09-0626 (RPL)f-1
f
• - I I
4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000626,_-
Property Address: 81421 RUSTIC CANYON DR
APN: 764-280-999-45 -300236-
Application description: POOL - RESIDENTIAL
Property Zoning: - MEDIUM HIGH DENSITY RES
Application valuation: 20000
Applicant:
Architect or Engineer:
Owner:
WEST
81421 RUSTIC CANYON DRIVE
LA QU•INTA, CA 92253
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
LTJ
Date: 6/17/09
JUN 191009
YOFL40-11 T.
-
--V- - - - i---------------------------_----------------------------------------- - - - - -- --
LIC SED RAC. R'S DECLARATION
I hereby affirm under penalty of pe y that I a I' ns un rovisions of Chapter 9 (co in; with_
Section]]oo 1 f Division 3 of the Bus s and rof sio o e, and my Licens ull force and effect.
Licer sq/C� C 0, 7, 2 se No.: 6 5 8
6 Contractor:
I hereby affirm under penalty of perjury that 1,4m > Ipt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business an P f Ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repo ny 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 ISec. 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.).
(_ 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(s) licensed
pursuant to the Contractors' State License Law.).
I 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: WN
LQPERMIT�.
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.
111 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 olicy number are:
Carrier SEA -BRIGHT Policy Nu BB 1080510
I certify that, in the erforma ce of the w for hich this permit is issued, I shall not employ any
person in any man so. as o bec a suNect to the workers' compensation laws of California,
and agree that, if I sho be a subje t orkers' compensation provisions of Section
9 P
3700 of the Wbor Code, fort it with those provisions.
WARNING: FAILURE TO SECURE V)(ORKERS' %6MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN IES AND CIVIL FINES UP TO 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 Ouinta, 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 an if work is not commenced
within 180 days from date of issuance of such permit, or satio of work for 180 days will subject
permit to cancellation.
I certify that I have read this application a state a ' n is correct. I agree to comply with all
city and county ordinances a state laws r n by authorize representatives
of thi co ty to iter u the above -me bone prope f ctio os
te: l natur (Applicant or A _
Application Number .
. . 09-00000626
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . .
207.00 Plan Check
Fee
134.55
Issue Date
Valuation
19675
Expiration Date
12/14/09
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
12/14/09
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
12/14/09
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
12/14/.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 09-00000626
Permit . . . WALL/FENCE PERMIT.
Additional desc
Permit Fee . . . . 15:00 Plan Check Fee
.00
Issue Date . . Valuation . . .
325
Expiration Date 12/14/09
Qty Unit Charge Per
Extension
BASE FEE
=----------------
15.00
-------------------------------------- 7 --------------------
Special Notes and Comments
POOL/SPA, 15 L.F. 5' EQUIPMENT
ENCLOSURE, CITY.STANDARD, GAS & ELECTRIC
STUB -OUTS FOR FUTURE APPROVED
APPLIANCES. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
----------.----------------
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----_-------------------------
-- - - - - - - - - - - - - - --_
Due
-- - - - - --
-
Permit Fee Total 326.00 .00 .00
326.00
Plan Check Total 160.55 .00 .00
160.55
Other Fee Total 1.00 00 .00
1.00
Grand Total 487.55 .00 .00
487.55
LQPERMIT
Bin #
City of. Lauinta
Q ,
Building u Safety Division f
a P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Ov4p
Project Address:.
0
Owner's Name: S ;
A. P. Number:
Address:
Legal Description:
Contractor: e r
City, ST, Zip:
Telephone:
Address: b -- 'SU
Project Description:. G
City, ST, Zip:
Telephone: `' �2�Z
State Lic. # : 5 Z City Lic. #:
t�Yl
✓ /
Arch., Engr., Designer:
Address:
t
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair `Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:(766 Q— UZ g 1
Estimated Value of Project: 2—
APPLICANT:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance
Energy Calcs.
Plans picked up
Construc-ion
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
2°d Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
i
IN HOUSE:-
3rd 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
ng
yi . _ • J ♦.. ,'` ' _, { { ° , i J • SPEC[ FICA'fIgISIS ,. nN T
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' '• . , • `,Y ` -I- d II/,LA.- - w r • ' �, CONCRETE REMOVAL LOADS DIRE CORE
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I. ' - TREE REMOVAL BY STEPFMP
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14P Q) I ' IRRIGATIONREMOVALBY TLE BASE
•. • I�. �[ c - IRRIGATION REPMi BAND ARDVI901EFN ..
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COPING TYPE
if"
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YTY
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w ® I • I I I 1 L_ 614 L •NT " ^ FLIER SA.ILy SIIE S PROP. E1IT. WA11B^ U
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• _
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it
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PUC6NG SIZE l • 1 FENCE TYPE
'g. - ` .. ' r� •_•, i r `� ---- � - I Y - : ,t r• -, • - FTE
II) i _ i . . iT, r'• GUNITE GATEREVERSAL 4.
A .., DEEPE1m RAMP REMOVE a RDw* ,
1 . ... • 1 " r J.. F - r • L .r L �� EMEND 7ro STEP —_ ,
• R Y: C r% �• /\ - I Y .A - d L 1 LOVFSEAT__ -
.. , / ,. • .. ` r SRLLWAY TYPE AIXL C7
[nr er-w IS �
FY / - \ •. I I ~ .' 1 L • — • r COP-_ t CANnLEVOR S OTHER
v� naN� SAiw $ r
r -,i II - \ 1 RB.B.. SEE STEO.
LL 1, UFF.ep4.y, <IEi.ASt .`
OWNER RESPONSIBILITIES
(1) DETERMINE ME APPROXIMATE ELEVATION OF POOL OR SPA AT LAYOVr ON DAY OF EXCAVATION.
.A ' ,' - - . '• ' -♦ I,\ �/IO.1 ���MIf1I (�. (Z) TAKE NOFIGE INAT POOL MIO EQUIPMENT LOCATIONS ARE SUBIECT TO ACCEPTANCE OF
/`I J
vim_
LOCAL BUILDING DEPARTMENT AT THE TIME OF ISSUANCE OF PERMIT. /f
♦ y •J • C A • I �f1 ���MI NO , (i YS AFTER SNELL 0 INSTALLED.
AGREE TRAT CANN �TESERFIA IS NOTRESPONSIBLE FOR CRETE SNELL AT LEAST TWCE LYUNDERGRgMDFOR SEVEN �C0rmTTIOM OR OBEQ . f/ .
AND My DAMAGE TOCURBS. SIDEWALKS. DRIVEWAYS. UWNS.OR OTHER ITEMS IN THE ACCES9MEA
151 SEE THAT ALL FENCING, GATES. AND GARAGE DOCKS MEET LOCAL LODES FORA POOL ENCLOSURE
PRIORTOPREPLAsTERLNSPECnOX
• . '1 L• Cj (oID��1L9SThU.. WI ` FILL
POOL UfEOUTELYAFTER PLASTER, FOLLOWINS7RUCTpNS- )
r�� ISI ( DO NOT USE RUBBER HOSE)
�� • ` 1�,.�� �• Wa O� 11n,1` ,`.1 (TI TRITTENTICE THAT THIS GRAMS IS THE SOLE PROPERTY OF TESFRM AND TNAT ANY USE WRHOUI
L• '. , 1f /• +- • • . - S�yY.Le`�iiiT 1 wT�±-� T v. �+laN •T N7iI77EN PERMISSION OF TESERAA IS PROHIBITED BY LAW.
- 01YNEA APPROVES PAN, POOL AND EQUIPMENT LOCATIONS AND NAS IffM THE RESPd6MIURES AFdIKgfl�s /QO'vF.
-. ' - 4 ' - .• rZ .I' , ♦ ., •.. n ® _ " / > - ' SIGNATLIEIS) DATE -
• _ �. .. S _ I - .. - -. , f rl. - C • - _ , . 1 SWIMMING POOL PLAN FOR:
., ... . "---- cA , k AME WEST RESIDENCE
. ,.. >. - 1T t •• STREET 61 -H2O R I 6 ,J OF•I
OJT
r r I, r• [/��y, yyyU �}pp�`�j(� • ,, JOB ADDRESS -rslLoc~ ,�•
—
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e e �(1 Q, J�'L7 � LOT tK TRACT PAGE BOOK
r r ,r '1, _ � : + _ ,Iw r.• �+.. 'A w .. - L ,T BUILDING CFC §AFIFf , 6EV • + MAP ADDRESS PAGE NO. _ CITY
• F MAIL ADDRESS
"s , • - ._.• f h ' ,y„= i ! _ E -1 -
FM
CONSTRUCTION OFFICE PHONE NO.
✓ r " r I' ^ + '.• A f •"" r' t: • r k .i . J F +.t` 7 I. ` "4; SCALE 'DATE ORANM B1' SOLD BY • CH ED BY
�W •0 W E `ak77 - - - L -
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SELECTIONS �..-..
1• v, y CONSTRUCTION"AUTHORIZATION STONE (L)A�l2LT� ���� /Wpu,JTA;0
1 -
�'L o ;• . SALES FIELD TILE clflL a¢a�bGT(I lwY a
a-. , ,cb S o n�.
�A GIAA (� " �
A*10-c,-BE( AQo 54Fk,`A RAw r�.AoL�O
.,
DIG
_ 'ALL DECKING EXPANSION JOINTS FOR ? �. r r _ DECK COLOR SA�v oLEleo g��' ~
.� } � ` � .• PRE-GUNITE .�° �
REPRESENTATION ONLY, FIELD LAYOUT .r ; 3F - " ' UNDERGROUND JANDY Vzc" SaJO �R jb A&L ;1 W
WILL VARY. : A - . + • MASONRY Peee�aLAs '�6eAu�T� Dix P la BLJE
DECK SIGNATURE 0f5 SSE NOTE.
,.
a I PRE -PEBBLE DRAINAGE NOTE: Drainage and Ingad6n for planters and puts, by amrs, '
un ess Otherwise Wed.
,n