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RPL (07-0739)P.O. BOX 1504 78-495 CALLE TAMPICO. LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: L APN: Application description: Property Zoning: Application valuation: 07-00000739 81535 MONARCH -CT 764-280-999-4 -300237- POOL - RESIDENTIAL MEDIUM HIGH DENSITY RES 23000 Architect or Engineer: aLpk,_ BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ------------------------------------------------- LICE SED 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 an rofessionals Code, and my License is in full force and effect. License Clas C8 C27 C29 License No.: 656128 at : actor. - -BUILDER DECLARATION I hereby affirm under penalty of perjury thatA�met from the Contractor's State License Law,for the following reason (Sec. 7031.5, Business ans 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).: (_) 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 (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.). f (_ 1 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(s) licensed pursuant to the Contractors' State License Law.). (_ ) 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: LQPERMIT Owner: STEDMAN 81535 MONARCH COURT LA QUINTA, CA 92253 F[io Contractor: TESERRA P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 L Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/12/07 G -�f MAR 13 2001 � I ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 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 ksa icy Number BB1070510 I certify that, in the perforwork for which this permit is issued, I shall not employ any person in any mannerme subject to the workers' compensation laws of California, and agree that, if I sh ubject to the workers' compensation provisions of Section 3700 of the Labor C dhwith comply with those provisions. A ant: WARNING: FAILURE TO SECURE WO SUBJECT AN EMPLOYER TO CRIMIN DOLLARS ($100,000). IN ADDITION I SECTION 3706 OF'THE LABOR CODE, ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN JTEREST, 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 thAs on is correct. I agree to comply with all city and county ordinances and state laws relating to and hereby authorize representatives of this co my t e upon the above-mentioned prurposes. ate: n�re (Applicant or Agent): 1 Application Number . . . . . 07-00000739 Permit . . . BLDG POOL PERMIT Additional desc.. Permit Fee• 234.00 Plan Check Fee 152.10 Issue Date Valuation . . . . 23000 Expiration Date 9/08/07 Qty Unit Charge Per Extension BASE FEE 45.00 21.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 189.00 Permit . . . MECH POOL Additional desc . Permit Fee '. . . . 26.00 Plan.Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 9/08/07 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 9/08/07 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 9/08/07 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, GAS & ELECTRIC STUB FOR LQPERMIT Application Number' 07-00000739 ----------------------------------------------------------------------------. „ Special Notes and Comments FUTURE APPROVED & SEPARATELY PERMITTED APPLIANCES. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. . EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due Permit Fee Total 338.00 00 00 338.00 Plan Check Total 178.10 .00 .00.. 178.10 Grand Total 516.10 .00 .00 516.10' LQPERMIT Drainage a , �1 PRE -PEBBLE'.. DRAINAGE NOTE: 9 and irrigation for planters and pots, by others, unless otherwise noted. r ., .•..,1 y Bin # Permit 1' Project Address: 1.��— A. P. Number: Legal Description: Contractor: 1 5� Add City of. La Quints Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet L t C.7� Owner's Name:'�� Address: City, ST, Zip: `,rte u r•J �� ress. l2 Project Description: 1111% City, ST, Zip:eojo 0�:-C L 1. Vim- G-"-, Telephone: .5.. State Lic. # : t!p S�O ,� 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: 1111 kSq.Ft.: s: #Units: #StorieTelephone # of Contact Person: AA # Submittal Plan Sets Structural Calcs. Truss Calcs, Energy Cates. Flood plain plan Grading, plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fces Total Permit Fees tmated Value of Projectr a APPLICANT: DO NOT WRITE BELOW THIS LINE Req'd Rec'd TRACMG PERMIT FEES Plan.Check submitted 3 Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2nd Review, ready for correctionsrassue Electrical Called Contact Person -----------------------------------Plumbing Plans picked up S.M.I. Plans resubmitted Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees