08-0270 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant: ( )
v
I.. Uv"rr
08-00000270
79315 BROOKVILLE
772-040-004- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
30000
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that II m licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi n ad Professionals Code, and my License is in full force and effect.
License Class: C8 C27 C29 License No.: 656128
Date: Contractor:
NER-BUILDER DECLARATION
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 1, 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.).
1 I 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:
LQPERAI IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/06/08
Owner:
LA QUINTA ORCHARDS PARTNERS
C/O LA QUINTA ORCHARD PARTNERS
P O BOX 1716 _
LA QUINTA, CA 9
n,
Contractor:
TESERRA FEB 081000
P.O. BOX 1280
COACHELLA , CA 2236 CITY OF QUINTA
(760) 398-9222 FINANCE DEPT
Lic. No.: 656128
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WORKER'S COMPENSATION DECLARATION _
1 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
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should bec me subject to the workers' compensation provisions of Section
3700 of the Labor Cad I sha forthwith comply with those provisions.
Date: lApplicant:
WARNING: FAILURE TO SECURE WOA E OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL .
SUBJECT AN EMPLOYER TO CRIMINAL 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 information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building co struction, and hereby authorize representatives
of this courtly toe ter upon the above-mentioned prop for in pection purposes.
Date: Pnature (Applicant or Agent):
n
LQPERMIT
Application Number . . . . . 08-00000270
Permit
. . . . . BLDG POOL PERMIT
Additional
desc .
Permit Fee
. . . . 284.50
Plan Check
Fee
184.93
Issue Date
. . . .
Valuation
. . .
. 30000
Expiration
Date 8/04/08
Qty Unit Charge Per
Extension
BASE
FEE
252.00
5.00
-------------------7--------------------------------------------------------
6.5000 THOU BLDG
25,001-50,000
32.50
Permit
. . . MECH POOL
Additional
desc . .
Permit Fee
26.00
Plan Check
Fee
6.50
Issue Date
. . . .
Valuation
. . .
. 0
Expiration
Date 8/04/08
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 8/04/08
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
. . . . 45.00
Plan Check
Fee
11.25
Issue Date
. .
Valuation
. . . .
0
Expiration
Date 8/04/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
4.00
6.0000 EA PLB
FIXTURE
24.00
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
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Special Notes and Comments
POOL, SPA,
ALARMS/BARRIERS SHALL
BE IN
F
ra
LQPERMIT
Application Number . . . . . 08-00000270
Special Notes and Comments -
PLACE AT PRE -PLASTER INSPECTION. (2)
WATERFEATURES PER APPROVED PLAN.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 400.50 .00 .00 400.50
Plan Check Total 213.93 .00 .00 213.93
Grand Total 614.43 .00 .00 614.43
Bin #
Permit # n/
(� 1v
City ®f La Wnta 1
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
Project Address:
KvfLja
Owner's Name: r—
Ifo
A. P. Number:
Address:
Legal Description:
Contractor.'_�. "' ` � _
City, ST, Zip:
ti
Telephone: ; r r" ? � � ,
Project Description:
Address: C) �j �? 0
City, ST, Zip:6�',V CAL: t L/'V Cts
JZ-
O
Telephone:.a
State Lic.
Arch., Engr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:��T�
State Lic. #:
Name of Contact Person: �
.?
.*MEM
Construction Type: Occupancy:
Project type (circle one): Ne12 Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: t3l'+ �`i' �� Estimated Value of Project: Q[Je7
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Ree'd TRACKING PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcoutactor hist
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3`d Review, ready for corrections/issue
Developer Impact Fee
r
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks, Appr
Date of permit issue
School Fees
Total Permit Fees