06-2638 (RPL)P.O. BOX 1504 VOICE'(760) 777-7012;
78-495 CALLE TAIvIRICO FAX (760) 777-7011
LA'QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT, INSPECTIONS (760)777-7153.
BUILDING PERMIT.
Date: 7/11/06
Application Number: (06-00002638 Owner:
Property Address: 79085 VICTORIA DR GUARINO ROBERT 'W W.
APN: 604=373-003-35 -27899 - 790.85 VICTORIA DRIVE
Application description: POOL - RESIDENTIAL LA"QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application, valuation: 29000 `
Contractor: JUL 13 206
Applicant: Architect or Engineer: GATTUSO' POOL CORPORA IO
667 S . EUGENE ROAD CITY OF. LA QUINTA
PALM ,SPRINGS, CA 922 4
FINANCE DEPT.
(760)327-7592
Lic. No.: 672850
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury, that I am licensed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. - _ _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C53 License No.: 672850 . 'for by Section 3700 of the Labor Code, for the performance of the work forwhich_this.permit is - -
issued. -
.; Date_ Factor. • - 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
OWNER -BUILDER DECLARATION - - insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE 'FUND - Policy Number 16150742006 ,
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any'
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or. 3700 of the Labor Code, I shall forthwith comply with those provisions.
_ that he or she is exempt therefrom, and the basis for the alleged exemption. A6y 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 is 500).: - Date: plicant:
( ) 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 WARNING: F [LURE TO SECURE WORKERS' COMPENSATION COVERAGEIS UNLAWFUL, AND SHALL' '
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS (5100,000).' IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
_ - improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES., _ 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.). - - - - - APPLICANT ACKNOWLEDGEMENT
( 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the.project (Sec. .IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the _ -
7044, Business and Professions Code: The Contractors' State License Law'does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who -contracts for the projects with a contractor(s) licensed - 1 . Each person upon whose behalf this application is made,.each person at whose request and for
pursuant to the Contractors" State License Law.).- - _ - whose benefit work is performed under or pursuant to any permit issued as a result of this application, -
• - 1-_) I am exempt under Sec. , B.&P.C. for this reason - 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. - • -
Date: Owner: 2... Any permit issued as a result of this application becomes null and void if work is not commenced - -
o issuance c p cessation 0
. _ .. .. ... ..-. .- -..;
within 180 days from date f ' ante of such permit, or cess 'on of wdrk for 18 days will subject-
• - CONSTRUCTION LENDING AGENCY permit to cancellation.
,.. -I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the. - Ycertify that Ihave read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ.. C.L. -city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this co to enter upon thea ove-mentioned property for inspection purposes. - -
Lender's Name: - - - - "
,. e: i ure (Applicant or Agent): -
Lender's Address: _ •.. . "
LQPERMIT
Application Number.;
06-00002638
Permit '. . . . .. .BLDG
POOL PERMIT
Additional desc:
_ Permit-Fee '.-' •. .:
278.00 Plan..Check. Fee ' :
180.70 '
Issue Date t
Valuation '.
29000 .
Expiration Date . .`
- 1/0.7/07
:.
Qty Unit Charge
Per
Extension-.
BASE FEE
252.00.,
'•4.00 6.5000
THOU BLDG'25.,001-50000
26.00'
Permit
MECH POOL
Additional desc
Permit Fee
26.00 Plan Check Fee ,..
=6-:50 '
Issue Date
Valuation ".
0
Expiration Date
1/07/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1..00 •11.0000
EA MECH FURNACE '>100K
i1.0o`
Permit
ELEC POOL PERMIT-RES
Additional desc
Permit Fee
45.00 Plan Check Fee :
11.25
Issue Date'
Valuation
0
" Expiration Date
1/07/07
I - Qty Unit Charge
Per.
Extension
BASE FEE
15:00
.1.00 30.0000
EA ELEC PRIVATE-SWIMMING POOL`.
30.0.0.,
Permit
PLUMBING
Additional desc .
Permit Fee
33.00 Plan Check Fee
8.25 .
Issue Date
Valuation
0
' Expiration Date
1/07/07
-. 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•INS_T/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
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427
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P.O. Box 1504 .
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La Quintai CA'92Z53
Building PermitApplication
and Tracking Sheet
Pruje4 Address: q ~ O � 1/sG7b 0wi:er's Nacre:
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P. tiu„itxr • Address: ~p 1Mw-
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LegalDcicription• Ciry.ST. Zip: LA Qi/2A/ �{ 'Al.
ConlraC r Telephone:
Address: (o r V CV N E Projea Dcw6ppon �4
City.ST. Zip' PN (s GA-.17—ZIA (
Telephone: Z Z
State 6C. w: y 5:Q ; City Lir— : d aLa
Arch.. En", Designer> ►' tiS �( it S S ,
Address: 7 3 (� to I �l
C11Y.57. Zip: PAZ>IR'1 IF' CA
Telephonc: 7 _ �j S
Construction Type: �Occupaaty
`• • project rYpt (circle our.); Add'n Alter Repair
Demo
State Lic. .. ,'
Name of Contact Person C A.t2y� • Sq. FL:
It stories:
#Units:,
Telephone = of Contact person: .3z.7' 7S Z Esdinated Value of Project:
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