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07-0337 (RPL)P.O. BOX 1,504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 07-00000337 79390 BROOKVILLE 772-040-020- - - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 50000 I hereby affirm under penalty of perjury that Section 7000) of Division 3 of the Busines� License Class: /C 88 C27 C29 r ate. /,entractor: � t T4"yl " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: AlA CTOR'S DECLARATION ar provisions of Chapter 9 (commencing with Code, and my License is in full force and effect. ense No.: 656128 \ O ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that mpt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Profes 'ons Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any str cture, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is lic sed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7 00) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for a alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a ivil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees ith 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: LA QUINTA ORCHARDS PARTNERS C/O LA QUINTA ORCHARD PARTNERS P O BOX 1716 LA QUINTA, CA 92253 Contractor: TESERRA P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 Date: 2/01/07 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 policy number are: Carrier SEABRIGHT ;1 Policy Number BB1070510 I certify that, in the perf6�mance of the work for which this permit is issued, I shall not employ any person in any manners3as o become subject to the workers' compensation laws of California, and agree that, if1f sdould becorT subject to the workers' compensation provisions of Section 3700 of the L_bor Code, I shall fofthwith comply with those provisions. v WARNING: FAILURE TO SECURE W/ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO\GAIMINAL 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 CO O E; INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby m de to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth o 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 Ouinta, 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 1 have read this application and st thgr'TrabQ information is correct. I agree to comply with all ng to bu Iding construction, and hereby authorize representatives city and county ordinances and state law�ad of this my to enter upon the above- m�vntioned prope ty f r inspection purposes. ature (Applicaent): r.t ,i Application Number . . . . . 07-00000337 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 414.50 Plan Check Fee 269.43 Issue Date . . . . Valuation . . . . 49600 Expiration Date 7/31/07 Qty Unit Charge Per Extension BASE FEE 252.00 25.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 162.50 Permit ... . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/31/07 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 7/31/07 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 7/31/07 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 Permit . . . . . . WALL/FENCE PERMIT LQPERMIT Application Number . . . . . 07-00000337 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 400 Expiration Date . . 7/31/07 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA, 25 L.F. 4' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited --------------------------- Due -------------------- Permit Fee Total 533.50 .00 ---------- .00. 533.50 Plan Check Total 295.43 .00 .00 295.43 Grand Total 828.93 .00 .00 828.93 LQPERMIT