08-1222 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:08 f0-00-0-1-222
Property Address: 81613 RUSTIC CANYON DR
APN: 764-280-999-59 -300236--
Application description: POOL - RESIDENTIAL
Property. Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 25000
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SMITH
81613 RUSTIC CAN)
LA QUINTA, CA 92�
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Dated 7/21/08
Contractor:
Applicant: Architect or Engineer: TESERRA Hq
80
COACHELLA12
CA 92236
(760)398-9222
•1� Lic. No.: 656128
-----------------------------------------------------------------------------------------=-------
LICENSED CON CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ,
I hereby affirm under penalty of perju y �a5es
d d rovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Bu ' n ,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
LicenseClass: C8 C27 C29' ense No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
_ issued,
ate: ractor: �. 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
WNER-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perju that I exempt from the Contractor's State License Law for the - Carrier SEABRIGHT - _-VMiM'Idumber BB1080510
following reason (Sec. 7031.5, Business a Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or r it 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).:
1 _) 1, 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 1, 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 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:
LQPERMIT
_ I certify that, in the performanc of the workfor "this this permit is issued, I shall not employ any
person in any manner so as t become sub's t e workers' compensation laws of California,
and agree that, if I should belVie sub' to ers' compensation provisions of,Section
370J�of the Loor Code, I shall wit o y nh those provisions.
WARNING: FAILURE TO SECURE WORK 'co NSA IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN EN SAND CIVIL FINES UP TO NDRED THOUSAND
DOLLARS IS 100,0001. IN ADDITIO 0 COST OF COMPENSATION, DAMAGES OVIDED FOR IN
SECTION 3706 OF THE LABOR CO , TEREST, 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 act or omission related to the work being
performed under or following issuance of ttiis permit.
2. Any permit issued as a result of this application become ull and void if work is not commenced
within 180 days from date of issuance of such permit, o ssation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor or
rrect. I agree to comply with all
city and county ordinances and state laws relating to building constr eby.auth ize representatives
of this �p.grf�eriaft'!? above-mentioned property for in - oses.
ate: jS'vature (Applicant or Agent):
t
Application Number .
. . . . 08-00001222
Permit . . .
BLDG POOL PERMIT .
Additional desc .
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date . . . .
Valuation .
. 24536
Expiration Date
1/17/09
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•.
.1/17/09
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
1/17/09
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
1/17/09_
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
LQPERMTT
Application Number . . . 08-00001222
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit.Fee . . . . 15.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 464
Expiration Date 1/17/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Notes and Comments
_Speckaj
POOL SPA, GAS.& ELECTRIC STUB OUT•FOR
FUTURE AND SEPARATELY PERMITTED BBQ. 4
L.F. 4' SCREEN WALL & 25 L.F. 40"
COURTYARD WALL, BOTH CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PR� STER_INS.PECTION.
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 371.00
.00 .00
371.00
Plan Check Total .189.80
.00 .00
189.80
Grand Total 560.80
.00 .00
560.80
LQPERMIT
Bin #
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
Permit #
Project Address:�G
�; IUMAI G7
Owner's Name: I
A. P. Number: t �JU4��
1,0 O
Address: 4/5 I
GT
Legal Description:
City, ST, Zip: 1 -
Contractor: S�
Telephone: �%%�
Address:
Project Description: 06L S Cd
96
City, ST, Zip:
POAUIE"C
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G G�j• 6
NT2 uG
Telephone: ?jg �ZZ[_}�'iov
_
AW
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State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
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�';y.- .R'
Construction Type: L Occupancy:
State Lic. #:
Project type (circle one): ew Add'n Alter Repair
Demo
Name of Contact Person: ck• e
Sq. Ft.: Zllr
# Stories:
#Units:
%
Telephone 4 of Contact Person: (7(2�,
'U U7_
Estimated Value of Project: Z CJ — Z S K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
TrussCalcs.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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 ROUSE:-
''d 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
aso o
2�531,o
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1 55
.3 100 AVE. 54 COACHELLA CA 92F36
■PN: (760) 398-9222 FAX: (760) 3,98-9255
Iii CA LICENSE No. 656126%
Builders t� Exceptional_ 0lndoor:Living