RPL (09-1236)61290 Living Stone Dr
09-1236
L09-00001236
61290 LIVING STONE DR
764-280-999-196 -300236-
POOL - RESIDENTIAL
MEDIUM HIGH DENSITY RES
25000
Architect or Engineer
-----------------------------------------------------
LICENS ONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I a nsed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a P fessionals Code, and my License is in full force and effect.
License Cess: 10, 27 2 License No.: 656128
/Date:L G _
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury t am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business d 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 isexempt 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 ISec. 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, 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.).
( 6 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
Owner:
SABATINI
61290 LIVING
LA QUINTA, CA
VOICE (760) 777-7012
FAX (760) 777=7011
R—�I�ONS (760) 777-7153
�IYERJ__
�1t Date: 12/03/09
~.;j V ,'.L 2fle..
� � wu
2253
CITY (?F LA
Contractor:
TESERRA,
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
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 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 bec esu orkers' compensation provisions of Section
of th L,'tbor Code, I sha forthwit m those provisions..
l/LC/ c '19
ate: plicant:.
WARNING: FAILURE TO SECURE WORKERS' C S ON C AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTI A CIVIL FINES U .p ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COS 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 p ove information is correct. I agree to comply with all
city and counte
inances nd state laws relating wilding c tr and hereby authorize representatives
of this ty ter he above-mentioned groa 'nature (Applicant or Agent):
Application Number
09-00001236
.Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
252.00 Plan Check
Fee ._
163.80
Issue Date
Valuation
25000•
Expiration Date
6./01/10
Qty Unit Charge.
Per
Extension
BASE FEE
45.00
23.00 9.0000
THOU' BLDG 2,001-25,000
207.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
0
'Expiration Date
6/01/10 '
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
6/01/10
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
6/01%10
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
Permit . . . . . ..
WALL/FENCE PERMIT
. - . LQPERMIT .. ..
...
Application Number . . . . . 09-00001236
Permit . . WALL/FENCE PERMIT i
Additional desc .
Permit Fee . . . 15.00 Plan Check Fee
.00
Issue Date Valuation
325
Expiration Date 6/01/10 "
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
-
POOL/SPA,WATERFALL & 15 L.F. 416"
EQUIPMENT ENCLOSURE,CITY STANDARD..
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. 2007 CODES.
------------------------------_--------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
------
Due
----------------- ----------
Permit Fee Total 371.00 .00" .00
371.00
Plan Check Total 189.80 .00 .00
189.80
Other.Fee Total 1.00 .00 00
.1.00
Grand Total 561.80 .00 .00
561.80
Bin #
City of La- Qui nta
Building a Safety Division
Box 1504, 78-.495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012 '
Building Permit Application and Tracking Sheet
Permit #P.O.
I A�b
pq
Project Address: 1�Zq0Gia �w
Owner's Name:
A. P. Number: 419
Address:/ Z qU G/��//� S e " �/Z
Legal Description:
City, ST, Zip -Ll
447 01
Contractor: ~ 2-_-i!F a4
Telephone:
Address: g(�— j CO A VE
Project Description: S"
City, ST, Zip: eqtw t4cLc C14 , ZZ3 (,::,a,
Telephone:
�J T
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one):New Add'n Alter Repair • Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:.
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIONG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .
Mechanical
Grading plan
21 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 ROUSE:-
Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
2 AT 412• Nrl�A avjm-U
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'ALL DECKING EXPANSION JOINTS FOR
REPRESENTATION ONLY, FIELD LAYOUT
WILL VARY.
SPECIFICATIONS
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