07-0695 (RPL)I
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si
P.O. BOX 1504
78-495 CALLE TAMACO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00000695
81689 HIDDEN LINKS DR
767-200-999-31 -312022-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
24000
Architect or Engineer:
N'P-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICE"ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I m lic se oder provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business nd Pro ssiona ode, and my License is in full force and effect.
License Clas C8 C27 C29 Lic se No.: 656128
atq.a_,_26ntractor:
• O NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am xempt from the Contractor's State License Law for the -
following reason (Sec. 7031.5, Business and Prof ssions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any tructure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she i licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Sect' n 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basi 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 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.).
(_) 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 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:
BIXLER
81689 HIDDEN
LA QUINTA, CA
(
LINKS DRIVE
92253
Contractor:
TESERRA
P.O- BOX 1280
COACHELLA, CA 9:
(760)398-9222
Lic. No.: 65612£
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/07/07
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 BB1070510
_ I certify that, in the perform ice of the work for which this permit is issued, I shall not employ any
person in any mann c become subject to the workers' compensation laws of California,
and agree that, if 1 houl eco subject to the workers' compensation provisions of Section
3700 of the Labo Cod I shall fo hwith comply with those provisions.
tle: plicant:
WA: FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION 0 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO , 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 p it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that a ab info tion is correct. I agree to comply with all
city and'county ordinances and state laws relating to struction, nd hereby authorize representatives
;ofthis co my t enter upon the above-mentioned pr a fo tion purp es.
�S�ireApplicant or Agent):
L
LQPERMIT
Application Number . . . . . 07-00000695
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee 243.00. Plan Check Fee 157.95
Issue Date . . . . Valuation 24000
Expiration Date 9/03/07
Qty Unit Charge Per Extension
BASE FEE 45.00
22.00 9.0000 THOU BLDG 2,001-25,000 198.00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . .26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/03/07
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 9/03/07
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 9/03/07
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
----7----------------------------------------------------- --- ----------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
0
LQPERMIT
Application Number . . . . . 07-00000695
---------------------------------------------------------------------
Special Notes and Comments
-------
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
---------- ------
Paid
- ---
Credited
---------- ----------
Due
-----------------
Permit Fee Total 347.00
.00
.00
347.00
Plan Check Total 183.95
.00
.00
183.95
Grand Total 530.95
.00
.00
530.95
Bin #
Permit #
Project Addres
r A. P. Number:
City of. La Quinta
Building 8I Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
%am Owner's Name:
GS Address: `_6) g� ^ _`
City, ST, Zip:
Contractor:
Address: l� I
City, ST, Zip:��G L u. 1� CA.,
Telephone: �Sfl <9-- / ZZ 2 --
State
State Lic. # -Q p City
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Lic. #:
`P
Project Description:
Construction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Nameof Contact Person: C 0 S Ft.:
4 # Stories: # Units:
Telephone # of Contact Person: Est. L'
# 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 Fees
tmated Value of Protect: (t
APPLICANT: DO NOT WRITE BELOW THIS LINE
Req'd
Recd
TRACEING
Plan.Check submitted
Reviewed; ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
2"" Review, ready for correctionsrissue
Called Contact Person
Plans picked up
Plans resubmitted
7re Review, ready for corrections/issue
Called Contact Person
Date of permit issue
01
PERMIT FEES
Item
Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees