07-2885 (SOTB)P.O. BOX 1504
78-495 CALLE TAM PICO
LA QUINTA, CALIFORNIA 92253
Application Number 07-00002885
Property Address: 8T92"8 -RUSTIC CANYON DR
w.
APN: 764-280-999-69 -30023.7-
Application description: STRUCTURES OTHER THAN. BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 500
Applicant:
n
Architect or Engineer:
WA
t 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICE SEDCONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of.the Business an Professionals Code, and my License is in full force and effect. .
License CI ss: C8 C27 C29 License No.: 656128
e:/ 6 Contractor:
OWNER -BUILDER DECLARATION
.1 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 licerised 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 _ 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 _) 1, 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 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
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER
SCOTTSDALE, AZ 85258.
1
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: 11/01/07
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 SEA3RIGHT Policy Number BB1070S10
I certify that, in the performance of 'e work for which this permit is issued, I shall not employ any
person in any manner so as to be ome subject to the workers' compensation laws of California,
and agree that, if I sho becom subject to the workers' compensation provisions of Section
37,00 of the Labor C e, shall f rthwith comply with those provisions.
Date: (/�FCppical nt: --'
WARNING: FAILURE TO SECURE W SC PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN L 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 constru ion, and hereby authorize representatives
of this county to enjer upon the above-mentioned propeytGfN inspect n purposes.
e pngnature IHppucant or v,gentl
Application Number,
. . 077000.02885
PerLmit . .
BUILDING PERMIT
Additional desc
Permit.Fee`, . . . .
15.00
Plan Check Fee
9.75
• Issue -Date
Valuation
500
Expiration Date
4/29/08
r 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
4/29/08
-
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Fee summary Charged Paid
Credited
Due
----------
Permit Fee Total
----------
33.00
---------- ----------
.00 .00
33.00
Plan Check Total
14.25
.00 .00
14.25
Grand Total
47.25
.00 .00
47.25
71
#4 TIE
STEEL AT 36" DIAM.
TOP COURSE
GAS FIRE RING: INSIDE DIMENSION
WATERPROOF
MEMBRANE
I.C.B.O. #((YP:'
# (,
INTERIOR
SURFACES}
ANSI
BTU
#4 BAR
VERT AT
U.L.APPROVED. `
32" O.C.
(TYP.)
7A
7B
LENGTH OF GAS PIPE-
SLID CMU'
DIAM. OF GAS PIPE Qq
SOLID GROUT
7 OUTDOOR FIRE RING
-
I
GAS-SHUTOFF GAS LINES SHALL
BE INSTALLED
VALVE GRAVEL
PER CPC FOR
DEPTHLAC,
LOCATED COURSE
COVERAGE, AND PEMENT.
WITHIN 36" GAS LOGSAND, WATER PROOF-
OF UNIT LIGHTER MEMBRANE
(TYP.) STONE CAP
3-1/2
- #4 TIE STEEL
#4 BAR VERT. AT 32" O.C.
8x8x8_CMU; SOLID GROUT
F.S.
{
Y
CLR :.
METAL GAS RISER
GRAVEL SUMP
"
2° ¢i DRAIN OR PROVIDE 12" DIAM. CRUSHED D ROCK
C
OPENING IN FOOTING
OUTDOOR FIRE RING - STONE CAP
I
1
7A 1/2"=1'-0":
.
Bin #'
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
2La
Project Address:r---
/
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
r-�
Contractor: � � �
Telephone:
Add'Fess: ,-P.O 191%0
Project Description:
City, ST,Zip: t-Ir=LLo r; r+ `�Z�lo
DOW
Telephone: b" / Z-� f'.-
r r O
State Lic. # i QL
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
m
Construction Type: Occupancy:
State Lic. #:
Project type (circle one):New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: t �1—Ci�
Estimated Value of Project: S'Q 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
t
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
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
tad 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:-
1rd Review, ready for corrections/issue
Developerlmpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees