06-4398 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00004398
Property Address: 47585 VIA_-MONTESSA
APN: 643-120-061-240 -26152 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 50000
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Code, and my License is in full force and effect..
License Class: C53"License No.;77601
ate• ntractor
OWN -B DER 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 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).:
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 fo 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, 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 notapply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed
pursuant to the Contractors' State License Law.).
1 _ I 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:
LQPER)•11T
Owner:
GILHOUSEN BRENT J
1 PEAKMONT LN
CLARKSON VALLEY, MO 63005
Contractor:
CAL-NEV POOL, INC.
P.O. BOX 2222
RANCHO MIRAGE, Ck 92270
(760)883-5561
Lic. No.: 777601
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/29/06 .
rDECDz J)ioos
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
7� 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 1795596
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,
and agree that, if I should become subje tot workers' compe tion provisions of Section
3700 of the Labor Code, I shall forth ply with those isions.
J��:TAILURE TO SECURE WORKERS' COMPENSA 10 OVERAGE 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 than I have read this application and state that the above information is c ct. I agree t mply with all
city and county ordinances and state laws relating to building cons author' representatives
of this co " to ennt�e✓r upon [he ve-mentioned property for ' do poses. _
at�Z z� ' ure (Applicant or Agen .
J Application Number 06-000043.98
Permit : . BLDG POOL PERMIT
Additional desc .
Permit Fee 414.50
Plan Check Fee'.
.00
Issue Date
Valuation.'
50000
.Expiration Date 6/27/07.
;
Qty Unit Charge Per
Extension'
BASE FEE
252.00
25.00 6.5000 THOU BLDG 25,001-50,000
162.50
Permit : . . MECH'POOL
Additional desc .
Permit Fee 24.00
Plan Check Fee
.00
Issue DateValuation
. . .
. 0
Expiration Date_. 6/27/07
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
.00.
Issue Date . . . .
Valuation . . .
0
" Expiration Date 6/27/07
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 30.00
Plan Check Fee
.00
Issue Date
Valuation
•0
Expiration Date 6/27/07
Qty Unit Charge Per
Extension
BASE FEE
15.00 .
2.00 6.0000 EA. PLB FIXTURE
12.00'''
1.00 3.0000 EA - PLB GAS PIPE
1-4 OUTLETS
3.00
---------------------------------------------------------
Special Notes and Comments
POOL & SPA. ALARMS/BARRIERS SHALL BE IN
".'PLACE PRIOR TO PRE -PLASTER INSPECTION.
LQPERAIIT
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
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POOLS Mark V. Touw
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