RPL (12-0922)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 .
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:. C12-00000922' •-
Property Address: 58465 MIJAS
APN: 764-200-999-5.1 -316812=
Application description: POOL - RESIDENTIAL
Property Zoning: . . LOW DENSITY RESIDENTIAL
Application valuation: 25000
Applicant: -Architect or Engineer:
� bA
U SED CONTRACTOR'S DECLARATION
I hereby affirm under rally of perjury thatlim licensed under provisions of Chapter 9 (commencing with
Section 7000 f Div'6rion 3 of the Business d Professionals Code, and my License is in full force and effect.
Lic se Clas . C , 10;27,2 If License No.: 656128
Date: ontractor.
OWNER -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 _) 1, 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.).
(_ I 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.)•
Lender's Name: -
Lender's Address: `
LQPERMIT
Owner:
CORAL OPTION 1 '
81570 CARBONERAS
LA QUINTA, CA 92253
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic: No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: • 8/15/12
------------------
WORKER'S COMPENSATION DECLARATION
1 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 EVEREST NATL IN Policy Number' 7600006481121
I certify that, in the performance of he work for which this permit is issued, I shall not employ any,
person in any manner so as to ome subject to the workers' compensation laws of California, .
d agr that, if I should beco a ject to the workers' compensation provisions of Section
700 the Labor Code, I shat f ith comply with those provisions.
ate: pplicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 per it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov information is correct. I agree to comply with all
city and county divan es and state laws relating to building n ction, and hereby authorize representatives
offtthis county enter pon the above-mentioned property for p ion urposes.
Oate:ture (Applicant or Agent):
Application Number
. . . 12-00000922
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
252.00 Plan Check Fee
163.80
Issue Date
Valuation
25000
Expiration•Date
2/11/13
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
2/11/13
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
2/11/13
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 .
2/11/13
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
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 2 FIRE BOWLS,FIREPIT &BBQ. GAS
LQPERMIT
Application Number . . . . .
12-00000922
--------------------------------------
Special Notes and Comments,
--------------------------------------
LINES TO SERVE APPLIANCES.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED. 2010
CODES.
---------------------------------------------------
Other Fees . . . . . .. .
--------------
BLDG STDS ADMIN (SB1473)
----
1.00
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 356.00
.00
.00
356.00
Plan Check Total 189.80
.00
.00
189.80
Other Fee Total 1.00
.00
.00
1.00'
Grand Total 546.80
.00
.00
546.80"
LQPERMIT
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SECTION 114 - MANDATORY REQUIREMENTS
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EXIT ALARMS TO BE INSTAL LED ON ALL DOORS WITH DIRECT
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RECOMMENDATIONS AND
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Bin #
...---
Cityof. La . Quinta
Building u Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
Project Address: �` O yb S t
A. P. Number:
Owner's Name:
Address: �° s
Legal Descrip�tion:—
City, ST, Zip:
Contract6r:
Telephone:t•
�. M 011.
Address:
/00 AVProject
City, ST, Zip: 2
Telephone: b b Ill ?V 92 2'Z
State Lic_ # : City Lic. #:
Description:
0 L d I.
V�D O
E t r I
Arch., Engr., Designer:
Address:
City, ST, Zip:
iT -;??1? 6,-F aWLL
t (.4 C r✓� Z S � L� ✓L cL h`�Prr
Telephone: Construction Type: Occupancy:
_ P Y:
State Lic. #: Project type (circle one New Add'n' Alter Repair Demo
Name of Contact Person: °
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: 26 ® 2 -So 2--3,1 Estimated Value of Project: 2
00 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Rec'd
TRACEING Q
Plan Check submitted v
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Truss Cales.
Called Contact Person
Energy Cales.
Plans 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. ApprovaC
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