08-0173 (SOTB)P.O. BOX 1504
T 4 4a Qum�w
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253!, BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 08-00000173
Property Address: 81700- RUSTIC" CANYON DR
APN: 764-280-999-131 -300237- .
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
AjJjJkauull V8ivatlOh! 1'100 `
Owner:
CHRIS WALT
81-700 RUSTIC CANYON
LA QUINTA, CA 92253
VOICE (760) 777-7012
- FAX (760) 777-701'1
INSPECTIONS (760) 777-7153
r..y O�Date: 1/23/08
Contractor: D
Applicant: / Architect or Engineer: LOZANO PROF POOL CON
p1Y P.O. BOX 11272 "U
ry PALM DESERT,'CA 92 /�
(760)275-4647 J � �1
Lic,. No.: 840397
. �i�ygHc �QU,Hr v
-
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
•1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Businesaf and ofessiona Code, 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
License Class: C53 *cense No.: 840397 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-ylfi issued.
�w Date: Contractor: &Uk_ 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
OWNER. DER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exem om the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any, structure, prior to its issuance, also requires the applicant for the person in any manner so as to become sub' ct to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should eco subjec' the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or 3700 of the Labor Cod I orthwi comply with those provisions.
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).: Date: _�4 ApplicantT_- .
(_ 1 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 WARNING: FAILURE TO SECUR WORKERS' COVA
SATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 sate.). - APPLICANT ACKNOWLEDGEMENT
( '.) I, as owner of the. property; am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set.forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - - - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. I B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
of La Quinta, its officers, agents and employees forany 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.
certify that I have read this application and state that the above information is correct.. I agree to comply with all
city and county ordinances and state laws relating to build* I con ruction, d hereby authorize representatives .
of this county to enter upon the above-mentioned prope for i ection poses.
Q i
Signature (Applicant or Agent)
Application Number .
. . . . 08-00000173
Permit . . . . .
BUILDING PERMIT
Additional desc .
Permit Fee .•
27.00.
Plan Check Fee
17.55
Issue=Date
Valuation
1100
• Expiration Date
7/21/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
6.00 2,0000
HND FLDG•501-2.000
12.00
:PermitELEC-MISCELLANEOUS
Additional desc .
Permit Fee
17.25
Plan Check Fee
4.31
Issue Date .• .
Valuation . .
0
Expiration Date
7/21/08
Qty Unit Charge
Per
Extension '
BASE
FEE
15.00
3.00 .7500
PER . ELEC
DEVICE/FIXTURE 1ST 20
2.25
Special Notes and Comments
- ---------------------
BLOCK & CONCRETE BBQ
STRUCTURE -
POOL
UNDER CONSTRUCTION
Fee summary Charged
Paid Credited'
Due
Permit Fee Total
44.25
.00 .00
44.25
Plan Check Total
21.86
.00 .00
21.86
Grand Total
66.11
.00 .00
66.11
LQPERMIT -
.
Bin #
'x
,(
'City of La Quinta
Building & -Safety Division � ,t
P.O. Box 1504, 78-495 Calle Tampico .
y La Quinta;' CA 92253 - (760) 777=7012 .
Building Permit Application and Trackin Sheet
Permit.#
/�..`✓
Project Address:
Owner's Name: C 115a "4— r
A. P. Number:
-Address: �i -`I0� `(uSCtt . -J.
Legal Description: -
Contractor: M; k.cl L��-ct,,� V1CSSlonliAL Jv.(.
Ci i)', ST Zip: LA QurN �✓�.. � �/� g X25,3
Telephoner
Address: •. fS � L' 4
�= �FfQ r `�1Jk?o,�J �
Project Description: U„v �
�c C�J'uC.yCLt� .
City, ST, Zip:
Telephone: -7(.0 69
City Lic. #: V
►� �—J�v S 6o6UC.6l N
,State Lica# :. e4o 3 c17
Arch., Engr., Designer: .'
Address:
+ ;
City, ST, Zip:
Telephone: _
State Lic. #;
Name.of Contact Person`. •.: -
Construction Type:. Occupancy:
Project type (circle one): New Add'ri Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO'NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd ..
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submittedItem
Amount
Structural Calcs. •
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs •
Called Contact Person,
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
B '
Flood plain plan.
Plans resubmitted
Mechanical
Grading. plad
2'd Review, ready for corrections/issue
Electrical —7
3, J:f
SubcontactorList'
`
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. '
H.O.A. Approval
-
Plans resubmitted
Grading
_
IN HOUSE:-
"d Review, ready for corrections/issue
g
Developer Irc pact Fee
Planning Approval
Called Contact Person
A.I.P.P.
`
Pub. Wks. Appr
Date of permit issue-
School Fees
CITY ®F Clum
�•
�7
BUILDING &,SAF
DEPT.
HHOV�'
E
To I Permit Fees
P!�
5
CITY OF LA QUINTA
BUILDING &.SAFETY DEPT.
XIsTIc� lo��E APPROVED
0 0.. Rvs--t L ";Xl No ij FOR CONSTRUCTION
�A . QViNtr�. DA
..
l a
FtL
CITY OF LA QUINTA
BUILDING &.SAFETY DEPT.
XIsTIc� lo��E APPROVED
0 0.. Rvs--t L ";Xl No ij FOR CONSTRUCTION
�A . QViNtr�. DA
..
l a