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08-1507 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001507 , Property Address: 79375 BROOKVILLE APN: 772-040-006- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3000 Applicant: - ----------- - - - - - - - - I hereby affirm under penalty of perjury that I am Section Z200) of Division 3 of the Business and I Licens ss: 8 C27 C29 Date: ontract.r: T4"yl °f 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: BERK 79375 BROOKVILLE LA QUINTA, CA 92253 Chapter 9 (commencing with License is in full force and effect. O�R=BUILDER DECLARATION I hereby affirm under penalty of perjury that I am Pxempt 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 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: VIM LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/02/08 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 carmber are: Carrier SEABRIGHT Policy Number BB1080510 I certify that, in the performance f thew r which this permit is issued, I shall not employ any person in any anner 'o as tobecoKe s ject to the workers' compensation laws of California, and agree that, i ould beco su ' to orkers' compensation provisions of Section 700 of the Labor C fo ith those provisions. D� cant: WARNING: FAILURE TO SECUR OR S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT 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 s pe 2. Any permit issued as a result of this app ion becom null and void if work is not commenced within 180 days from date of issuance of s permit, o essation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above r o ' co ct. I agree to c ly with all city and county ordinances and state laws relating to building cons a e y��{Itorize sentatives of this courW to ep=r upoVhe above-mentioned property for pec n s. (Applicant or Agent): Contractor: Architect or Engineer: TESERRA P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lica No.: 656128 Chapter 9 (commencing with License is in full force and effect. O�R=BUILDER DECLARATION I hereby affirm under penalty of perjury that I am Pxempt 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 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: VIM LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/02/08 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 carmber are: Carrier SEABRIGHT Policy Number BB1080510 I certify that, in the performance f thew r which this permit is issued, I shall not employ any person in any anner 'o as tobecoKe s ject to the workers' compensation laws of California, and agree that, i ould beco su ' to orkers' compensation provisions of Section 700 of the Labor C fo ith those provisions. D� cant: WARNING: FAILURE TO SECUR OR S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT 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 s pe 2. Any permit issued as a result of this app ion becom null and void if work is not commenced within 180 days from date of issuance of s permit, o essation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above r o ' co ct. I agree to c ly with all city and county ordinances and state laws relating to building cons a e y��{Itorize sentatives of this courW to ep=r upoVhe above-mentioned property for pec n s. (Applicant or Agent): Application Number . . . . . 08-00001507 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . . 3000 Expiration Date . . 3/01/09 Qty Unit Charge Per Extension . BASE FEE 45.00 1.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 9.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/01/09 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 . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/01/09 Qty Unit Charge Per Extension BASE FEE 15.00 _ 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments FOUNTAIN IN FRONT COURTYARD, PER APPROVED PLAN Fee summary Charged --------------------------- Paid --------'-- Credited -------------------- Due Permit Fee Total 123.00 .00 .00 123.00 Plan Check Total 52.35 .00 .00 52.35. Grand Total 175.35 .00 .00 175.35 LQPERMIT w Bin # • Permit # I �� 1 fi✓1 Project Address: A. P. Number: -]*- Legal Description: Contractor: Address: 8b— City, ST, Zip: Telephone: - q27 State Lie. # : Z Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Teleahone # of Contact Person:( # Submittal Plan Sets Structural Calcs. Truss Calcs. Energy Calcs. Flood plain plan Grading plan Subcontactor List r 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 Owner's Name: Address: City, ST, Zip: L, tN Telephone: Project Description: '� // q aZz 1 � -� Lie. #: 11 o ntt_ . Construction Type: Occupancy: Project type (circle one): New), ew Add'n' Alter Repair Demo Sq. Ft.: 16 # Stories: # Units: Ago) 7-50-07— %1 Estimated Value of Projec APPLICANT: DO NOT WRITE BELOW THIS LINE 'd Rec'd TRACKING Plan Check submitted �l1/ Reviewed, ready for corrections Called Contact Person Plans picked up Plans resubmitted 2" Review, ready for corrections!'issue Called Contact Person PERMIT FEES Item Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing H.OA-Approval------ - - -- Plans resubmiftea— — - -- - - -- Grading -iNal Ous RtV..---- -- ------ -- - - - -- --- - - ;--- �pac-- -- Planning Approval `Caile`d Coritact'Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Amount