09-1103 (RPL);1 -
P.O. BOX 1504
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253.
Application Number: -09-00001103 =
Property Address: - 81322 -RUSTIC CANYON DR
APN: 764 -280 -999 -177' -300236 -
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
App!ication valuatien: 30000
Applicant:
Architect or Engineer:
P /A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pe t I am lic ed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the s and es ' als Code, and my License is in full force and effect.
License C4Q: , 10 , 27, 2 License No.: 656128
C Factor: - -
V
WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjuryexempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Businesessions 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 (5500).: -
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and d
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 herselfthroughhis or her own employees, provided that the
improvements are notintended 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(i) 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
I hereby affirm under penalty of perjury that there is a constructionlending agency for the performance of 'the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: --P / 1
LQPF,RMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Dater. 10/15/09
Owner:
GINTER
81322 RUSTIC C N DRIVE/1
LA QUINTA, CA 92
OCT
Contractor:
TESERRA G'IT'f?F!
P.O.. BOX 1280 !:ra+.1 agiLFj�;A
COACHELLA, 'CA 92236 _
(760)398-9222
Lic. No.: 656128
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
1 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 Policy Number BB1080510
I certify that, inthe performa of the work for which this permit is issued, I shall not employ any
person in any manner so as t ome sub' to the workers' compensation laws of California,
and agree that, if I should beco e s o the workers' compensation provisions of Section
2��-���ppficeant:
bor Code, I shall o it ply with those provisions.
Date: ,
WARNING: FAILURE TO SECURE WOR RS' MPENSATION AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES U -O.ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO TH 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 actor 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 that the a e information is correct. I agree to comply with all
city and county ordinances and state laws relating to building c 'on, hereby authorize representatives
of thi ty nt po the above-mentioned property for ins echo es.
DIC' 4 nature (Applicant or Agent)
.:Application Number
. . . . 09-00001103
Permit
BLDG POOL PERMIT
Additional desc .
Permit. -Fee _
207.00 Plan Check
Fee
134.55
Issue.Date . . . .
Valuation
. . .
. 20000
Expiration Date
4/13/10
Qty Unit Charge
Per
Extension
•
BASE FEE
45:•00
18_00 9.0000
THOU BLDG 21001-25,000
162.00
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0
Expiration Date
4/13/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
PermitELEC
POOL PERMIT -RES
Additional desc .
Permit Fee
45.00 Plan Check
Fee
11.25
Issue Date . . ...
Valuation
. . . .
0
Expiration Date
4/13/10
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
4/13/10
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 STUB -OUT FOR FUTURE
LQPERAIIT
Application Number . . . . . 09-00001103
Special Notes and Comments
• APPROVED APPLIANCE. ALARMS/BARRIERS
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. EQUIPMENT ENCLOSURE NOT
' INCLUDED.2007 CODES
----------------------_------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
Credited
Due
Permit Fee Total 311.00 .00
.00
311.00
Plan Check Total' 160.55 ,00
.00
160.55
Other'Fee Total" 1.00 .00
.00
1.00
Grand Total 472.55 .00
.00
472.55
Bin #
City of La Quinta -
Building a Safety Division
P.Q. Box 1504, 78-495 Calle Tampico .
La Quinta, rA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
��
Project Address: Ul�j� (4)•l oyti
Owner's Name: 6 t�J^
A. P. Number: ` .4 'r
L.4
Address:
Legal Description: D > S out
Contractor: zP--,i!F a4 "
City, ST, Zip:
Telephone:
Address: "g(�— l 20 A V6- ;E
Project Description:
City, ST, Zip: = L 77- 7-3
—q{ilQ C)W+
Telephone: 3g?i- q? ZZ
State Lic. #: City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one):w Add'n Alter Repair . Demo
Name of Contact Person: `
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:. - 0
Estimated Value of Project: U '�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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
2"d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L r
ILO.A. Approval:
Plans resubmitted
Grading
IN ROUSE:
1n° 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
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13WNER REIBRONSIEILI_TIES
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(I) DE7ERMWETHEMPROIBNATEELEVATKNOFPOOL Qt SP%T UVpUt ON DAY OF EXCAVATION.
(2)TAIO;NO�ICE THAT POOLANDEWIPM@ITLOCATION3MESlIB:�CT TD ACCEPTANCE OF
LOCAL BUILDING DEPOOLMENTAT THE TIME OF ISSUANCE OF PERMIT.
(3) WETDOWM CONCRETE SHHJ.AT LEASETVACE DMLY pOR SQIEN DAYS AFTER SHBL R (NSTALI.ED;
THAT TESERRA IS ROTRESPON�LE PoRIINOERGRQIYID CONDITIONS OR OBIECTS,
AND ANY DAMAGE YO CURBS, SIDEWALKS, ORIVEWAYiS,LAWMS, ON OTHER REAS IN THE ACCESSAREA EQ
(5) SEE THAT ALLPENCWQ OATE$ALb BARAGEDOORSMEETLOGLCOOES FORAPOOL ENCLOSURE
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(T) TAKE NOTICE MAT YH I5 DRAWING IS THE SOLE PROPFATYOF TESERRAAND Ti USE WITHOUT
WRITTEN PFRIYSSOII � TESERRA IS PROHBNFD BYLAW
MNER APPROVES RAN, PCW, AND EQUIPMENT LOCATIONS AND HASREODTHE RESMMBWDTIES ANO wncEBABOVE
NGNATURE(W DATE
SWIMMING POOL PLAN FOR: ' IA ME LINTER RESIDENCE
CONSTRUCTION NSTRUCTION 0 FICE PHONE NO.
SCALEDATE DRAWN BY SOLD BY ECKED Y
ill= T' -7125-09 MB JEFF
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ExTEND 2nd STB' -
LOVESFAT "'�--C16 <1w
-
SPILLWAY TYPE SE�. 1Y__
CANTILEVii �^ er, o a Ha
COPM OTHER
R$B.. SEE STM.
V
13WNER REIBRONSIEILI_TIES
OWMER TL
(I) DE7ERMWETHEMPROIBNATEELEVATKNOFPOOL Qt SP%T UVpUt ON DAY OF EXCAVATION.
(2)TAIO;NO�ICE THAT POOLANDEWIPM@ITLOCATION3MESlIB:�CT TD ACCEPTANCE OF
LOCAL BUILDING DEPOOLMENTAT THE TIME OF ISSUANCE OF PERMIT.
(3) WETDOWM CONCRETE SHHJ.AT LEASETVACE DMLY pOR SQIEN DAYS AFTER SHBL R (NSTALI.ED;
THAT TESERRA IS ROTRESPON�LE PoRIINOERGRQIYID CONDITIONS OR OBIECTS,
AND ANY DAMAGE YO CURBS, SIDEWALKS, ORIVEWAYiS,LAWMS, ON OTHER REAS IN THE ACCESSAREA EQ
(5) SEE THAT ALLPENCWQ OATE$ALb BARAGEDOORSMEETLOGLCOOES FORAPOOL ENCLOSURE
PRORTOPREPBASTFA WSPECOON.
IS) FILL PODLIMMN£DUTaYAFTERPLASTER (FOLLOW INSjAUCTI0M4- DO NOT USE RUSBERI108Ej
(T) TAKE NOTICE MAT YH I5 DRAWING IS THE SOLE PROPFATYOF TESERRAAND Ti USE WITHOUT
WRITTEN PFRIYSSOII � TESERRA IS PROHBNFD BYLAW
MNER APPROVES RAN, PCW, AND EQUIPMENT LOCATIONS AND HASREODTHE RESMMBWDTIES ANO wncEBABOVE
NGNATURE(W DATE
SWIMMING POOL PLAN FOR: ' IA ME LINTER RESIDENCE
CONSTRUCTION NSTRUCTION 0 FICE PHONE NO.
SCALEDATE DRAWN BY SOLD BY ECKED Y
ill= T' -7125-09 MB JEFF
Jam# RSVINS
D TE
211
CONSTRUCTION AUTFiO IZATION
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w
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