09-1178 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09`000_01.178
Property Address:
81505 RUSTIC CANYON DR
APN:
764-280-999-50 -300236-
Application description: PLUMBING
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:'
700 _
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perju that I am licen end under ovisions of Chapter 9 (commencing with
Se �7) A' ision3 of the Buss and Profess on e, and my License is in full force and effect.
Li ,10,27,2 eNo.: 656128
atontractor:
PI
-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I m e pt from the Contractor's State License law for the
following reason•ISec. 7031 .5, Business and Pr a ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair a ructure, 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, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 000
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
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: P
LQPERAI IT
Owner:
" JOHNSON
81505 RUSTIC CANYON DRIVE
LA QUINTA, 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) 777-7153
C9
J
11/09/09
-----------------------------------------------
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 he performance of the work for which this permit is
issued.
I have and will maintain workers' compensation surance, as required by Section 3700 of the Labor
Code, for the performance of the work for ich this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier SEABRIGHT Policy Number B1080510
certify that, in'the performance of the work for ich this permit is issued, I shall not employ any
person in any manne become su ' to the workers' compensation laws of California,
'l��i�/���s and agree that, if I s uld beco sub' he workers' compensation provisions of Section
/�s� / �� 0 of the Labor Cod hall fo omply with those Provisions.
ate: 'A 'ant:
oo-
WARNING: FAILURE TO SECURE WORKER COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE TI AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST PENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTOR .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 s or cessation of work for 180 days will subject
permit to cancellation.
I certify th t I have read this application and state that t bove infor ati s correct. I agree to comply with all
city and my i=ces and state laws relating to buildin tru , and hereby authorize representatives
oft s nt o to on t 'above-mentioned property for ins purposes.
Date: 'i ature (Applicant or Agent):
Application Number
. . . . . 09-00001178
Permit . . .
PLUMBING
Additional desc .
#
Permit Fee . . .
18.00•
Plan Check Fee
4.50
Issue Date
Valuation . . .
. 0
` Expiration Date
5/08/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1."00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS
3.00
Special Notes andComments
INSTALL 10 L.F. 1"
POLYLINE FOR
FUTURE
FIREPIT (BY OTHERS)
Other Fees . . . .
. . . . . BLDG
STDS ADMIN (SB1473)•
1.00-
.00Fee
Flee-summary
summary
Charged
Paid Credited'
Due
Permit Fee Total
18:00
.00 ..00
18.00
Plan Check Total
4.50
•.00 . .00
4.50
Other Fee Total
1.00
.00 .00
1.00
Grand Total
23.50
.00 .00
23.50
,
'Bit! #
City d La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
'
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # `
��
01
Project Address: e p. ....
Owner's Name: S v
/SU�7�
A. P. Number: J/2-17
Address:
Legal Description: ,¢-s S�t1: �t
_
City, ST, Zip: G 44 -
Contractor: 2--i-r,- a4
Telephone:
Imam
Address: 9(1-1G0 -- � V
Project Description: V �g
City, ST, Zip: e0 = CA- 7—Z3 i�—
Telephone:
State Lic. # : CityLic. #:
Arch_, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: # Stories: #Units:
Name of Contact Person: <-
Telephone # of Contact Person:.
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMTT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance
Energy Caics.
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.L
ILOA. Approval:
Plans resubmitted
Grading
IN HOUSE:-
7i° Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
El
Total Permit Fees
i
In
SPECIFICATIONS �In
I mN
y TYPE Slg XP m
I SURFACE AREA OF POOL e,
PERIMETER Cc
DEPTHS MIN. MAK v Ei m
SPECIFIC<NSTILE �rN
TILE TrPs J_
� SO YJA/ERIDE W ..
8PA WWW LY011TAE TTAI AQ'1 NG OFJEISQUAR RROMLIGHTZ
4uWr � ovg4-kAEe YVI1T1-rNo RNSE _RaB TeE O Nm
RNSNGJ�BR TYPEUNOTESDECKING uj m
XCAVATION / STEEL RNm 46TYPE
E/9wi51DN.IG'NIS O O
CAHITO A
EEVAnO�'R t
DECK DRAMENA
LOSEAT DEOCOmm
CL
CONCRETE •mD
0x.CURBCOEWZ sm SIM
hA-p/L F�/r'A ��4p(—
VFW,4ot (-M Ff 04-TA"tD) " r{ _Z 0 ® O In'! ON Ely ST& FACE
sT°R11 ovF-W AST 13°X la11 ALITY TILE SAM
DiA6
TIW- 1�-iAi- 0*0) I r IRRIGATION sAAaeD
_ I (/D��� � U S0.fl& POSBOIB
•�• V 'W > Z) MILE&. NOWSiii� :-0
IB'R&9 .�
ETU I�Ca (.ordG W cr } zA•Rsa 3�
® mRaa
cvFQ,RlsIyMF�T IP! K Imo" TIS GlJ DIAE,a.L4L cn ®� m TANSEu SiPnL °o
®®®®®®� i ( to ep) cc 06 Z COPING
GryOKNRY Q�.
'' �,L�1 ® 0
U.. ... .... O O .` 9LLWAY TYPE qO
® ®1}CL Sff
PFILLUMBING 4 MBING �
t _ PROP. EXT. WALLS
�XISTI�Cc CD�C�eI Y �I ��i 2�L��b2h ( 'T y—ifiSLlbTSY iif �I' V eooa ERnAv • •__ s� RUNNING ws r^
602l,AYME-tT IVY' SUE
12" TPI•E 014 6 < 1k ® J O ADDLPIAV SIDE EGup..WAUs �/' J
LL
�oJ�AI, (Iay T�� I � ... •l; ® �� � O w ADDLPIAP ..�—= e� .r.N:. r _
eEo
HEATER T. EDE J
r ®( AOOovnETS
T-EIIGIG cL T STo,4e SfEfFWU P�k� 0 suaAPM°°Oa m
KR(}IHi
-- s pfEE Po1 LVE f - P LE -/`PLASTER �•
!!i ,
GAS UNE- S1USS UGHRSF ,I.
!
:
IP GREAT • - �AESImJ�an�ADS_+ �sGSPA
.. _..__ eaaeEW
ROOM r,;._ BATH eEw.wSPp.
DINNG ® - --- 'y r�;h .I.0 F� - LIGHTS w POOL ��`• ISP. E
�'JVT�/,Q.
ROOM SNS SET l��mtT CIN G
PLUMBING SIZE FEHM
HEIGHT
hd
5�4t+l.kb GATE
Q_ __ ' - .•. rTE GATE TELER&L
® r - �YS YVITA` L�RSA S" DEEP 00 REMrnEa
w•
y'' :cowtv�o.� EXEND��
OVESEAT
STLILWA, TYPE 1'
•,� GUST Mnt1
CPw-
*0C060RtD cQ IG�TE TLA -41,46 P r 15; � aJf I J-pu�sTl� 01112 LIn RSS s� oTH�R
wrM'12216Wf10r1 # �irJ moves, ® ® (co w�T Frzor� ovT
-�LJum VA l�VP,, yck; F-. -40A �[M�S, OWNER RESPONSIBILITIES
,E_IraLIONL .:
7K (II GETEWAOIE THE APPROXNATE flEVATON aF PDOLOR SPAATLAYOLRON DAY W EXCAVATKN.
Ta TAIDi NOTICE THAT POOL NND EOIIIPMENTLDGnans AAE SUDJECf TO ACCEPTANCE OF'ALIUILDO
a` TJ)LWoI
R DOWN
NCONRLEIE SHELL ATTLEAST TWICE DARY FOR EL'EN MY9DAYS MER SNHL 6INSTAMID.
_ - - (4) AGREE THAT TESERRA IS NOT RESPONSIBLE FOR UNDERGROUND CONDITTDNS OR OREC,%
AND ANY DAMAGE M CURBS. SIDEWALKS. DRIVEWAYS. LAWN$OR OTHER ITEMS N THE ACCESS AREA
T ' 11 L ls) SEE THAT ALL FENCING. GATES, AND GARAGE DOORS MEET LOCAL CODES FOR A POOL ENaGL1RE
_ - ALUIvLAyVpOI� t�/fT, j�f{/-�/�I/� WITi� tOvF2 PRIOR TOPRErusTER NSTECTIM
X11 ,
•, R . --- -- 1o/'ALl2ETL- FC'Crr(-I C -t 'F�' t� FILL AKENOPOOL CE THAT HIS AFTERPLA.STHESOLE PROPERTY
TESEDO NOT IaEANy USETn.
(TI RTTNOTCETHAT THIS DMWNAIS PR SOLEEED By LAW. TWA TESERTUAND TWATANYIBEWR LOUT
VAOTTEJ PERA0.4apN OF TESEwuls PROHIBITED By uw.
OWNER APPROVES PLAN. POOL AND EWIRMM LOCATIONS NA HAS READ THE SNA TAllff9
ARwe
SIGNATURES)DATE
POOL PLAN FOR:,
DATE
Eil
JOHNSON RESIDENCE HS z oq
------------------- ' 1j STREET 1- JL
-
--- JOBADDRESS TRILOGY CRY LA--AAT4
PHONE OFFICE RES
1 O yL� 6050 TRACT' PAGE BOOK
GARAGE € & `. MAP BOOK PAGE NO. CRY
MAIL -___. J v , CO STRUC ON OFFICE PHONE NO.
I By LI M?TI Tt O SCALE
L 7 ' IO DATE DRAB BY SOLD BY CKED BY
I:
C4AAOuf--771 21,5o Jpa - - REVISIONS
DATE:
LTE: I 1
I -)S� 3 w
In
SELECTIONS w
CONSTRUCT ON AUTHORIZATION STONE sTEYP'46.''A;,S _CA�WlE CA,-LcoAt N
C SALES FIELD — e 4411 hwaoD —SW AvI O I
i DIG U)
PRE-GUNITE ° S REEL BE" W UTI} Z
'ALL DECKING EXPANSION JOINTS FOR - UNDERGROUND "�"""" �3aea4 1i=9"-4- -EREPRESENTATION ONLY, FIELD LAYOUT MASONRY PEBB.PUS . -E
WILL VARY.
DECK SIGNATURE y (S — ► -
PRE -PEBBLE - DRAINAGE NOTE DTs61ap old kdgabDn kr planters and pots, OY others,
unless oDwv&a road '
ii. w
11 1