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RPL (07-1856)- 12 P.O. BOX 1504;• VOICE (760) 777-7O 78-495 CALLETAMPICO' FAX (760) 777-7011 LA QUINTA, C-A[IkORNIA-192253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING.PERMIT Date: 6/26/07 Application'Number: X07-00001856 ! Owner: Property Address: '58505 MIJAS— :� CORAL OPTION I `APN: 764-200-999-49 -316812- 79295 RANCHO LA QUINTA DR _ Application description: POOL - RESIDENTIAL LA QUINTA, CA 922 4 Property Zoning: LOW DENSITY RESIDENTIAL Q "� Application valuation: 20000. D LPT- .(760).398-9222 Contractor: JUNApplicant: Architect or Engineer: TESERRA P.O. BOx 1280 CITY OF LA QCOACHELLA, CA 9223 FINANCE D Lic. No.: 656128 ------------------------------------------------------------------------------------------------- r LICENSED,CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION, ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and krofessionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided License Class: C8 C27 C29 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ' Date_ z ontractor; - _ ,I have and will maintain workers' compensationinsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation NER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier SEABRIGHT Policy Number BB1070510 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair ani-structure, prior to its issuance, also requires the applicant for the person in any manner so as to b ome subject to the workers' compensation laws of California, permit to file a signed statement that he or shEris.licensed pursuant to the provisions of the Contractor's State . - and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor Cod I shall for hwith comply with those provisions. 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 huhdred dollars IS5001.: i Date: �J ,�Applicant . (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and - S+ the structure is not intended-or offered for sale (Sec. 7044, Business arid Professions Code: The WARNING: FAILURE TO SECURE W K PENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND _ and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). - APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of, conditions and restrictions set forth on this application. - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed -1 . Each person upon whose behalf this application is.made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I _ 1 I am exempt under Sec. B.&P.C. for this reason 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. ' Date: • Owner: 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. CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to buildin construction, and hereby authorize representatives of this county to enter upon the above-mentioned p erty f r inspection purposes. Lender's Name: - 'r ..� I Date: 61Z'n-ature ( (Applicant or Age Lender's Address: , LQPER1NIIT Application Number . . . . . .07-00001856 Permit . ... BLDG POOL PERMIT Additional desc . Permit Fee' -207.00 Plan Check Fee 134.55 Issue Date Valuation . . . . .20000 Expiration Date 12/23/07 Qty Unit Charge Per Extension . BASE FEE 45.00 18.00 9.0000 THOU BLDG 2,001-25,000. 162.00 Permit . . . MECH POOL Additional desc . Permit Fee 26.00 Plan 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 11.00 Permit . ... 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 33.00 Plan Check Fee 8.25 Issue. Date . . . . Valuation 0 Expiration Date 12/23/07 . 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 ONLY. PERMIT DOES NOT'INCLUDE LQPERMIT LQPERAIIT Application Number . . . . . 07-00001856 ----------------------------------------------------------------------------- Special Notes and Comments EQUIP WALLS Fee summary- Charged Paid Credited Due Permit Fee Total 311.00 .00 .00 311.00 Plan Check Total 1.60.55 .00 .00 160.55 Grand Total 4.71.55 00 ..00 471.55 LQPERAIIT 'r Bin # City of. La Quinta Building u Safety Division Permit #P.O. Box 1504, 78-495 Calle Tampico Q y6 La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and TrackingSheet Project Address:rJ�� o r ' S � Owner's Name: _ A. P. Number: Address: Legal D'scription: City, ST, Zip: Contractor: Telephone: .... Address: -------- L Project Project Description: City, ST, 2�ip:Col�C Telephone: ZZ 2— State State Lic. # : 6.5 6, Z City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:�� Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: � S _ Z Estimated Value of Project: O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKWG PERMIT FEES Plan Sets Plan �Checksu�bmi((ed�� 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 2nd Review, ready for correctionsfiissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.T. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. \Vks. Appr Date of permit issue School Fees Total Permit Fees