07-0783 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,'CALIFORNIA 92253
` Application Number:
Property Address:
APN:
Application description:
Property Zoninq:
Application valuation:
Applicant:
07-00000783 J
81781 RUSTIC CANYON DR
764-280-999-43 -300237-
STRUCTURES OTHER THAN BUILDINGS
MEDIUM HIGH DENSITY RES
2000
Architect or Engineer:
NIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WATERMAN RESIDENCE
81-781 RUSTIC CANYON DR.
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
Date: 3/16/07
-------------------------------------------------------------------------------------------------
ICENSED CONTRACTOR'S DECLARATION WORKER'S'COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury 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 B in s a d Professionals Code, and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cla C8 C27 C29 - License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
r ;; issued.
1 Date: 1 Contractor: _ I have and will maintain worke ' compensation insurance, as required by Section 3700 of the Labor
_ Code, for the performance f the work for which this permit is issued. My workers' compensation
OWNER-BUILDER.DECLARATION - insurance carrier and policy number are: -
I hereby affirm under penalty of perjur that I am exempt from the Contractor's State License Law for the Carrier SEABRIGHT i Policy Number BB1070510
following reason (Sec. 7031 .5, Busine and Professions Code: Any city or county that requires a permit to - I rtif that inthe rf r k f h' h th' d I h II 1
construct, alter, improve, demolish, or pair 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 atleged 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).:
(_) 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 _ 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:).
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:
t Lender's Address:
LQPERMIT
ce iy a,i epe o
person in any mann so
and agree that, if hoult
7 0 of the Lab e,
Date: f Applicant:
WARM G: FAILURE TO SECURE
SUBJ T'AN EMPLOYER TO CRIMINAL
DOLLARS ($100,000). IN ADDITION. T(
SECTION 3706 OF THE LABOR CODE, I
wor or w �c is permit is issue , s a not emp oy any
beco subject to the workers' compensation laws of California,
Mme sub) ct to the workers' compensation provisions of Section
I forthwi comply with those provisions.
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
:ST, 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 Quint,, its officers, agents and employees for any ac 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 b mes II and voi if work is not commenced
within 180 days from date of issuance of suc ermit, o cessation o work for 180 days will subject
.permit to ancellation.
certify that I have r d this application and state that above inf ,tion is torr t. I agree to comply with all ,
city and co ty ordi ncas and state laws relating to uil ons ion, and here y authorize representatives,
of this u e Je� po the above-mentioned pr erty ins n urpos
y ( �_ _
Date: 'Sig ture. lApplicant or Agent):
Application Number ... . . . 07-00000783
Permit . . . BUILDING PERMIT
Additional desc .
Permit.Fee . . . . 45.00 Plan Check Fee
29.25
Issue Date . . . Valuation . . .
. 2000
"Expiration Date 9/12/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
15.00 2.0000 HND BLDG 501-2,000
--------.--------------------------------------------------------------------
30.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 15.75 Plan Check Fee
3.94
Issue Date . . . . Valuation . . .
. 0
Expiration Date 9/12/07
Qty Unit Charge Per.
Extension
BASE FEE
15.00
1.00 .7500 PER ELEC.DEVICE/FIXTURE 1ST 20
----------------------------------------------------------------------------
.75
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00 Plan Check Fee
4.50
Issue Date . . . Valuation . . .
. 0
Expiration Date 9/12/07
Qty Unit Charge Per.
Extension
BASE FEE
15.00
1.00 3,.0000 EA PLB GAS PIPE 1-4 OUTLETS.
3.00
-------------------------- -- --- - --------------------------7--------------
Special Notes and Comments
FIREPIT/AGAL 496 PER APPROVED PLAN/2
ELECTRICAL STUBS
Fee summary Charged Paid Credited
Due
Permit"Fee Total 78.75 .00 .00
78.75
Plan Check Total 37.69 .00 .00
37.69
Grand Total 116.44 .00 .00
116.44
LQPERMIT
I
Bin #
City of. La Quinta
Building 8L Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
�U La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking. Sheet
Project Address:'' `�� Owner's Name:
A. P. Number:
Address: 1 c
Legal Description: City, ST, Zip:
Contractor: 1<.
�. 5� �Z h. � Telephone:
Address:
C)X
Project Description:
City,`P _
Telephone: 9-2 -2
y _ 2-
State Lic. # —--
S�O � City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
P y:
State Lic. #:
Project type (circle one): New Add'n Alter Repair
Demo
Name of Contact Person:
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: �d
_ Z Estimated �Value Project: Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd
TRACKIIYG . PERMIT FEES
Plan Sets
F :;Plan.Check submitledl—z:: �I
Structural Calcs.R
Item
'e
• Reviewed aer dy for corrections
Amount
Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up
Construction
'r
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2nd Review, ready for correctionsfissue Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`d Review, ready for corrections/issueoper-I• pact Fee
Planning Approval
�+ YY
Called Contact Perso UI� nF @I p.P.
Pub. Wks. Appr
Date of permit issue BUILDING & S!� t: rJE
School Fees
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LFT. IB
HEADER BOARD
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FIRE PIT: +12" QUARTZITE SIDES AND THICK CUT
QUARTZITE CAP WTIH 1-1 2” CANTILEVER
108
L•FT.3R
GAS RUN
—
192-
L. FT. I --R
ELECTRIC RUN
RESIDENTIAL IAL LANDSCAPE SC
APE PLAN N F
OR.3
2
-3FI
2
,SWITCH FOR GFI
CITY OF lA QUINTA
-
DUILDING & SAFETY DEPT,
7, 4' A.D.S. PERFOR ATEA PPE
42- LONG W1 ONE BUBBLER
APPROVED
WATERMAN RESIDENCE
FOR CONSTRUCTION
> ),T y o �
4
<B. 3/4- PEA GRAVELf
n, •
a -
REV. NO.
OM
C M EN T S
•
DATE
APPROVED
ED
_
PAVER .
CAMBRIDGE BRI -
GE CO B BL E UNT UM BLED CO LO
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BLEND
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`3.
FI ELD SUPERVISOR
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4 PVC SCHEDULE 40 STREET Ell
5. PVC SCEDULE 40 TEE AND ELL
—
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APE PLAN N F
OR.3
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-
g
7, 4' A.D.S. PERFOR ATEA PPE
42- LONG W1 ONE BUBBLER
WATERMAN RESIDENCE
i
,
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<B. 3/4- PEA GRAVELf
-
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9. DRAIN GRATE
81-7
781 RUSTIC C CANYON
N
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L A QUIN T A CA. 9 2
00
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.253
0
00
O
SOLD BY.
DEVELOPMENT
NT
'I
JO E M
PAR CEL N0.
P.o No.
i
i
DEEP ROOT
BUBBLER SYSTEM `
DESIGN BY.
JOE M.
TRILOGY OG
Y LOT N0. - 7 043
JOB No.
•'
DRAWN BY.
•
sF EET NAME
SHEET NO
Y
JUAN H.
REVIEWED BY.
P ANTING PLAN
: .
DATE: 02 28.07
G G
RE H
SCALE.
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:
4
.
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