08-0063 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
Application Number: 08-00000063
Property Address: 81832 RUSTIC CANYON DR
APN: 764 -280 -999 -76 -30023 -7 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
,Application voluotion: 1000
Applicant: � � ^
�b�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
'MCNAB RESIDENCE
81-$32 RUSTIC CANYON
LA QUINTA, CA 92253
Contractor:
Architect or Engineer 1:9nPi
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
JAN �j Lic. No.: 656128
---------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am 'censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and ofessionals Code, and my License is in full force and effect.
License ss: C8 C27 C29 License No.: 656128
'Date: `Contractor:
1
ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tha& I am exempt from the Contractor's State License Law for the
following reason ISec: 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 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).:
(_) 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 herselfthrough 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 _ 6 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS {760) 777-7153
Date: 1/09/08
WORKER'S COMPENSATIONDECLARATION
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 BB1080510
I certify that, in the performance f the work for which this permit is issued, I shall not employ any
person in any manner so as to ecome subject to the workers' compensation laws of California,
and agree that, if I sho bec a subject to the workers' compensation provisions of Section
700 of the Labor C de, shal forthwith comply with those provisions.
'Date:/ Applicant:
WARNING: FAILURE TO SECURE W OMPENSATION 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 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 infor ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building construc on, and hereby authorize representatives
of this couny toghterupon the above-mentioned property)drTspecti n purposes.
"Date:• Signature (Applicant -or. Agent): .
Application Number...-. . . . 08-00000063
Permit BUILDING PERMIT
Additional desc .
Permit Fee 25.00 Plan Check Fee
16.25
Issue.Date. . . . . Valuation . . .
. 1000
Expiration Date 7/07/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 2.0000 HND BLDG 501-2,000
. ----------------------------------------------------------------------------
10.00
Permit . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee (. . . . X17.25 Plan Check Fee
4.31
Issue Date Valuation . . .
. 0
Expiration Date 7/07/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
2.25
Permit. . PLUMBING
Additional desc".
Permit Fee . . . 18.00 Plan Check Fee
4.50
Issue Date Valuation . . .
. 0
Expiration Date 7/07/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB,•GAS PIPE 1-4 OUTLETS
3.00
------------------------------------------------
Special Notes and Comments
BBQ & FIREP.IT PER APPROVED PLANS
--------------------.----------------
- Other Fees . . . . . . . . ENERGY REVIEW FEE
1.63
Fee summary Charged Paid Credited
Due
Permit Fee Total. 60.25 .00 00
60.25
Plan Check Total 25.06 ..00 .00
25.06
Other Fee Total. 1.63 .00 .00
1.63
Grand Total 86.94 .00 00
86.94
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: c,
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:— _ `�
Telephone:
��M
Address: G} . 0
Project Description:
City, ST, Zip: O CHC LL,k 01�
�}a
Telephone: l �– t�f Z l- �
x
M�� ��"9
State Lie. # : �,� I
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
rY K ,'
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): Nell Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted 1 TJboo
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
l
Subcontactor List
Called Contact Person
Plumbing Pt
c r
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"' 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
r clTy OF LA QUINTA
BUILDING & SAFETY D PT.
APPRUVLU
Total Permit Fees
LrUK LOUINI7 t rluv r IWI
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