09-0073 (RPL)P.O: BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00000073
Property Address:
81445 RUSTIC CANYON DR
APN:
764-280-999-47 -300236-
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
. i0000
4
• u�l'ItrGv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JIM & LYNDA CALDER //��
81445 RUSTIC CANYON DRIV�
LA QUINTA, CA 92253 Irf lul
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/09
FFA Cflr,? )
Applicant: Architect or Engineer: BRYAN INVESTMENTS GROUV INCLA
CIiyOF'
P.O. BOX 1804 FIA!A yCIE
PALM SPRINGS, CA 92263
Ivl (760)345-8483
if Lic. No.: 552140
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions.of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B C53 Q� License No.: 552140
or: YtG P05,11 -
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 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).:
1 _ 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.).
(_) 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 _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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
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.
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 NORTHERN INS NY Policy Number WCO281765000
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with th a provision/s,.,r/�•
Pee. ON -0q A cant: R, V �
WARNING: FAIL RE TO SECURE W ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 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 above information is correct. I agree to comply with all
city and c y ordinances and state laws relating to building construction, and hereby authorize representatives
oft ' county to enter upon th bove-mentioned y f
grope or�inspe�cvtio�n puff���1(QQQses.
Date: 99 .i (J / Sig ure (Applicant or Agent): W r v iw 1
Application Number .
. . . . 09-00000073
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
117.00 Plan Check Fee
76.05
Issue Date . . . .
Valuation
9760
Expiration Date
7/29/09
I Qty Unit Charge
Per
Extension
BASE FEE
45.00
8.00 9.0000
THOU BLDG 2,001-25,000
72.o
Permit. . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
7/29/09
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
7/29/09
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
27.00 Plan Check Fee
6.75
Issue ,Date
Valuation
0
Expiration Date
7/29/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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 . . . .• 09-00000.073
Permit . . . WALL/FENCE PERMIT
Additional desc-.
Permit Fee . . . . 15.00 Plan Check Fee
.00
"Issue Date . . . . Valuation . . .
. 240
Expiration Date 7/29/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
-- ----------------------
-
Special
Special Notes and Comments
- -------
SPA ONLY & 15 L.F. 41- EQUIPMENT WALL,
CITY STANDARD. 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 230.00 .00 .00
230.00
P1an.Check Total 100.55 .00 .00
100.55
Other Fee Total 1.00 .00 .00
1.00
Grand Total 331.55 .00 .00
331.55
W
Bin #
City of La Quinta
Building a Safety Division
Permit # M P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: ��'Owner's Name: ' y
A. P. Number: Address:5?,
Legal Description: City, ST, Zip: Q\jt-ir
Contractor: CA L— PACT F t C- RJO L -S Telephone:
Address: 90
<��- Project Description:
City, ST, Zip:t—1��Ut�L�
Telephone l't 1 ) \!
State Lic. # : S Z6,,D City Lic. #<)IDZ 1 CJ
Arch., Engr., Designer:
Address:
City, ST, Zip:
Tel hone:
p Construction Type: Occupancy:
State Lic. #:. Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �� A Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: L . Z Estimated Value of Project: 10,
Q O
Amount .
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
---------------
Item
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" Review, ready. for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
S.M.I.
Grant Deed
Plans picked up
H O.A. Approval
Plans resubmitted
Grading
Developer Impact Fee
IN HOUSE:-
'`' Review, ready for.corrections/issue
Planning Approval
Pub. Wks. Appr
School Fees
Called Contact Person
Date of permit issue
r
A Ep p
Total Permit Fees
/0000
Amount .