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RPL (07-1860)( )P.O. BOX 1504 VOICE 760 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA; 'CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/26/07 Application Number: 07-00001860 Owner: Property Address: 58305 MIJAS CORAL OPTION I APN: 764-200-999-59 -316812- 79295 RANCHO LA.QUINTA DR Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 25000 D 2001 I Contractor: Applicant: Architect or Engineer: TESERRA QA P.O. BOX 1280 OF CE DEP COACHELLA, CA 92236 FINAN (760)398-9222 Lic. No.: 656128 ----------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a .. Professionals Code, and my License is in full force and effect. License Class: C8 C27 C29 License No.: 656128 Date Contractor: OWNER -BUIL ER -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 1$5001.: (_ 1 I, asowner 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 contractorlsl*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: LQPERi11IT 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 _ 1 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 ecome subject to the workers' compensation laws of California, and agree that, if I should beco a subject to the workers' compensation provisions of Section 3700 of the Labor C e omply with those provisions. Date: l�pplicant: WARNING: FAILURE TO SECURE WO KERS' 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 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 ' formation is correct. I agree to comply with all city and county ordinances and state laws relating to buil 'ng cc 'ruction, and hereby authorize representatives of this cou ty to a/niter upon the above-mentioned prop ction purposes. Date: Z /ognature (Applicant or Agent)' Application Number . . . 07-00001860 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee 252.00 Plan Check Fee 163.80 Issue Date Valuation . . . . 25000 Expiration Date 12/23/07 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 P1an.Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/23/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ---------------------------------- EA MECH FURNACE >100K w 11.00 ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee.. 11.25 Issue Date Valuation . . . . 0_ Expiration Date.. 12/23/07 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 . . . . 39.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/23/07 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 & WATER FEATURE ONLY. PERMIT LQPERDIIT Application Number 07-00001860 ---------------------------------------------------------------------------- Special Notes and Comments ..DOES NOT INCLUDE EQUIP WALL. Fee summary Charged.. --------------------------- Paid ---------- Credited -----.--------------- Due Permit Fee Total 362.00 .00 .00 362.00 Plan Check Total 191.30 .00 .00 191.30 Grand Total 553.30 .00 .00 553.30 LQPERAIIT T Bin # Total Permit Fees QtY of. La Quina Building 8z Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico Q La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: t Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: �� l��•. Telephone:' ..d. r y Address: i Project Description: City, ST, Zip:�_'Or�C`P Telephone: �� ZZZ "V. a... � State Lic. # 1 2 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: .State Lic. #: Name of Contact Person: Project type (circle ooe): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: SO _ Estimated Value of Project: asQoo APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKWG Plan Sets PERMIT FEES heck submitted Structural Calcs_ 7Reviewed,ready for corrections Item Amount Truss Calcs. Plan Check Deposit Contact Person Energy Calcs. Plan Check Balance Plans picked up Flood plain plan Plans resubmitted Construction Grading plan 2nd Review, Mechanical ready for correctionsfissue Electrical Subcontactor List Called Contact Person Grant Deed Plans picked up Plumbing H.O.A. Approval Plans resubmitted 5.114.f. IN HOUSE:- Grading Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees