07-1568 (RPL)P.O. BOX 1504
78-495.CALLE TAMPICO
LA QUINTA,: CALIFORNIA 92253
f
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00001568
81733 RUSTIC CANYON DR
764-280-999-39 -3002377
POOL - RESIDENTIAL
MEDIUM HIGH DENSITY RES
25bb6
Architect or Engineer:
.... . 0A
- - --LICENSED CONTRACTOR'S DECLARATION
" VOICE' ('760) '777=7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and rofessionals Code, and my License is in full force and effect.
LicenseClass: /C8 C27 C29 License No.: 656128
Date: Gf lo: Contractor:
.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, 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 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.).
I—) 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
MOHR RESIDENCE
81-733 RUSTIC CANYON DR.
LA QUINTA, CA 92253,E
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA
(760)398-9222
Lic. No.: 6561,
Date: 5/25/07
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 SEABRIGHT Policy Number EB1070510
I certify that, in the performance of the work for which this permit is issued, I shall notemployany
person in any manner so as t become subject to the workers' compensation laws of California,
and agree that,. if I should be me subject to the workers' compensation provisions of Section
3700 of the LaborC hwith comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES.UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001: 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 ofthis 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 in rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to building constr ction, and hereby authorize representatives
of this county to enter upon the above-mentioned property o ins ec 'on purposes.
ter r7 -Signature (Applicant or Agent):
Application Number 07-00001568
' Permit BLDG POOL PERMIT .
Additional desc .
Permit Fee 252.00 Plan Check
Fee
163:80
Issue Date Valuation
. . .
. 25000.
Expiration Date 11/21/07
QtyUnit 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 11/21/07
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 11/21/07
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 11/21/07 -
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
---- ---------- - -------------------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS.SHALL BE IN
LQPERD4IT
.
Application Number 07-00001568
• Special Notes and Comments
-------------------------------
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
• Fee summary Charged.
Paid
Credited
Due
- Permit Fee Total 356.00
.00
-- - - - - - - ------------
.00
356.00
Plan Check Total 189.80
.00
.00
189.80
Grand Total 545.80
.00
.00
545,80 ,
Bin #
City of La Quinta
Building 81 Safety Division .,
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I n�
LA
Project Address: �— 3� u S l l
Owner's Name: lvi(0 4rz Eris
A. P. Number:
Address:
Legal Description:
Contractor:Telephone:
City, ST, Zip:
a.
Address: 0.- goX ez�'
Project Description:
City, ST, Zip: OLi Cl ^L1-4
L �—
.Telephone: Z Z Z
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
• Y
State Lic. #:
Name of Contact Person: J � jJL _HEN,.1JDCZ,
Construction Type:
NL� Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #I Jnitq:
Telephone # of Contact Person: O —Oaqtl
Estimated Value of Project: j QQ0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
2
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Leposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction.
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2n' 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 HOUSE:-
Review, ready for corrections/issue
Developer Im;pact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
-- SPECIFICATIONS
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R.B.B.SEE STEE
it
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I OWNER RESPO
NS ILIT S
II
OWNER ,
1 T0. 1 .DETERMINE THE APPROXIMATE A PR XIMATE
ELEVATION TI N OF POOL OR
C) SPA AT
LAYOUT ON
DAY OF EXCAVATION
4 N
II ,
I
(2) TAKE NOTICE THAT POOL AND EQUIPMENT ENT LOC
A IONS ARE SUBJECT TO ACCEPTANCE OF
/i LOCAL BUILDING DEPARTMENT AT 11MC OF ISSUANCE I
0
F PERMIT
i
i
_ 3
WET DOWN CONCRETE SHEL I'
LAT
LEAST TWICE I E DAIL F
�) Y OR SE
— _ _ u SEVEN DAYS AFTER _ _ — R ELL 15 NSTA D
_ SH 1 LLE
t
4 AGREE THAT TESERR
T A ISNOT RESPONSIBLE I LE FOR UNDERGROUND
CONDITIONS OR OBJECT'S
it AND ANY DAMAGE TO CURBS, SIDEWALKS,
DRIVEWAYS, LAWNS, WN R OTHER THER ITEMS IN THE
5 S
ACCESS AREA
EE THAT ALL FENCING GATES, .' ATE AND GARAGE
�) DOORS MEETOC
L AL CODES FOR A POOL ENCLOSURE
PR
, TOR TO PREPLASTER'E
INSP GTION
I
(6) FILL POOL IMMEDIATELY AFTER PLASTER. FO
LLOW INSTRUCTIONSCTIONS_
_
DO NOT USE
RUBBER HOSE
I
7 TAKE NOTICE
THAT THIS DRAWING IS THE SOLE LE PRO ,
PERTY OF TESERR Q
A AN THAT ANY
USE WITHOUT WRITTEN PERMISSION OF•
TESERRA IS0
PR HIBI
TED BY LAW.
OWNER APPROVES PLAN POOL, AND EQUIPMENT LOCATIONS AND
HAS READ THE RESPONSIBILITIES AND NO E D
N TIC S ABOVE.
I
SIGNATURE(S)
'DATE
SWIMMING POOL PLAN A FOR.
I
NAME ('�
_ _ V
�. mm RES u CE_
Y
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STREET C
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CONSTRUCTION
❑FFICE PHONE
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SCALE
DATE
DRAWN BY CHECKED
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SELECTIONS
CTIA
N S
CONSTRUCTION UCTIO
N AUTHORIZATION
-
STONE
SALES
FIELD
DIG
BOULDERS
PRE-GUNITE
JANDY
UNDERGROUND
PEBB,/PLAS
/e 0cl
MASONRY
DECK'
PRE -PEBBLE
STONE
TILE
BOULDERS
DECK COLOR
JANDY
PEBB,/PLAS
/e 0cl
SIGNATURE
DRAINAGE NOTE, Drairrnage and irrigation for planters and pots, by
others, unless otherwise noted.