RPL (07-2323)78165 Masters Cir
07-2323
P.O. BOX 1504,,"
-18-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA .92253
BUILDING & SAFETY DEPARTMENT
C A pp%Z ation
'Numberf07-00002323 I
—
P—roperty AddTe—ss.7-8-176-
STERS CIR
APN:
770-350-010- -
Application description:
POOL - RESIDENTIAL
Property Zoning:
13OW DENSITY RESIDENTIAL
Application valuation:
V_ 30000
Applicant:
Architect or Engineer:
WX -
ILDING PERMIT
Owner:
SCHLEISMAN RESIDENCE
78-16S MASTERS CIR
LA QUINTA, CA 92253
70J/
INV CE. 6 VTA
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I ar4licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of th . e Business and trofessionals Code, and my License is in full force and effect.
Lice
Licensegass: C8 C27 Ut Li nseNo.: 656128
CDate: Contract
& *:=r
_ 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).:
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the st lructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The .
Contractors' State License Law does not apply to an owner 6f 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, 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(sl 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
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:
LQPFRAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/16/07
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following.cleclarations:
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, I shall not employ any
person in any manner so as to b ome subje I to the workers' compensation laws of California,
b c
and agree that, if I should beco a subject to the workers' compensation provisions of Section
37,QO of the Labor.0 I shall orthwith comply with those provisions.
Date, pplicanv
0 Co.,
WARNING: FAILURE TO SECUR14E COMPENSATION 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
wi thin 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 inform.
s correct. I agree to comply with all
city an6 county ordinances and state laws relating to building constructif nd hereby ut horize representatives
,o "a
of this courIlly to egter upon the above-mentioned o s ectio
-pL_pACty foyfr purposes.
LQPFRMIT
Application Number .
. . . . 07-00002323
Permit . . .
•BLDG POOL PERMIT
'. Additional desc .
Permit Fee'.—
284.50 `. Plan Check Fee
184.93
Issue Date
Valuation . . .
. 30000
Expiration Date
2/12/08
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
2/12/08'
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 . .
2/12/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
-------------------------------------------7--------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee
39.00 Plan Check Fee
9.75
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/12/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 6.0000
EA PLB FIXTURE
18.00 .
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
LQPFRMIT
.Application Number . . . . . 07-00002323
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
_ EQUIPMENT ENCLOSURE NOT INCLUDED.
COURTYARD WATERFEATURE PER APPROVED.
PLAN.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 394.50 .00 .00 394.50
Plan Check Total 212.43 .00. .00 212.43
Grand Total 606.93 .00 .00 606.93
J
LQPERA1IT
i
•
I. .
_ _ _ - .
I G I I I I 'i
Bin #
City of La Quinta
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 #
n
Project Address: _!
Owner's Name: 5C L s
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
Telephone:
Address:
MX 12—:5 6
Project Description:
City, ST, Zip: t[ CA„- ZZ 3 6
Telephone: f ?►
State Lic. #: ps 2 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle on N Add'n Alter Repair Demo
Sq. Ft :
# Stories:
1. #Units:
Telephone # of Contact Person: Z s
s
Estimated Value of Project: gat- 000 _
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2' Review, ready for correctionsfissue
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