PLBG (07-2820)51461 Marbella Ct
07-2820
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002820
Property Address: 51461 MARBELLA CT
APN: 772-250-998-60 -31349 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
c&ty/ aF 4 4"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner: '.
DUNCAN RES.
51-461 MARBELLA CT.
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
LICENSED ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am li -n-2 under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prhfessionais Code, and my License is in full force and effect.
License Cl ss: C8 C27 C29 License No.: 656128
Dater G✓ (ontractor: -
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury t at 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.).
(_) 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
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/24/07
OCT 2 5 2007
CITY OF LA QUINTA
FINANCE DEPT.
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 o the work for which this permit is issued, I shall not employ any
person in any manner so as to come subject to the workers' compensation laws of California,
and agree that; if I should beco a subject to the workers' compensation provisions of Section
3 00 of the Labor C e, shall forthwith comply with those provisions.
Date) pplicanti
WARNING: FAILURE TO SECURE OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 statethat the abo information is correct. I agree to comply with all
city and county, ordinances and state laws relating to building onstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned pro ty for 'nspection purposes.
Dat%/ 0 Signature (Applicant or Agent/'
Bin #
-
Gty ®f La Quinta
Building 8z Safety Division
Permit #
P.O. Box 1504, 78.495 Calle Tampico
- a2 i2-D
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sleet
Project Address: S (
-
L- Ll- Owner's Name;
A. P. Number;
'
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone: °' OEM-,
Address:
_—Lai 6 Project Description:
City, ST, Zip: 111 d
CA_ TZ-3 to C4, AkS L1'1 ) r
Telephone:
"-AL/( p
State Lic, # : Qs Z,
City Lic, #: 1
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
P
State Lic, #:
4
_
Project type (circle one): ew Add'n AlterRepair Demo
Name of Contact Person:
2- Sq. Ft,; #Stories:
Telephone # of Contact Person:
nit
#Us:
Estimated Value of Project: 57I?)
APPLICANT: DO NOT WRITE BELOW THIS LINE
✓f Submittal Rcq'd
Rec'd TRACKING
Plan Sets
PERNUT FEES
Plan Check submitted
o rl/ Item
Structural Calcs,
Amount
Reviewed,
Truss Cafes.
Plan Check Deposit
Called Contact Person
Energy Calcs.
Plan Check Balance
Plans ticked up
Flood plain plan
Construction
Plans resubmitted
Grading plan
Mechanical
2nd Review,
ready for corrections ssue Electrical
Subcontactor Fist
Called Contact Person - — ---------------
Grant Deed
Plumbing _ Jr et`
Plans picked up
H.O.A. Approval
s.M.I.
Plans resub '
IN HOUSE;-
ing.
,rd
Review, ad r o re s/is PktD v toper Impact Fee
Planning Approval
Called Con ct Person t
Pub. Wks. Appr
l A.I, ,P,
Date of per it issue
O CONSTRU 'TION
School Fees
Total Permit Fees
Application Number .
. . . . 07-00002820
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
18.00
Plan
Check Fee
4.50
Issue Date . . . .
Valuation
. . .
.
0
Expiration Date
4/21./08
Qty Unit Charge
Per
Extension
•
BASE
FEE
15.00
1.00. 3.0000
EA PLB GAS PIPE 1-4
OUTLETS
3.00
Fee summary Charged
---------- --------
Paid
----------
Credited
Due
-----------------
Permit Fee Total
18.00
7-
00
----------
.00
18.00•
Plan Check Total
4.50
00
.00
4.50
Grand Total
22.50
.00
.00
22.50
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