RPL (08-1626)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property'Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
U,,-tftaO'
08-00001626
79075 MISSION DR W
646-330-065-5 —30185
POOL — RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
Tit!t 4 4 Qum&
Architect or Engineer:
�/�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------------------- —-------------
NSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty perjury that I a lic sed r provisions of Chapter 9 (commencing with
Section 7000) of Division 3 o e Business and ss' e, and my License is in full force and effect.
License Class: C8 C27 C29 ce a No.: 656128
% Date: /1 Contractor:
l�__ WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business d Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or r air any structure, prior to its issuance, also requires the for
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 ($5001.:
(_ 1 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 ISec. 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 1 1 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
Owner:
TD DESERT DEV
C/O TOM CALLINAN
79285 RANCHO LA QUINTA
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: 9/25/08
01200
a
C– OCTIVANCP — rA I
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.
_ 1 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 BB1080510
_ I certify that, in the p ormance of work for which this permit is issued, I shall not employ any
person in any man r so as to becom act to the workers' compensation laws of California,
and agree that, if I a qtld become ct a workers' compensation provisions of Section
3700 of the labor Codea w' co ith those provisions.
Date: Applicant;
WARNING: FAILURE TO SECURE WO KER ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL TIE! AND CIVIL FI 0 ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITIOIJ T 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 th'
2. Any permit issued as a result of this applica ion becom null and void if work is not commenced
within 180 days from date of issuance of s ch permit, . r cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab a infor . is correct. I agree to comply with all
city and county ordinances and state laws relating to building co on, ereby authorize representatives
of this c y t enter upon the above-mentioned property f e poses
Date Signature (Applicant or Agent):
Application Number . . . . . 08-00001626
Permit
. . . BLDG POOL PERMIT
Additional
desc . .
Permit Fee
. . . . 252.00.
Plan Check Fee
163.80
Issue Date
. . .
Valuation . . . .
25000
Expiration
Date . . 3/24/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
23.00
--------------7-------------------------------------------------------------
9.0000 THOU BLDG
2,001-25,000
207.00
Permit
. . . MECH POOL
Additional
desc . .
Permit Fee
26.00
Plan Check Fee
6.50
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date . . 3/24/09
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 . . 3/24/09
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 . . 3/24/09
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,
ALARMS/BARRIERS SHALL
BE IN
LQPERMIT
Application Number . . . . . 08-00001626
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED. BBQ
PER APPROVED PLAN.
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Grand Total
LQPERMIT
Charged Paid
---------- ----------
356.00 .00
189.80 .00
545.80 .00
Credited Due
---------- ----------
00 356.00
00 189.80
00 545.80
VE
G Fi PER CEC 6,qn 22 zlKite T GRILL LIGHT
4, 680. 22, u 0 r_ PROVIDE VENT, WASTE, AND
UCI BONDED TO POOL STEEL IF PLU B
LL S
PLUMBING FOR SINK ON SEPARATE
WITHIN 5 Co T UC
WITHIN 5 FT. OF POOL WALL T
CONSTRUCTION DOCUMENT.
S NLESS WATERTICWT CEC 680.6 8, 680.22(2)
ELEC
c,,j STE
-RECEPCLE-
SINSHALL NOT BE LESS TTAHA_�
GRILL N
br)_
10 FT., FROM POOL WALL
f; .w 00 OO
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<
PRE -HUNG 00
S.S. DOORS
EEO -
LENGTH VARIES
LENGTH F GAS PIPE
L P1
S pi
;[D A OF PE
—2) OUTDOOR KITCHEN NEAR POOL
U2 FRONT ELEVATION
ya
1/2"=1'-0"
-LIGHT SWITCH
GFI DUPLEX
OUTLET, —
6X8XI6 CMU AT
FRONT AND SIDE WALLS
SOLID GROUT
BBQ: y`IC foo
I.C.B.O. #
ANSI# 7Z2-2 3,
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U.L. APPROV-05.7--5
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mm
�m
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VE
G Fi PER CEC 6,qn 22 zlKite T GRILL LIGHT
4, 680. 22, u 0 r_ PROVIDE VENT, WASTE, AND
UCI BONDED TO POOL STEEL IF PLU B
LL S
PLUMBING FOR SINK ON SEPARATE
WITHIN 5 Co T UC
WITHIN 5 FT. OF POOL WALL T
CONSTRUCTION DOCUMENT.
S NLESS WATERTICWT CEC 680.6 8, 680.22(2)
ELEC
c,,j STE
-RECEPCLE-
SINSHALL NOT BE LESS TTAHA_�
GRILL N
br)_
10 FT., FROM POOL WALL
f; .w 00 OO
1 V2"
<
PRE -HUNG 00
S.S. DOORS
EEO -
LENGTH VARIES
LENGTH F GAS PIPE
L P1
S pi
;[D A OF PE
—2) OUTDOOR KITCHEN NEAR POOL
U2 FRONT ELEVATION
ya
1/2"=1'-0"
-LIGHT SWITCH
GFI DUPLEX
OUTLET, —
6X8XI6 CMU AT
FRONT AND SIDE WALLS
SOLID GROUT
BBQ: y`IC foo
I.C.B.O. #
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RLQ LOT
554
r
COACHELLA CA 92236
t B-9222
NOX 6176028398-9255
S ERI-A,,-
Builders o/Exceptional Outdoor:u. .ng .
•� 1
Bin #
City of. La Quinta
Building & Safety Division .
Perm! #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: .-6"7s'
Owner's Name: k4.-62 6C7/ S-
Address: . W.— OTS- 111;-is-/�lv , AI
City, ST, Zip: / j
A. P. Number: L
60(� —
Legal Description: UC
.S O2V.
Contractor: e r
Telephone:
Address:b--
igu.
Project Description: - S 12e
((
City, ST, Zip: C,1 eyq ' l LZ
Telephone:
-7
State Lic. # : 2
City Lic. #:le
AVA �d r /L
Arch., Engr., Designer:
Address:
City, ST, Zip:
-2
Telephone:
Construction Type: Occupancy:
P cY:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: (Avo
2 Go— az s I Estimated Value of Project: 2 5 K
APPLICANT: DO NOT WRITE BELOW THIS LIN001,
'®� 5
N Submittal Req'd
Rec'd 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
tie Review, ready for correctionsfissue Electrical
Subcontac tor List
Called Contact Person Plumbing
- - - - -.- -
__:_.,::_-.-__._...___._max...._._,._...-------
'-
�Plans resu m _..._ . .
Grading
_ --- —
aannmg=ApPFova't=--�-..�__�
�___ .
-a e ° o ems-= _ .. _� ..-,--.-- ...
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees