_ 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 become subject to the workers' compensation laws of California,
and agree that, if I shout c e subject to the orkers' compensation provisions of Section .
3700 of t bor Cad I all ortInwith co m ith those provisions. .
ate:i b ppli nt:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEISUNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). 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
city a county ordinances and state laws relating to building co tion, and hereb authorize representatives
of is cou ty to enter up o the above-mentioned p y for ' s ct, n purpos
Date: `) ignature (Applicant or -Agent). _k AA
Application Number . . . 06700002974
-
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit.Fee- - 382.00 Plan Check
Fee
248.30
Issue Date Valuation
45000
Expiration Date 2/07/07
Qty Unit Charge Per
Extension
BASE FEE
252.00
_ 20.00 6.5000. THOU BLDG 25,001-50,000
-----------------------------------------------------------------------------
130.00
Permit MECH POOL
Additional desc
Permit Fee . 26.00 Plan Check
Fee
6.50
Issue Date Valuation
0 .
Expiration Date 2/07/07
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
s
0
Expiration Date.. 2/07/07
Qty Unit Charge Per
Extension
-BASE FEE
15.00
1.00 30.00,00 '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 2/07/07
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
1:003.00.00 EA" PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------- -----------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
LQPERMIT - _
Aug 07 06 11:51a Robert Ainsworth 760 200-0040 p.1
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