07-0398 (SOTB)P.O. BOX 1504
X78-495 CALLE TAMPICO
c
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
01&60`'
T4tyl 4 4 4"
07-00000398
79300 BROOKVILLE
772-040-017- - -
STRUCTURES OTHER THAN BUILDINrS
LOW DENSITY RESIDENTIAL
10000
Architect or Enginee
IV ��
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------Asd
-----------------------------
D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjurcensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busofessionals Code, and my License is in full force and effect.
LicenseClags: Q8 C27 C29 License No.: 656128
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjuryat 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 re air any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he o 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 1$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 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.).
(_) 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.).
( ) 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:
THE ESTANCIAS
79-300 BROOKVILLE
LA QUINTA, CA 92253
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: 2/05/07
-----------------------------------------------
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 f
m rare:
Carrier SEABRIGHT licy Number BB1070510
I certify that, in the perfoo e work for which this permit is issued, I shall not employ any
person in any manner o subject to the workers' compensation laws of California,
and agree that, if I shsubI t to the workers', compensation provisions of Section
3700 of the. Labor Coo hwi comply with those provisions.
DatAFZApplicant:
WARNING: FAILURE TO SECURE W' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINLTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF.THE LABOR CODEST, 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 an permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall d end, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any t 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 beco II a d void if work is not commenced
within 180 days from date of issuance of such per it o cess tion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab e i or iatio is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin ru tion, nd hereby authorize representatives
of this count to enter upon the above-mentioned property f r in urposes.
Date: -Signature (Applicant or Agent):
Application Number . . . . . 07-00000398
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 117.00
Plan Check'Fee
76.05
Issue Date
Valuation
10000
Expiration Date 8/04/07
Qty Unit Charge Per.
Extension
BASE
FEE
45.00
8.00 9.0000 THOU BLDG.2,001-25,000
----------------------------------------------------------------------------
72.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 17.25
Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 8/04/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
3.00 .7500 PER ELEC
DEVICE/FIXTURE 1ST 20
2.25
----------------------------------------------------------------------------
Special Notes and Comments
BBQ/Z21-58-1995 FIREPIT/AGAL 496
Fee summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 134.25
--------------------
.00 .00 •
134.25
Plan Check Total 80.36
.00 .00
80.36
Grand Total 214.61
.00 .00
214.61
LQPERMIT
Bin It City of. La Quinta
Building U Safety Division
Permit # P.O. Box 15041 78-495 Calle Tampico
1�# La Quinta, CA 92253 - (760) 777-7012
' Building Permit Application and Tracking Sheet
#
Project Address- 7 �-?� Owner's Name: -T4�k_A C�
A. P. Number: P-J O �>✓ t L t-� Address:
Req'd -
Legal Description: City, ST, Zip:
Contractor: Telephone:
TRACIONG . PERMIT FEES
Address: (� Project Description::
Plan Sets
City, ST, Zip: �PC �1 11-x- CIS Cj7�3 �P� Q 12+� �-�$ ��1�
Telephone:39 Cl ZZ 2—'
q
Structural Cates.
State Lic. City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy: "
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: l_. C_`c,o Sq. Ft.: # Stories: # Units:
Called Contact Person Plan Check Balance
Telephone # of Contact Person: ,Z `j Estimated Value of Project: 1 sem, OCA
Energy Cates.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd -
Rec'd
TRACIONG . PERMIT FEES
Plan Sets
Plan.Check submitted Item Amount
Structural Cates.
Reviewed; ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Energy Cates.
Plans picked up Construction
Plans resubmitted Mechanical
Flood plain plan
Grading. plan'
2°" Review, ready for correctionsfissue 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 correctionstiissue Developer Impact Fee
Planning Approval
Called Contact Person A-1-P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
CIN OF
BUILDING D
Total Permit Fees
Lr' v.....-.-_
y
DATE_.-- gY