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08-0574 (SOTB)3h 1 P.O. BOX 1504 78-495'CALLE TAMPICO LA QUINTA, CALIFORNIA 92253' Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: ROO 08-00000574 J 81846 RANCHO SANTANA DR 767-200-999-5' -312023- STRUCTURES OTHER THAN BUILDINGS LOW DENSITY RESIDENTIAL 350 Architect or Engineer: �[k I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of .perjury that I am licensed under provisions of Chapter 9 (commencing with Section7000)of Division.3 of the Busi and Professionals Code, and my License is in full force and effect. Lice. a Class: CS License No.: 802919 Dat ..tractor. OWNER-BLWER 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 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.). (_) 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 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: T.QPF.RMTT Owner: TERLECKY RESIDENCE 81846 RANCHO SANTANA LA QUINTA, CA 92253 Contractor: AZURE POOLS AND SPAS P.O. BOX 10641 PALM DESERT, CA 92255 (760)322-7665 Lic. No.: 802919 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/08/08 ° D APR 212UOB QUNTS CTY OFApT. WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty ofperjury 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. 1 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 DELOS INS CO Policy Number 01DKRM12002794 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 agr hat, if I should ec a sub'ect to the workers' compensation provisions of Section 370 t e Labor Code, 1 s thwi[ w ose provisions. i Dater '�- pplicanti' WARNING: FAILURE TO SECURE WOR RS' COMPENSATION 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 abo i �ns Orrect. I agree to comply with all city and county ordinances and state laws relating to buildin on r' ion, b authorize representatives of thicounty to enter o the above-mentioned property f i pectin ps. .Dater gnature (Applicant or Agent)' LQPERAIIT Application Number . . . 08-00000574 Permit . . . . . BUILDING PERMIT ,Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . 350 Expiration Date 10/05/08 Qty Unit Charge Per Extension BASE FEE ---------------------------------------------------------------------------- 15.00 Permit . . . PLUMBING Additional desc . . Permit Fee 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 10/05/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments FIREPIT, 24" FIRE BOWL PER APPROVED PLAN Fee summary Charged Paid Credited Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 14.25 .00 .00 14.25 Grand Total 47.25 .00 .00 47.25 LQPERAIIT RBB. WITH 2-24" WIDE CASCADES Uure wools & Spas; Inca ' P.O. Box 10641 r . --Palm-Desert, CA 92255_PSI -- .2AISED PIREPIT AREA 12" , IIQ - Im- Zn �• -. � - ;•~ R, � �. • Yy"- f _ * . LL..rr a '� ITY OF LA QUINTA h ,T.INNINCT UILDING &SAFETY DEPT.. LED ��F8�1846%ncho esidence - ��' , qP P ROV E D WITH UMBRELLA antana Drive ' FO C NSTRUCTSLEEV1~ta, Ca * , • - - � ;� � DAT _ , - • y Bin # City of La Quinta -, Building 4 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: A. P. Number: r Address: @ 9-1 Legal Description: Contractor: r? /s a, City, ST, Zip: Telephone: Address: O k o o • / Project Description: City, ST, Zip: /{rM : �%�% �/� 1 Z i Telephone: 7ZZ -'7� '— State Lic. # : Wm ( r, City Lic. #: 2 ` Arch., Engr., Designer: Address: City, ST, Zip: a y i ��-I Telephone: State Lic. #: Name of Contact Person: ,e ,e Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 2 1 Z- ly� b j Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss CRICs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan 2,d Review, ready for corrections/issue . Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'ro Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees s�. It