08-0414 (SOTB)Y ,.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00000414
� Pro-perty Address: 61254 CACTUS SPRING DR
APN: 764 -280 -999 -18 -300235 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1000
Applicant:
Architect or Engineer:
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4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENS D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P fessionals Code, and my License is in full force and effect.
L�icenseClass: C8 C27 C29 License No.: 656128
Date O' Contractor: 1
r 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).:
(_) 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 vaork 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 _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPFRAIIT
Owner:
WHITE RESIDENCE
61-254 CACTUS SPRING DR
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: 3/07/08
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 carrier and policy number are:
Carrier SEABRIGHT Policy Number BB1080510
1 certify that, in the performance qk
for which this permit is issued, I shall not employ any
person in any manner so as to ecome subject to the workers' compensation laws of California,
and agree that, if I should beco a subject to the workers' compensation provisions of Section
3700 of the Labor C all forthwith comply I shwith those provisions.
Date: gJ/jFj r'A" pplicant:
WARNING: FAILURE TO SECURE W6RZKEETM40MPENSATION 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, o cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor ation is correct. I agree to comply with all
city and county ordinances and.state laws relating to buildin onstruc ion, and hereby authorize representatives
of this n�tW!erpon the above-mentioned prop or ins ecti n purposes.
�_.Date:nature (Applicant -or Agent):
Application Number . . . . . 08-00000414
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee '. 25.00
Plan Check Fee ..
16.25
Issue•Date'
Valuation . . .
. 1000
Expiration Date 9/03/08
Qty Unit Charge Per
Extension
BASE -FEE
15.00
5.00 2.0000 HND BLDG
501-2,000
10.00
----------------------------------------------------------------------------
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee 17.25
Plan Check Fee
4.31
Issue Date . . . .
Valuation
0
Expiration Date 9/03/08
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/FIREPIT PER APPROVED PLAN
Fee summary Charged
Paid Credited
Due
-Permit Fee Total. 42.25
.00 .00
42.25
Plan Check Total 20.56
.00 .00
20.56
Grand Total 62.81
.00 -.00
62.81
LQPEINIIT
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 #
Project Address:
Owner's Name: S ,
A. P. Number:
Address:
Legal Description:'
City, ST, Zip:
Contractor:
Telephone: -
,�
Address: -16 LDSMILS— V '
Project Description:
City, ST, Zip:&wL0w It CIZZ3
/
Telephone:
` � , �
PoOL u '/L Co
State Lic. #: CityLic. #:
Arch., Engr., Designer:
Address: _
City, ST, Zip:
4 v�
Telephone:.`., :`��} "
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one) New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: 2 , — Z
Estimated Value of Project: 0066
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec°d
TRACKING. PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Depbsit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction C3
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan
2nd Review, ready for corrections/issue
Electrical ► F �v
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''dReview, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
School Fees
Date of permit issue
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12� TAKE NOTICE T4,%t PCkIL AND EQUIPMENT OCATKNS 4RF S0111EGT TO ACCEPTAPnE OrIc
LiXAL BUILU IN(; [*PAR TMENT Al THE TWE OF ISSLI AN CF (IF FUUrF
(3� VWT 00^ (;MGIZETF Sfi!ELL AT L FAST TVVIQE GA_- LY FM SEVEN BAYS AF TEER SHELL qS i��-,TAUZD.
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AND ANY VAVALE IV CURBS, 8 1 DEWALKS. VRI VEWAYS. L_k1AfIhjS, OR DTkITEWS IN THE ACW
151 SEE TTfAT ALL GALTES, AND ORRACE DOORS IAEE-d LOCAL CODES FOR A P001. EW-LOSURE
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(6F FILL FW1_ I.W&COATFLY AFTER P LASTItk ( Fil - L 010 IN "RLIC MW .. DD NOT IJ,;E RUKER IaSEr
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