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08-1610 (RPL)m P.O. BOX 1504 4 t l 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08-00001610 Property Address: 78995 CALLE BRISA APN: 602-160-028- - - Application description: POOL - RESIDENTIAL .Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Applicant Architect or Engineer: 60 X -- ----------------- LICENSED L'MTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lice ed tlnd rov'4ions of C Ater 9 (commencing with Section 7000) of Division 3 of the Business essi - -CCD d icense is in full force and effect. License QassC8 C27 C29 Lic 6.128 Date: Contractor: f OWNER -B ILD ECLARATION - I 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 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.). (_ 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: LQPERMIT Owner: MASTER ASSN. RLQ 78995 CALLE BRISA LA QUINTA, CA 92253 VOICE (760) 777-7012. FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/23/08 Contractor: TESERRA tpD. P.O. BOX 1280 COACHELLA, CA 922 (760) 398-9222 SEP 241003 Lic. No.: 656128 3 I ciryoF LA ouuu, ---------------------------------- —------ 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 SEABRIGHT Policy Number BB1080510 Icertify that, in the perform of the work for which this permit is issued, I shall not employ any person in any manner s >sto ome subject to the workers' compensation laws of California, and agree that, if I shoute t t the workers' compensation provisions of Section 3700 of the Labor Codeo ith those provisions. Date: Applicant: WARNING: FAILURE TO SECURE W RKE MPENSATIO E IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIO E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CO , 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%ri gn n is correct. I agree to comply with all city and co ty ordinances and state laws relating to ban rebs authorize representatives of this unt �o enter upon the above-mentioned propes. Date: Z Signature (Applicant or Agent): "t,. Application Number . . . . . 08700001610 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation 19872 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 THOU BLDG 2,001-25,000 162:00 -----------------------------------------------------------------=---------- Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 --------------------=------------------------------------------------------- Permit . . . MECH,POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 ---------------------------------------------------------------------------- Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25. Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/09 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 LQPERMIT Application Number . . . . . 08-00001610 Permit . . . . . . PLUMBING Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/09 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 . . . PLUMBING Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . 0 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE .15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 ---------------------------------------------------------------------------- EA PLB GAS PIPE 1-4 OUTLETS 3.00 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 128 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL, SPA, ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. (2) 48" X 4 EQUIPMENT WALLS. BBQ-FIREPIT PER APPROVED PLAN ONLY. Fee summary Charged --------------------------- ---------- Paid Credited -------------------- Due Permit Fee Total 367.25 .00 00 367.25 Plan Check Total 170.86 .00 .00 170.86 Grand Total 538.11 .00 .00 538.11 LQPERMIT Bin # City of. La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # u0o Project Address: I%q rS�► Owner's Name: A. P. Number: G � �j Address: .-70— 7<>1,%S Legal Description: Contractor: ser raTelephone: City, ST, Zip: Address: b-- Is Z-/ Project Description: i)L City, ST, Zip:C, y VDk, '"1 LZ Telephone: — g222_Z — .y�r- DvZ- -- C /iV f" // A State Lic. # : 2 City Lic. #: Arch., Engr., Designer: Address: s ADD e7A-CX0 City, ST, Zip: 70'0 /.�j1. Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): ew Add'n AI epair Demo Name of Contact Person: Sq. Ft.: #Stories: un : Telephone # of Contact Person:(76 v— OZ $ 1 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. 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°d Review, ready for correctionsfissue4EIecrical Subcontactor List Called Contact Person bingIfo;c�pprova = anI s rasa m ing — . - aaoning--Approve — _ _ -- .� _...�.. �. a on az grso °... - _ Tp p "= _- .._ .—.. -- Pub, Wks. Appr Date of permit issue School Fees Total Permit Fees