09-0465 (RPL)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDINGPERMIT
-_ Date: 5/13/09
Application Number: t09-000004651 Owner: ,
Property Address: 81-397 RUSTIC CANYON DR CROUCH
APN: 764-280-999-43 -300236- 81397 RUSTIC CANYON DRIVE
Application description: POOL - RESIDENTIAL. LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
.Application valuation: 25000
Contractor:
Applicant: Architect or Engineer: TESERRA
P.O. BOX 12
{ 29 U
COACHELLA, A 92236_ — L�
(760) 398-9 22 C;>!iyi+F .,y ,eft
r Lic. No:. &5-&,28
Am
SED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penaltyrjury licen d under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 o BusP ssionals Code, 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
Licens ass:Q-101_27(_ License No.: 656128 — for by Section, 3700 of the Labor Code, for the performance of the work for which this permit is
�/ issued.
ate: tractor
: ^ I have and will maintain workers' compensation insurance, as required by Section.3700 of the Labor
1-1 Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER-BUILDER DECLARATION insurance carrier and poli tuber ar
I hereby affirm under penalty of m exempt from the Contractor's State License Law for the Carrier SEA-BRIGHT Policy Nu bar B 080510
following reason (Sec. 7031 .5, ofessions Code: Any city or county that requires a permit to _ I certify that, in the perfo nance'of the work f r is permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner s s to become sub' t rs' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should ome sub' r s' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or �e Labor Code, I shall ly h 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).: te: A scant:
( 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 WARNING: FAILURE TO SECURE WOR C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL, N IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or.improvement is sold within SECTION 3706 OF THE LABOR CO_ TEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - _ whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason 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 relatedto the work being
performed under or following issuance of this permit.
Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced f
within 180 days from da ' suance of such permit, or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this applica ' nand state that th ove informatio ec agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state law to building onstru uthorize representatives
of this county e4 u� the above-mentioned pro cY pu ses.
Lender's Name: .—F/�
ate: Si ature (Applicant or Agent): +
Lender's Address:
/0,,t
LQPERDIIT -
Application Number
. . . . 09-000004.65
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date
Valuation . . .
. 24760
Expiration Date
11/09/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
23.00 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
11/09/09
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
11/09/09.
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
11/09/09
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
Permit . . . . . WALL/FENCE PERMIT
LQPERMIT
Application Number . . . 09-00000465
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00
Plan Check Fee".
.00
Issue Date . . .
Valuation . .
240
Expiration Date 11/09/09
Qty Unit Charge Per
Extension
BASE FEE
15.00'
---------------------------------------------------------------------------
Special Notes and Comment's
PUUL/SPA, 15 L.b'. 4' EQUIPMENT
ENCLOSURE, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION.
-----------------------------------7----------------------------------------
Other Fees . . .'. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee'summary Charged Paid
-----------------
Credited
Due
----------
Permit Fee Total 371.00
--- ----------------
.00 .00
371.00
Plan Check Total 189.80
.00 .00
189.80
Other Fee Total 1.00
.00 .00
1.00
Grand Total 561.80
.00 .00
561.80
LQPERMIT
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OWNER
OWNER RESPONBialLITIEB
..
_ MTAKE NOOK THKE AT
AXDEBEVATKT OF POOL 0f1SPA ATlAYWFON DAY 6ElfCAVATgN.
(7)TAI�E NOTICE THAT POOL NIDEWIFVBIi IOGTgN9MESUBIELTm A0CEPTNNE6
• • /!� - r i' • e L - .I tl r ` Ay - •I !l i (p WET DOM OCONCREM STEL TTIEAST THICK DADY FOA SEVEN DAYS DAYS AFTER SHELL 6 INSTALLED I
.w • _ ,. - '• - r n NI AGREE THAT TESERRA IS NNOTRE"SIBLE FOR UNOEROROUNDCONDRpNS ORCDx=
` • '8. M , ' l • - • - (5) PNORTOTALLFEN TEAW TE4CTI0IL AND My DAMAGE TO SX
ARAOEDOwi YS. LOCAL COOEBFRU,,,W FNn�mSc�'L 1
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. •\ ���� . - t WRIRE/N POWSBION OF TESFRM O ProarTED BY LAW. i[
- - !. - a •, • _ - - • -- DMTEIAPPRWESPLWPOMAND ENx1EAE1lT LACA,NwB AND1WSREAD THE R®PODBIREB AND
DATE
I.
• y �' - ♦> • : " - , - , ' y SWIMMING POOL PLAN FOR:
GATE - N
• ! r - - y t { ♦ y CROUCH RESIDENCE
• ' • - ', - ; - N _ r , A ♦ + - ' - ; STREET 81-397 RUSTIC CANYDN I
ADDRESS TRILOGY C
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LOT 6043 TRACE PACE BOOK !
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MAIL ADDRESS
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+• ti +• + '� , '✓;" i °^ -tr _ �y- _ ° - SCALE DATE DRAWN BY SOLD BY
CHECKED BY
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• - q r i. i. '. ,y •I. 1' i - 5 ..I • k .r - • .+. REVISIONS DATE- c, r
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. - -- - __ t. n 4 v..
Ld
SELECTIONS v)
' ` , •Y_, i ,1. CONSTRUCTION AUTHORIZATION sroNE
SALES FIELD nl� fids
• •_ DIG BOULDERS - I
'ALL DECKING EXPANSION' JOINTS FOR r r° PRE-GUNITE DECK COLOR T6 U
REPRESENTATION ONLY. FIELD LAYOUT {" UNDERGROUND JANDY AT10 I
WILL VARY. I > _ � 6- 44 O I
_ _ . _ _ MASONRY PeBBNus
- DECK slcwlTURe U r
PRE-PEBBLE " - DRAINAGE NOTE'. Dann and Mpation for Pknt-ard pots, by0ank
B'° #
City of. La Quinta.
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
I
Permit #
(per
00 �
Project Address:: 397 `G l
Owner's Name:
A. P. Number: } t ld ZQZ4Address:
srA6 ( ji
Legal Description:
City, ST, Zip: ( I
Contractor: e r
Telephone:
Address: b— !E '
Project Description:
City, ST, Zip:
A5Z-1
Telephone: � g22_Z
n_
P
City Lic. #:
State Lic. # : 5
Arch., Engr., Designer:
i
i
Address: .
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): e Add -n Alter. Repair Demo
Name of Contact Person:.
Sq. Ft.: ��-
# Stories:
# Units:
Telephone # of Contact Person:(766 v— CMZ g 1
Estimated Value of Project: S K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan CheckDeposit
Truss Calcs.
Called Contact Person
Plan CheckBalance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up
S.M.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
a j700
a4b
�y ?6'0