07-0384 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUJNTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
07-00000384
79375 BROOKVILLE'
772-040-006- -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
40000
Architect or 6
T4ht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LIISED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t#ra Insed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu 'les an Pro sionais Code, and my License is in full force and effect.
License Class: C8 C27 C29 LicenseNo.: 656128
n —-7_
_✓ — I Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under. penalty of perjury th t I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031:5, Business a d Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repo any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or a 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 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 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
79-375 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: 2/02/07
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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'Ti�ensfaticwn insurance, as required by Section 3700 of the Labor
Code, for the performance of torkorhich this permit is issued. My workers' compensation
insurance carrier and policy nu are:
Carrier SEABRIGHT icy Number BB1070510
I certify that, in the pertc
person in any manner
and agree that, if I shi
37W of
the Labor Cc
�
Dat ee^ ✓ I Applicant
work for which this permit is issued, I shall not employ any
n ubject to the workers' compensation laws of California,
,bje to the workers' compensation provisions of Section
/with omply with those provisions.
WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PqNALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO E 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 sha defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees fora 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 beco es null and void if work is not commenced
within 180 days from date of issuance of suc er cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th abov forma an is correct. I agree to comply with all
city and county ordinances and state laws relating to bui ing co truction, and hereby authorize representatives
of this ccooun�t�y tLo..e�rJ]/ter�upon�the above-mentioned prope i cti rposes.
Date: V J r Signature (Applicant or Agent):
Application Number . . . . . 07-00000384
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 349.50 Plan Check Fee 227.18
Issue Date . . . . Valuation . . . . 40000
Expiration Date 8/01/07
Qty Unit Charge Per Extension
BASE FEE 252.00
15.00 6.5000 THOU BLDG 25,001-50,000 97.50
---------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 8/01/07
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 8/01/07
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
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/01/07
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
----------7-----------------------------------------------------------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . . . 07-00000384
------------------------------------------------------------------7---------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 453.50 .00 .00 453.50
Plan Check Total 253.18 .00 .00 253.18
Grand Total 706.68 .00 .00 706.68
LQPERMIT
NQQ\ `Cw_ry 0 .ti\ l0Z
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 #
1'
Project Address: 3 q .- 37+-
Owner'sName:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: � � 5� -�-Z b—
Address: [2
Telephone:
Project Description: C7 CA,�pp►
City, ST, Zip:e_0j,,C E_
Telephone: cl ZZ 2
"CityLic.:
State 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:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: L- 0 6 0 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Recd
TRACKING. PERMIT FEES
Plan Check submitted 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`
2°" Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted A MPI r d
IN HOUSE:-
''" Review, ready folc �r f ° LI 8t AF eloper I pact Fee
Planning Approval
� P.
Called Contact Pers nAP
Pub. Wks. Appr
Date of permit issue FOR CO
School Fees
13Y
ITE
Total Permit Fees