RPL (14-0025)54435 Avenida Madero
14-0025
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
14-00000025
54435 AVENIDA MADERO
774-231-008-8 -000000-
POOL - RESIDENTIAL
COVE RESIDENTIAL
32100
• W
VOICE(760)777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/10/14
Owner:
BIGGERSTAFF, DEBRA
3829 N WESTON PL
LONG BEACH, CA 90807
f
Architect or Engineer: IU I AN to 2014
0 0, WA ecA J /
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th a I e under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines nd s ionals Code, and my License is in full force and effect.
License Class: C27-053 License No.: 964474
Date:' ' I Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of p rjury th t I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Bu 'ness nd Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, o 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 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 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 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:
I.QPERMIT
SERT OUTDOORS INC
7 065 MAIN ST STE #205
QUINTA, CA 92253
( 60)399-9600
,iC. No.: 964474
----------------7------------------------------
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 carrierand policy number are:
Carrier AMTRUST INS CO Policy Number WWC3072369
I certify that, in the performanc the work for which this permit is issued, I shall not employ any
person in any manner so as o b ft
subject to the workers' compensation laws of California,
and agree that if I should b co workers' compensation provisions of Section
3700 of th abor Code, I s a fy with those provisions.
Date:J Iu :1 Applicant:
WARNING: FAILURE TO SECURE ORKE COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI INAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITI N T HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO , 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 beco ull an id if work is not commenced
within 180 days from date of issuance of such per it, or es do of work for 180 days will subject
-permit to cancellation.
I certify that I have read this application and state that the abo infor ion ' correct. I agree to comply with all
city and county ordinances and state laws relating to building nstru on, nd hereby authorize representatives
of thipe6ounty to /enter u71he above-mentioned property for ns p t' urposes.
Date: I ' l ' —1 Signature (Applicant or Agen
Application Number . . . . . 14-00000025
Permit ELECTRICAL 2013
Additional desc BBQ ONLY
Permit Fee . . . . 23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date.. . 7/09/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
----------------------------------------------------------------------------
23.83
Permit POOL 2013
Additional desc .
Permit Fee . . . . 178.75
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 7/09/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . PLUMBING 2013
Additional desc . . BBQ AND FIRE PIT
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date . . 7/09/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
----------------------------------------------------------------------------
11.92
Permit . . . WALL/FENCE PERMIT
2013
Additional desc . .
Permit Fee . . . . 47.19
Plan Check Fee
00
Issue Date . . . .
Valuation . . . .
32100
Expiration Date . . 7/09/14
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC WALL,
FIRST 100 LF
47.19
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA, FIRE PIT, BBQ AND TWO (2) 52
INCH HIGH SCREEN BLOCK WALLS AT REAR
YARD [DENISE POELTLER ENGINEERING AND
ORCO SPEC WALLS] THIS PERMIT DOES NOT
INCLUDE RELOCATION OF HVAC UNIT, METAL
FENCING OR YARD LIGHTING. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
LQPERMIT
Application Number . . . . . 14-00000025
----------------------------------------------------------------------------
Special Notes and
Comments
PRE -PLASTER INSPECTION. 2013
CALIFORNIA
BUILDING CODE.
January 9, 2014 9:29:34 AM AORTEGA
-------
------
-------
---------------
--------------
-----------------------
Other Fees . . .
----
. . . . . .
BLDG
STDS ADMIN (SB1473)
2.00
PLAN
CHECK,
ELECTRICAL
23.83
PLAN
CHECK,
POOL
97.24
PLAN
CHECK,
PLUMBING
.23.83
PLAN
CHECK,
WALLS
60.06
Fee summary
-----------------
Charged
----------
Paid
----------
Credited
---------- ----------
Due
r Permit Fee Total
261.69
.00
.00
261.69
Plan Check Total
.00
.00
.00
.00
Other Fee Total
206.96
.00
.00
206.96
Grand Total
468.65
.00
.00
468.65
LQPERMIT
Bin. #
City. of- La Quihta
Buik ft- a Safety Division JAN
"
P.O. Box 1504,79-495 Calle Tampfco 072014
La.Quinta, CA 92253 -:(760) 777-70 2 CI7j pF
Building Permit •Application and Tra LA- 4uIN_rA
Permit #
l • 0025
Project Address: q y 5 A~ O
Owner's Name:. ) EN
A. P. Number:
Address:
Legal Description:
Contactor: C)UrrD
City, ST, Zip:
Telephone: • Zj '2&CXD1`
ect Description:
Address: •7SO S • A
City, ST, Zip: L Pt U CA
cog,/
Telephone: .' Lz
{
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t
u'C
1 i
State Lic. # : City Lie.. #;
Arch., Engr., Designer
Address:1
i A '
City., ST, Zip:
Telephone:
Construction Type:. Occupancy:
State Lie. #: 33 tt LD";
Name of Contact Person:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: #Units:
Telephone # of Contact Person: -7 ?6
Estimated Value of Project: I
APPLICANT: DO NOT WRITE BELOW THIS UNE
0
Submittal
Req'd
Recd
TRACMG
PERMTT FEES -
Plan Sets
Plan geek submitted -Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person JPlan
Check Balance
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Pians resubmitted.' •
Mechanical
Giadiog plan
2'! Revlcw, ready for correctionsrmte
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
ML
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:-
''d Review; ready for correeti e I
Developer Impact Fee
Planning Approval •
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees "
Total Permit Fees
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