RPL (07-2549)78060 Lost Elk Tr
07-2549
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00002549
Property Address: 78060 LOST ELK TR
APN: 658-140-999-48 -29436 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 30000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty 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.
Licen Cl ssQ: C8 C27 C29 License No.: 656128
ontractor.
NER-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).:
(_) 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.).
1 _ 1 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
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.I.
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/18/07
Owner:
NASSIR
78060 LOST ELK TRAIL
LA QUINTA, CA 92253/'
Contractor:
P.O.TES
RA
BOX rQ
ry
P. BOX 1280
COACHELLA, CA 9 236
(760) 398-9222 pQrrA
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 BB1070510
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manners s t ecome subject to the workers' compensation laws of California,
and agree that, if I sho d be me subject to the workers' compensation provisions of Section
3700 of the Labor o , I sh II forthwith comply with those provisions.
ate: pplicant:
WARNING: FAILURE TO SECURE W SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER -TO CRIMIN PENALTIES AN -CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION 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 above info ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building constru tion, and hereby authorize representatives
of thisA (oto ter upon th above-mentioned property r in ect n purposes.
ate: / / ature (Applicant or Agent):
M
LQPERMiT
Application Number . . . . . 07-00002549
Permit - . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
284.50 Plan Check Fee
184.93
Issue Date . . . .
Valuation
29892
Expiration Date . .
3/16/08
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
3/16/08
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
3/16/08
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
3/16/08
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
Permit . . . . . . WALL/FENCE PERMIT
Application Number . . . . . 03-00002549
Permit . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 15.00 Plan Check Fee .00
Issue Date . . . . Valuation . . 108
Expiration Date 3/16/08
Qty Unit Charge Per Extension
BASE FEE. 15.00
--------------------------------- -------------------------------------------
Special Notes 'and Comments
POOL/SPA, 5 L.F. 5' EQUIPMENT WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION.
Fee summary Charged Paid Credited Due
----------------- ------ - --- ---------- ---------- ----------
Permit Fee Total 403.50 .00 .00 403.50
Plan Check Total 210.93 .00 .00 210.93
Grand Total . 614.43 .00 .00 614.43
LQPERMIT
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. ... .: .. .. , . • •. .. .. .. OWNER TD: ' 1 N
. _ . .. ....•.. ... ... .. .• LIVING
.: .. , _ , . ,.••. ,. O DETERMINE THE APPROXIMATE ELEVATION OF POOL OR SPA AT LAYOUT ON 0 V 0
.. ,. ,.. ..,,.. , .•. . .. .. •, L . ., •.... . 1 .: AY OF EXCA ATI N r.
• . t,... •. ta. .. .,T ,• ,;•. , I III`
' 2 TAKE NOTICE THAT POOL AND EQUIPMENT LOCATIONS ARE SUBJECT.
. .'. ..,. --I I I:... ...;•,.; , .• .: •R• M. ,... .. • =• . O TO AccEPrnrlcE OF s:
LOCAL BUILDING DEPARTMENT
I •: , . , . , I , , , T TIME OF ISSUANCE OF PERMIT.
Lt ,..
• ' ' ' ' ' •' ,. •'. ! ! '•1 : 3 WET GOWN CONCRETE SHELL LEAST TWICE DAILY FOR SEVEN
•.; : •., :.:. • •.. q ., • ' I -_-.A , . •. .::...... .:. DAYS AFTER SHELL IS INSTALLED
L . ,
I I ; .. :., . l: :'': :,., :.. :.''•'i .°. 4 AGREE x
1 :., I , , . :: • .. .• O THAT 1ESERRA IS NOT RESPONSIBLE FOR UNDERGROUND CONDITIONS OR OBJECTS,
k AND ANY DAMAGE TO RB
SIDEWALKS. DR
IVEWA LA
S, LAWNS, OR OTHER S N SS
... YS, ITEM I THE ACCESS AREA
SEE THAT
ALL FENCIN GATE AND GARAGE RAGE 00
C DOORS ME
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S, ALC FOR P00 ENCLOSURE
A L ENCL S RE
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.'PRIOR TO PREPLASTER'INSPEC ON
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. .' : '•'.:. J (6) FILL POOL IMMEDIATELY AFTER PLASTER. FOLLOW INSTRUCTIONS -- DO
'-A Y ( NOT USE RUBBER HOSE)
. - - - 1 : .:. :'•..;• •.. ••.,• .. :• . •. : • I ' 7 TAKE NOTICE THAT THIS DRAW GIS THE SO
, . I . r ,.. .. .;. ... ... .. :. ... : . • ' •• ' : ': ' ' I ' tl .T. ,f ) LE PROPERTY OF TESERRA AND THAT ANY
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, . , .. ... :. .. :,. .. ., . • i .. ... OWNER APPROVES PLAN POO AND EQUIPMENT OCA710NS N +;
. . , . •., - .. :,. [..•• -_ F , . .. ,•. ,.. ... ..•. .. ... .. :: I L, AND HAS READ THE RESPONSIBILITIES AND NOTICES ABOVE
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Bin #
City of LaQ Uinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, cA 92253 - (760) 777-7012
..Building Permit Application and Tracking Sheet
Permit.# GG
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Project Address:' 0(psfl
•
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Owner's Name: SSlfZ...
A. P. Number.
Address:
Legal.Description:
City, ST, Zip:
Contractor:
Address: .o m.
s
Telephone:
Project Description:
City, ST, Zip
Cid-.
'itZ3
POOL a- S
Telephone:.
City Lic. #:
State Lip. # i0i
•
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type:. Occupancy:
P ey:
State Lic. #: Project type (circle on NewAdd'n Alter Repair Demo .
Name of Contact Person: Ft.:#Stories: #Units: .
Telephone # of Contact Person: - 'a-75_0Z_q Estimated Value offroject ,30 O )
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Reed TRACE3NG . PERMrr FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Structural CAlcs
Reviewed, ready -for corrections
Plan Cheek Deposit
Truss Cafes.
Called Contact'Person
Plan Check Balance'
Energy Cales..
Pians 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 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
,30000
l O Fr