09-1145 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
1.
Application Number: x`09`00001-145
Property Address: 81385 RUSTIC CANYON DR`
APN: 764-280-999-42 -300236--
Application description: POOL - RESIDENTIAL.
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 20000
I hereby affirm under penalty of ag
Section 7000) of Division 3 of the
License Class: C8, 10 , 2 7, 2
that I
Architect or Engineer:
air
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WHITAKER
81385 RUSTIC CANYON DRIVE
LA QUINTA, CA 92253
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA 9223E
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/29/09
---------------------------------------------------------------- - - -
a-- ----
NSED C CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
ifi ' nse er provisions of Chapter 9 fcommencing with I hereby affirm under penalty of perjury one of the following declarations: r
Wrofo Ce, 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
se No.: 656128 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
X11 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
(, OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of peri y at I am exempt from the Contractor's State License Law for the Carrier SEA3RIGHT Policy Number BB1080510
following reason (Sec. 7031.5, 6 in and Professions Code: Any city or county that requires a permit to _ I certify th 'n the performance of work for which this permit is issued, I shall not employ any
construct, after, improve, demoli r repair structure, prior to its issuance, also requires the applicant for the - per anner so as a me subject to the workers' compensation laws of California,
permit to file a signed statement at he or she is licensed pursuant to the provisions of the Contractor's State and agree that, tout eco a b' ct 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 of the�Labor ith 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 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 safe.).
(_ I 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.).
( 1 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
WARNING: FAILURE TO SECURE V iQWERS' COMPENSATIO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP M ONE HUNDRED THOUSAND
DOLLARS ($100,000).. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. '
APPLICANT ACKNOWLEDGEMENT'
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result -of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City -
of La Quinta, its officers, agents and ,gees for any act or omission related to the work being
.performed under or following issua ce of thi$ permit.
2. Any permit issued as a result of thi application becomes null and void if work is not commenced
within 180 days from date of issu ce of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify than have read this application and state t t the abov �' orj�a ' is correct.-I'agree to comply with all
city and co ty ordinances an state laws relating to i o ' L ,and hereby authorize representatives
of this unty t Verpohe above-mentioned grope o urposes.
q(�
ate: v e (Applicant or Agent):
e: 1
Application Number .
. . . . 09-00001145
Permit . . . . .
BLDG POOL PERMIT
Additional desc .
Permit. Fee
207.00 Plan Check
Fee
134.55
Issue Date
Valuation
. .
. 20000
Expiration Date..
4/27/10
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
4/27/10
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
4/27/10
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
4/27/10
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, GFI & GAS STUB
OUTS FOR FUTURE
LQPEINIIT
Application Number . . . . 09-00001145
Special Notes and Comments
APPROVED APPLIANCE (BBQ).
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
LQPERMIT
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I - •I� ti (1)GETEMNE THE APPROXIMATE ELEVATION OF POOL OR SPA AT LAYOUT ON DAY OF EXCAVATION.
♦! "T' f • +A ° (2) TATE NOTICE THAT POOL AND EOLLOUET LOCATIONS ARE SUBECTTO ACCEPTANCEOF
LOCAL BIDDING OBARTMENTAT THEME OFISSVIET DOWN CONCRETE SNELL AT LEAST TWICE INICE OF PERYR.
-'("'r ~ ` •T,., - a1. ' ' • - • _ - _ '- - - ( [' r i•d
(4)
)AGREE THAT TESERRA 0 NOT RESPONSIBLE FOR YFINIERCBOIMDOONDMONSOR 0BELTS,OR SEVEN DAYS AFTER SHELL 6 AND AMY DAMAGE TO MISS. SIDEWALKS. �ID
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(5) SEE THAI ALL FFHCNNGDRIVEWAYS
GATES, AND GARAGE DOCRSAEE'T LOCAL CODES IONA POOL DELL IE
d e Y _ FILL POO UJWE STER NSPECIgN
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(7)TAIEEN PERMISSION
NOFTESRM IS 60LRED By LAZY 0i TESEWUANDTHATAW USE W,ITgUT
• WRITTEN PERA065KN OF TFS£RRANPRp1®OED By LAW.
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♦ ` - . I :. i . .L . _ • 5 - ` - ,, z sKiIATNEP GATE
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T WHITAKER RESIDENCE
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Bin #
City of. La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253- (760) 777-70f2
Building Permit Application and Tracking Sheet
Permit #
ov`\�
Project Address: I�uSbC ddkt V,2J,1)A
Owners Name:
A. P. Number: -2 f1'a
Address: ? 'C k
Legal Description: U`% Cf/l.v
Contractor:
City, ST, Zip:
Telephoner .
Address:�j (j �G�j v(r/
Project Description:
City, ST, Zip:
�•�s Q Xwce Red)
Telephone:'
State Lic. # : bS-b1
City Lic. #:
+
Arch., Engr., Designer:
Address:
City: ST, Zip:
Telephone:
,
_A" g5�
Construction Type: Occupancy:
State Lic. #:
YP � Project type (circle P
J cle one): New Add'n Alter Repair Demo
Name of Contact Person: e
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:(760 "
Estimated Value of Project: Z s3
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
MechanEai
Grading plan
2°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S)\7 I
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' 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