07-1768 (RPL)•
4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY. DEPARTMENT
BUILDING PERMIT
Application Number: 07-00001768
Property Address: 81796 RUSTIC CANYON DR
.APN: 7.64-280-999-79 -300237---
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation; 25000
Applicant: Architect or Engineer:
�a
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thaJaProfessionals
censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the BusinesCode, and my License is in full•force and effect.
LicenseClass: C8 C27 C29 LicenseNo.: 656128
/
Date: LWJ9&:ZContractor:
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. 7031.5i 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 7006) 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
1, 'as owner of the property, or my employees with wages as their sale 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 doesthework 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.l. -
1' ) I am exempt under Sec. B.&P.C. for this reason
Date: Owner: '
CONSTRUCTION LENDING AGENCY
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: -
LQPER111IT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENT
SCOTTSDALE, AZ 852
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/07
1UN 20 2007
Contractor: j CIYY pF LA Q�IU'— If�iA
TESERRA I FINANCE DEFT.
P.O.BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
/ WORKER'S COMPENSATION DECLARATION.
I hereby affirm under penalty of perjury one of the following declarations:
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 BB1070510
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to bec a subject to the workers' compensation laws of California,
and agree that, if I should becomes bject to the workers' compensation provisions of Section
37700 of the Labor Cod II fort ith comply with those provisions.
.Date: -Ip ,G LbApplicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 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 n I and void if work is not commenced
within 180 days from date of issuance of such permit, or c ssation of work for 180 days will subject
permit tocancellation.
I certify -that I have read this application and state that the above informati is correct. '1 agree to comply with all
city and county ordinances and state laws relating to building structionja d hereby authorize representatives -
of this county. to enter upon the above-mentioned property f r i pe an purp as.
Date: I�ature (Applicant or Agent):
Application Number
07-00001768
Permit. .
BLDG POOL PERMIT
' Additional desc .
Permit.Fee" . .
252.00 Plan.Check
Fee..
163.80
Issue•Date
Valuation
. . .
. 24680
Expiration Date..
12/15/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
23.00. 9.0000
----------------------------------------------------------------------------
THOU BLDG'2,001-25,000
7.07.00
Permit
MECH POOL
Additional desc .
Permit Fee.
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . .
. 0.
Expiration Date
12/15/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
--------------------------------------------------
EA MECH FURNACE >100K
--------------------------
-------------------------PermitELEC
11.00
Permit. . .
ELECPOOL.PERMIT-RES
Additional desc..
Permit Fee . . .
45.00 Plan Check
Fee
11.25
Issue Date . .
Valuation
0
Expiration Date
12/15/07
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
12/15/07
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
Permit . . . ..
WALL/FENCE PERMIT
LQPERn4IT - -
Application Number 07-00001768
,.. :Permit WALL/FENCE
PERMIT
Additional desc .
Permit Fee 15.00
Plan Check
Fee
_ 00
Issue Date.-
Valuation
. . .
320
Expiration Date 12/15/07
Qty Unit .Charge Per
Extension
BASE
FEE
15.00
Special Notes and Comments
------ -----------------------------
POOL, SPA, ALARMS/$ARRIERS SHALL
BE IN
J
PLACE AT PRE -.PLASTER INSPECTION.
20' LF
X 48".CITY STANDARD BLOCK WALL.
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
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: �1 _ 2,
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
Address: 0 O • I 25e,:9
City, ST, Zip:
Telephone:{
Project Description:
City, ST, Zip: C Ox�Lf'` ^LL C lfr -7 7,Zj
O
q
Telephone: / — L Z Z
'
State Lic. # : (p 2 City Lic. #:
Arch., Engr., Designer:
01 rY 911
Address:
City, ST, Zip:
Telephone:
i r ''
Construction Type:O'rcu anc
P y:
State Lic. #:
Project type (circle one): New Add'a Alter Repair Demo
Name of Contact Person: `�``
J �5�= N�}�JDGZ
S Ft.:
9•.
# Stories:
# Units:
Telephone # of Contact Person: O —(7 .
Estimated Value of Projec 2_--- 000
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Constructioa
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact PersonPlumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
' d Review, ready for corrections/issue
Developer L-npact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Perm:t Fees