07-2844 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253-
Application Number:
07-00002844
Property Address:
81856 RUSTIC CANYON DR
.APN:
764-280-999-74• -30'0237-
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property. Zoning:_
MEDIUM HIGH DENSITY. RES__
Application valuation:
500
Applicant:
Architect or Engineer:
13UILDING & SAFETY DEPARTMENT
BUILDING PERMIT
.Owner:
SHEA LA QUINTI
C/O JEFF MCQUE
8800 N GAINEY
SCOTTSDALE, A2
Contractor:
TESERRA
P.O.-BOX 1280
COACHELLA, CA
(760)398-9222
Lic. No.: 6561
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/29/07
.. LICENSED C TRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
�. 1 hereby affirm under penalty of perjury that I am licen dunder-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 Business and rofe 'ovals 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
CI ss: 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
� �- Cor. - _
L�a
issued.
1 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
WN R -BUILDER DECLARATION
insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am exemptfrom the Contractor's State License Law for the
Carrier SEABRIGHT Policy Number BB1070510
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of a work for which this permit is issued, I shall riot 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 be ome subject 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 becom subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor CO hall fo hwith 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�;i Applicant( --
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, willdo the work, andthe
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE W MPENSATION 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 PENALTIES AND 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 COST OF 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 sale.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 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 ori 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.). I
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
( 1 I am exempt under Sec. , 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 permitis issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERAIIT
of La Quinta, its officers, agents and employees for any act or omission relatedtothe 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 i or Von
is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin c tru n, and hereby authorize representatives
of this county to ter upon the above-mentioned propert or ' pec purposes.
Date/ 7Q g re (Applicant or Agent):
Application Number 07-00002844
Permit . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .15•.,00
Plan Check
Fee
9.75
Issue Date
Valuation
. . .
. 500
Expiration Date 4/26/08
Qty. Unit Charge Per
Extension
BASE FEE
15.00
Permit PLUMBING
Additional desc .
Permit Fee . . . . 18.00
Plan Check
Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date 4/26/08
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
- --- - - - - --
FIREPIT ONLY PER APPROVED PLANS
Other Fees . . . . . ENERGY
REVIEW FEE
.98
Fee summary Charged Paid
Credited
Due
Permit Fee Total 33.00
.00
.00
33.00
Plan Check Total, '14.2.5
.00
.00
14.25
..Other Fee Total .98
.00
.00
.98 .
Grand Total 48.23
.00
.00
48.23
LQPERDIIT
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 #
-2- zByy
Project Address: 2L O
Owner's Name: 1(—
6�(D ��
A. P. Number:
Address:
Legal Description:
Contractor. _ �
City, ST, Zip:
w �
Telephone: MINIMIZE
Address:.d
Project Description:
City, ST, Zip:r'
CtAZ L Lid- Ct-,� qZZg (o
Telephone:
State Lic. # : S
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
,. A
Telephone:
State Lic. #: ,.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: Ori
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections,04
9,&?
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing S O e-75
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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
C
ITY OF LA Q JINTA
B1
JILDING & SAM YDEPT.
T al Per it ee
DATE ------By—