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08-0169 (RPL)IE P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 40 T4ht Qum& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1/23/08 Application Number: 08-00000169 Owner: D Property Address: 81703 ANDALUSIA FREI RERSIDENCE Q APN: 764-200-999-64 -316813- 81-703 ANDALUSIA Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL JA Application valuation: 30000 ^I Contractor: Applicant: Architect or Engineer: TESERRA gNCE O�p�' P.O.-BOX 1280 COACHELLA, CA 92236 l�(760)398-9222 !�T Lic. No.: 656128 - --------------------------------------------------------------------- --------------------------— LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I 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 Pr essianals 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: CS C27 C29 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date:` Z tractor: 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 workerscompensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier SEA13RIGHT Policy Number BB1080510 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 be me 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 ubject 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 La r Code hall fo with comply with those provisions. 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).: at `d licant: (_) 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: FAIL RE TO SECURE WRKE PENSATION COVERAGE IS 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 ($100,000). 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.). (_ 1 I, asownerof 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 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 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 t 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 1 have read this application and state that the above info mation is correct. I agree to comply with all city and county ordinances and state laws relating to building constr tion, and hereby authorize representatives ofy+ts cou ty to//`enter upon the above-mentioned propert o in ec ion purposes. Date: � (" Si ature (Applicant or Agent): Application Number . . . . 08-00000169 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date Valuation . 30000 Expiration Date 7/21/08 . . . . { Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 ------------------------------------------------------------------ THOU BLDG 25,001-50,000 32.50 Permit . . MECH POOL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 7/21/08 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 Expiration Date 7/21/08 .0 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 7/21/08 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0.000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1'.00 3.000.0 ----------------------------------------------------------------------- EA PLB GAS PIPE 1-4 OUTLETS 3.00 Special Notes and Comments POOL / SPA ALARMS/BARRIERS SHALL BE IN LQPERMIT .Application Number . . . 08-00000169 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 284.5.0 Plan Check Fee 184.93 Issue Date Valuation . . . . 30000 Expiration Date 7/21/08 . Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 ----------------------------------------------------------- Permit . . MECH POOL Additional desc . .Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 7/21/08 .Qty. Unit Charge Per Extension BASE FEE 1.5.00' 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 Date1. Valuation .0 Expiration Date 7/21/08 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 esc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 7/21/08 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0.000 EA PLB FIXTURE 12.00 1.00 .3.0000 EA PLB WATER INST/ALT/REP 3.00 1'.00 3.000.0 EA PLB GAS PIPE 1-4 OUTLETS 3.00 --------------------- ------------------------------ --------------------------- Special Notes and Comments POOL / SPA ALARMS/BARRIERS SHALL BE IN LQPERMIT s Application Number 08-00000169 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED (NO WALLS) Fee summary Charged Paid Credited. Due ----------------------------------- Permit'Fee Total 388.50• OQ .00 388.50 Plan Check Total 210.93 .00 .00 210.93 Grand Total 599.43 .00 .00 599.43 LQPERMIT +' 1111111111111 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 42 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08-00000169 Property Address: 81703 ANDALUSIA APN: 764-200-999-64 -316813- Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 30000 Owner: FREI RERSIDENCE 81-703 ANDALUSIA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/23/08 Contractor: Applicant: Architect or Engineer: TESERRA y x P.O.-BOX 1280 COACHELLA, CA 92236 (760) 398-9222 LiC. No.: 656128 9 - ------------------------------------------------------------------------------------------ - - - - - — LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an Professionals Code, and my License is in full force and effect. License Cl s: C8 C27 C29 LicenseNo.: 656128 Date: tractor: WNER-BUILDER 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).: (_ 1 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.). 1 _ 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 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—) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: Pk Lender's Address: LQPER111IT 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 SEABRIGHT Policy Number BB1080510 I certify that, in the performance o the work for which this permit is issued, I shall not employ any 4m' n any manners s to b come subject to the workers' compensation laws of California, e that, if I s uld ecom subject to the workers' compensation provisions of Section the La r od � h comply with those Provisions. ate:licant:WARO SECURE W 'COMP SATION COVERAGE IS UNLAWFUL, AND SHALL SUBJR TO CRIMINA PENAL ND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). 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 abo information is correct. I agree to comply with all city and county ordinances and state laws relating to building con uc . , and hereby authorize representatives of y�As co my to enter upon the above-mentioned pro y r ins a on purposes. DDate:� ature (Applicant or Agen . Application Number . . . . 08-00000169 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date Valuation . . . . 30000 Expiration Date 7/21/08 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 32.50 Permit . . MECH POOL Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/21/08 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 7/21/08 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 . . 7/21/08 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 . . . . . 08-00000169 ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED (NO WALLS) Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 388.50 .00 .00 388.50 Plan Check Total 210.93 .00 .00 210.93 Grand Total 599.43 .00 .00 599.43 LQPER 11T Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I V Project Address: Ig— 3 Atir94GcTl Owner's Name: �� T A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: `— Telephone: Address: 0RoxProject Description: City, ST, Zip: 691LOAE LLIV CA, qzZ- fO oCJ OL, Telephone: 3-1, 1. Z, State Lic. # : S City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Name of Contact Person: Project type (circle one):(New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: aT5 --d)J 7 Estimated Value of Project: O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted 110 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees . roo L, l� ITS -JA r� PE,,FL--ff-, LF-Tt-G Pi Ji s�-] AFF P 0 Pr T r7,, UT T 5 rl LJ L;T-1 'F1 L -E V-IATEr-1,i til E 18'�L0t,0 p-Lp Lo�jw-e-TIF- Lo rl►-IU rI �--&rrr ATfi IZ'' W, TSI (-OL,012:-P�p Loi-lUz�fE LAr IZA�-JPIO 'I STo�JE �/�►J��t; JID 'ri4 c,LJ T sto i 1 E s�r�l'P�+JC�I PAbS CITY OF LA CQUINTA BUILDING & SAFv DEPT. D APCp�®UCT.ION: FOR OPS gY DAT S��AT+I�'II��ITi-� LOI,D�-E� Goi-1E L Trl I �K (,LJT ST�.GKF� SToi-lE ri Vtr I• � � �,,('7 �#- � SI -I � o�J�TF� ►-I'(� �oTi-I E I E AT I rITE I o o ff.;, E:r t5 H LJ LT I P� d f sus Ao .. O .�■ ■■ ■■ 0 ■ ■■■ ■■ ■■-■n ■■ ivim ia iii�ii��. ���w�i��ii�ii��ii ��s�ii;ii;ii�iiiim!i! : ii►. -- /� Gia -(RSL 0 ASA t3 S� Ad A -f A-7 j5N. EZZL e- "Iz . [WE