08-1970 (RPL)4 P.O. BOX 1504 ^�
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: /-08-00001970 - Owner:
Property Address: 81433 RUSTIC CANYON DR REYNOLDS
APN:, 764-280-999-46 -300236- 81433 RUSTIC
Application description: POOL - RESIDENTIAL LA QUINTA, CA
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 25000
Applicant: Architect or Engineer:
C1
\OENDD N ACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 11 a r� d'under provisions. of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d es 'o Is Code, and my License -is in full force and effect.
License s: C8 C27 C29 License No.: 656128
ate:��� _ ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions 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 70001 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 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.).
1 _ 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 contractors) 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 e 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
CANYON DRIVE
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) 777-7153
Date: 12/22/08
-------.---------------------------------------
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. '
pL I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
i Code, for the PeAr nce of the work for which this permit is issued. My workers' compensation
insurance carrier an icy number are:
Carrier SEABRIGHT Policy Number BB1080510
I certify that, in the perform nce o work for which this permit is issued, I shall not employ any
person in any manner so s to bec 'act to the workers' compensation laws of California,
and agree that, if I should b c .orkers' compensation provisions of Section
/�/y 3700 of the Lab r Code, -co ith those pvisions.
ate/ �Z' plicant-. / ~
WARNING: FAI RE TO SECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDI ON 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 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 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 o do correct. I agree to comply with all
city and co my ordinances and state laws relating to building con c , a eby authorize representatives
of this
/' my to enon the above-mentioned property for ins o s
atgt 7,— ature (Applicant or Agent):
LQPERMIT
Application Number .
. . . . 08-00001970
Permit . . .
PLUMBING POOL INV FEE
Additional desc .
Permit Fee . . . . .
.66.00 Plan Check Fee
8.25
Issue Date
Valuation
0
Expiration Date
6/20/09
Qty Unit Charge.
Per
Extension
BASE FEE
30.00
2.00 12.0000
EA PLB FIXTURE24.00
1.00 6.0006
EA PLB WATER INST/ALT/REP
6.00
1.00 6.0000
EA PLB GAS PIPE 1-4 OUTLETS
6.00
Permit
MECH POOL
Additional desc .
Permit Fee . . ...'
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
6/20/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
EA. MECH FURNACE >100K
11.00
Permit . . .
BLDG POOL PERMIT INV FEE
Additional desc .
.Permit Fee . . . .
504.00. Plan Check Fee
163.80
Issue Date
Valuation
24760
Expiration Date
6/20/09
Qty Unit Charge
Per
Extension
BASE FEE
90.00
23-.00 18.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
414.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date_
6/20/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
u
LQPERMTT
Application Number . . . 08-00001970
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 15.00 Plan Check Fee
.00
Issue Date Valuation• . . .
. 240 .
Expiration Date 6/20/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
-----------------------------------------------------
Special Notes and Comments
POOL/SPA, 15 L.F. 4' EQUIPMENT WALL,
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER
INSPECTION.INVESTIGATION FEE ASSESSED
PER 1997 UNIFORM ADMINISTRATIVE CODE
§304.5 FOR WORK BEGUN WITHOUT BUILDING
PERMIT.
Fee summary Charged Paid Credited
Due
Permit Fee Total 656.00 00 .00
656.00
Plan Check Total. 189.80 .00 .00
189.80•
Grand Total 845.80 .00 .00
845.80
u
LQPERMTT
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1 _ : ' O>Sr / %`[- \ y.•. ,v " ; (T NyINE THE 0T10E THAT POOL AND EQUIPMENT LOCATIONS ARE SUBJECTYGALCBUNfE OFIMATE ELEVATION OF POOL OR SPA AT LAYOUT ON DAY OF VATON. O
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BUILDING DEPARTMENT AT THE RIff OF ISSUANCE OF FMfr.
• ,,.. . •. , • • 1" . GOBBLE PAVERS WITH ® g ,O g '` !' - ..
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TES FULA SHELL
KOT AT LE -ST TWICEFOR UND W RDILMSEVENDDAYS
AY DITIONAF70SHELL 6 INSTALLED
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WRITTEN PERMISSION OF TESEW E PROHIBITED BY LAW.
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DATE
SWIMMING POOL PLAN FOR:
.4 2-CARGARAG r I ` �S�� •_• E REYNOLDS RESIDENCE
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- uNeas otllelWia)roted. ,..
Bin #
City of. La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701
Building Permit Application and Tracking Sheet
Permit # n O
\
Project Address:
Owner's Name:
A. P. Number: �(�
L (�
Address: /u('
.Legal -Description: —
-S
City, ST, Zip:
Contractor: e r
ra
Telephone:
Address: b--
Project Description: S L�
City, ST, Zip: //''�� p, � l C� qLzL
Telephone: ""122:Z
State Lic. # : 5 City Lic. #:
Arch., Engr., Designer:
t
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:Frc�nKn
e
Construction Type: Occupancy:
Project type (circle one): a Add'n Alter Repair
Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:(\?(pp
—07-'91
Estimated Value of Project: j K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACEJNG .
PERMTT FEES
Plaa Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Cheek Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
2" Review; ready for correctionsTssue
Electrical
Subcontactor List
Called Contact Person.
Plumbinb
Grant Deed
Plans picked up
S.M.I.
A.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
7 -
School Fees
Total-Pe:-mit Fees
r
asoo .
ay 7
ell