07-2546 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
Coe
07.=00002'54"6
53135 AVENIDA OBREGON
774-044-019-7 -000000-
POOL - RESIDENTIAL
COVE RESIDENTIAL
17000
Architect or. Engineer:
»
LICENSED,CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury, that I,am lj6ensed unde_r:provision.s rof"Chapter 9 (commencing with
Section? 00)bf Divisiom3-of t an ro es" - "d an m'y License is in full force and effect.
Lice a ass-_A.]B-C4
rr6 .7 23
at ontractor. x
OWNER- U ERb C � 4 TION
hereby affirm and ?.penalty erj at I am exempt from _ a Contractor's State License Law _ he
following reason Ise I, .5, Business and Professions Code: Any city or county that requires aperni i to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed`statenierit 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 (5500).:
(_ I 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 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.). -
1 _ 1 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 performanceof the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: Y�
LQPERMIT
Owner:
STEVE CORTEZ
53135 AVENIDA
LA QUINTA, C4
CORTEZ
$2253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777=7153
Contractor:
GILBERT,
43,501 TOF
INDIO,,,,CT
(760-) 835,-
Lic. No.:
Date: 9/19/07
'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',6ompensation;!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.ZEMPT Policy Number EXEMPT
I certify that, in the performance of the work for whichthispermit is issued, I, shall not employ any
person inany manner. s to become subject to the workers' compensation laws of California,
and agree 'LL be su workers' compensation provisions of Section
WARNING:,, �FAILUR CUR W ERS NSATION CO IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI AL PENALTIES,AND CI %flNES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000): AN 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'cessat-, of work for 180 days will subject
:permit to cancellation.
I certify that I have read this application and sta ve information is co ect. I agree to comply with all
city and county ordinances and state law sting t uild' g onstr authoriz represe/nJ��+v¢Is
of this c90my lb enter upon the abov entioned r p f e i6n� G� � / / i
Application Number . . . . . 07-00002546
Permit . . . . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
180.00 Plan Check
Fee
117.00
Issue Date . . . .
Valuation
. . .
. 17000
Expiration Date
3/17/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
135.00
Permit . .
MECH POOL
Additional desc .
Permit Fee . . .
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
3/17/08
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
0
Expiration Date
3/17/08
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
33.00 Plan Check
Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date ..
3/17/08
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
LQPERMIT
Application Number . . . . . 07-00002546
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT. ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
-------- -- ---------- ----------
Permit Fee Total 284.00 .00 :00 284.00
Plan Check Total 143.00 .00 .00 143.00
Grand Total 427.00 .00 .00 427.00
LQPERMIT
al=as 2o1
i:.
SEP 1 7 2007
)F LA QUINTA
G & SAFETY DEPT.
PROVED
'-ONSTRUCTION
7 -o? By Clrl
G 6'Atc *?- SOS
61W-0�(7,00l.; d
Bin #
City -of La: -Quinta..
Building u'.Safety Division
P.O.`Box 1.504, 78: 495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# .1
Project Address:
,'
Owner's Name:
Address::
A. P. Number:
Legal Description:
City,. ST, Zip: �
Contractor:
Telephone:
Address:
balu
Project Description: L
City, ST, Zip:
Telephone:.
State Lic. # :
3.
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
`
Telephone:
State Lic. #:
Name of Contact Person:
l �:
Constitictton Type:. Occupancy:
P c3':
Project type. (circle oneNew Add'n Alter Repair Demo.
Sq';Ft:
#Stories:
#Units: .
Telephone # of Contact Person:
�
Estimated Value -of Project: m( 9 .
APPLICANT:,DO.NOT WRITE BELOW THIS LINE.
q
Submittal
-Req'd
Recd
TRACMG ,
PERMIT PEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs
Reviewed, ready -for correctionsPlan
Check Deposit
Truss Cults.
Called ContactTerson
Plan Cheek Balance"
Energy Ca les..
Pians.picked,up
Constriction
Flood plain plan.
Plans resubmitted_'
Mechaaicah
Grading. plan
2'"Review, ready for correctionsft°sue
Electrical
Subcontactor List
Called Contaet Person
Plumbing
Grant Deed.
Plans picked up
S:M.I
II.O.A. Approval
Plans resubmitted
Grading .
IN HOUSE:-
'' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P:P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�� , -
CITY - -`� ��` ' .
PERMITJOB ADDRESS NUMBER OWNtR.�BUILDER
This form sh6ll be posted on.the job with the* Building Inspection Card at all times Only a appearing on this. list or their employees are authorized to work.n6e�toth�'xotro`/`b�aodrbva ' ` he Bui[di�oIliviaion ' or to^oo� °�.c�nnentmfvvork. ai|v[etonorn . vviUr��ubinaatn/p�g�ofvvorkand/or the voidance .
of building permit. For e6chapplicable teadej all information requested below must be completed
by applicant. "On'File"
is not an acceptable.response-.
Company Name
Classification
Exp.,
Carrier Name
Policy Number'
Exp. Date
License Number
Exp. Pate
xx)
(xx/kx/xx)
(Format Varies)
H. WORKTox
-7131
4.