09-0843 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 XP Q"
Application Number:
09-00000843
Property Address:
81297 BRIDLE PATH
APN:
764-280-999-178 -300236-
Application description:
POOL -. RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
10000
Applj;a Architect or Engin er:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ICENSEkedunder
TOR'S DECLARATION
I hereby affirm under ty of perjury tha m 1provisions of Chapter9 (commencing with
Section00)vision 3of the Business an ode, and my License is in full force and effect.
License CI 10,27,2 se No.: 656128
ate: ontractor:
CLARA
I hereby affirm under penalty of perjury that I am exempt fro ctor's ate License Law for the
following reason (Sec. 7031 .5, Business and Professions Cade: 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 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 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 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.).
f _ 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:
Lender's Address:
LQPER114IT
Owner:
REHLING
81297 BRIDLE PATH
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/03/09
Contractor:
TESERRA D
P.O. BOX 1280
(760H)398-9222
0ACELLA, CA 92236 AUS 05 �, O
Lic. No.: 656128 C/ ooJ
-------------------------------- - - - - -- -- -
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.
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
insurance carrier and policy number are:
Carrier SEABRIGHT Policy Number BB1080510
I certify that, in the rfor anc the work for which this permit is issued, I shall not employ any
person in any—
so s to be ome subject WIN workers' compensation laws of California,
an a that, if 1 should b ome ub' the s' compensation provisions of Section
00 of the Labor Code, I sha ith c ose provisions.
_ *'
Xate: pplicanv
WARNING: FAILURE TO SECURE WORKE PENSATIO�FIN
IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA N IES A ILO ONE HUNDREDTHOUSAND
DOLLARS ($100,0001. INADDITION E COST OF CAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTOR
APPLICANT ACKNOWLEDGEME
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 applicatio state that t e information is correct. I agree to comply with all
city an county ordinances an state la rela ' t g c ruction, and hereby authorize representatives
of c to upo a above -menti f i pection purposes.
Date: nature (Applicant or Agen :
LN
Application Number . . . . . 09-00000843
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 117.00 Plan Check
Fee
.76.05
Issue Date . . . . Valuation
. . .
. 10000
Expiration Date . . 1/30/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
8.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
72.00
Permit . . . MECH POOL
Additional desc .
Permit Fee 26'.00 Plan Check
Fee
6.50
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 1/30/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
----------------------------------------------------------------------------
11.00
71
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check
Fee
11.25
Issue Date . . . . Valuation
0
Expiration Date 1/30/10
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 . . . . 27.00 Plan Check
Fee
6.75
Issue Date . . . . Valuation
. . .
. 0
' Expiration Date 1/30/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
11.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
SPA ONLY. ALARMS/BARRIERS SHALL BE IN
LQPERMIT
LQPERMIT
' Application Number . . . . 09-00000843
- ----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER •INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
.CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid
Credited
--------------------
Due
Permit Fee Total 215.00
.00
.00
215.00
Plan Check Total 100.55
.00
.00
100.55
Other Fee Total 1.00
.00
.00
1.00
Grand Total 316.55
.00
.00
316.55
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 #
(}�(
C�
Project Address::
Owner's Name: RI GI C
A. P. Number: 70`/�
Address:
17
Legal Description:
City, ST, Zip:
Contractor: F>e
Telephone:
Address: b--
Project Description:
City, ST, Zip: e y� �� '7L2
Telephone:
State Lic. # : 5 2
City Lic. #:
Arch., Engr., Designer:
Address: .
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. It:
Add'n Alter Repair Demo
Project type (circle oi�tes:
Name of Contact Person:
Sq. Ft :
#Units:
Telephone # of Contact Person:Moo v— UZ $ 1
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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'
2"' 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:-
'"' Review; ready for corrections/issue
Developer Impact Fee
Plaaning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
+