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06-0014 (RPL)•4f��NI1�f1(/ P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/18/06 Application Number: 06-00000014 Owner: Property Address: 80710 VIA MONTECITO WIER APN: 772-410-999-72 -298944- 80-710 VIA MONTECITO Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8000 Contractor: Applicant: Architect or Engineer: d AINSWORTH POOL CONSTR, ROBERT 40900 GLENMORE DRIVE ^— y g� PALM DESERT, CA 92260 Asti JAN 1 100E (760)568-4993 _._ _ Il LiC. No.: 598681 SED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury ttfit I alicensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busin s and rofessionals Code, and my License is in full force and effect. License,C1 s:: C 3 - LiNo.: 598681 Ar) d Contractor// OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 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).: (_) 1, 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.). (_) 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.). (_) 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 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 46-0030110101 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 sh Id ecome subject to the workers' compensation provisions of Section /yl(�3700 of the Labor C de, I hall farthw' "comply with those provisions. Dale: �Iv Applicant: WARNING: FAILURE TO SECUR#RRS' OMPENSATION COVERAGEIS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). IN ADDICOST 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 bove information is correct. I agree to comply with all city and county ordinances and state laws relating t uild' constr ion, and hereby authorize representatives of thi unt to/penter upon the above-mentioned p pe y f ins p tion purpo s. Date v Signature (Applicant or Agent):\q V Application Number . . . . . 06-00000014 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee 99.00 Plan Check Fee 64.35 Issue Date . . . . Valuation . . . . 8000 Expiration Date . . 7/17/06 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 54.00 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 . . . . 21.00 Plan Check Fee 5.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/17/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 ---------------------------------------------------------------------------- Special Notes and Comments TWO ENTRY FOUNTAINS ONLY. Fee summary Charged ----------------- Paid Credited -------------------- Due ---------- Permit Fee Total ---------- 165.00 .00 .00 165.00 Plan Check Total 80.85 .00 .00 80.85 Grand Total 245.85 .00 .00 245.85 LQPERMIT Dec 29 05 02:51 p Robert Ainsworth 760 200-0040 p.1 LA QUANTA U 1 CIA li11 r City of, La Quinta QllildI Sifery Divu� ►emlti r P-0. doz 1 SO4.1 8-49S Calle Tampico v 0/l LJ Q�na, U 9.�M - (740) 777-7012 / Building Pernnit Application and Tracking Sheet X P,a,00 Address. nn 0 N T i Clod or„<r ,Name A. P. Nrar Address � � _ U V # j /N r x COnIlICIOl Ciry. ST. Zip... i NS �„I iz- L On.�, 1.0C�� /f FTekploowe: �..� x Addre s: y U - L, ti .SOK 0 ro)eo D�a X CII'. ST. 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