12-0467 (RER)t P.O. BOX 1504 VOICE (760) 777-7012
78-49`5 CALLE TAMPICO 4FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
_ Date: 4/27/12
Application Number: `12-00000467 Owner:
Property Address: 81748 RANCHO SANTANA DR ARNOLD
APN: 767-630-001- - - 81748 RANCHO SANTANA DR
Application description: REMODEL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1000
Contractor:
Applicant: Architect or Engineer: TESERRA
P.O. BOX 1280-
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
------------------------------------------------------------------.------------------------------—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business an Professionals Code, and rimy License is in full force and effect. _ I have and will maintain a -certificate of consent to self -insure for workers' compensation, as provided
Lic se Cie y
10 , 7 , 2 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: ontractor: 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL IN . Policy Number 7600006481121
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file.a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should bec a subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 70 of the bor Code, I sl forthwith comply with those provisions.
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).: ate: -I plicant:
(_) 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- - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the. work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
I—) 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:
RPR 3 0 2012
LQPERMIT
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 abov i for ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building co t tion,and hereby authorize representatives
of is county/o a ter upon a above-mentioned property for i ction purposes.
Date: /"Z 'nature (Applicant or Agent):
Application Number .
. . . . 12-00000467
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
16.50 Plan Check Fee
4.13
Issue Date . . . .
Valuation
0
Expiration Date
10/24/12
Qty. Unit Charge
Per
Extension
BASE FEE
15.00
2.00 .7500
---------------------------------------------------------------------------
-------------- --------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST 20
1.50
Permi
Permit . . .
PLUMBING
Additional desc .
Permit Fee
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
10/24/12
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
GAS LINE & ELECTRICAL
STUB -OUTS FOR
FUTURE BBQ & FIREPIT.
2010 CODES..
-----------------------------------------------------
Other Fees . . . . .
----------------------
. . . .. BLDG STDS ADMIN (SB1473).
1.00
STRONG MOTION (SMI).- RES
.50
Fee summary Charged
-----------------
Paid Credited
Due
--------
Permit Fee Total
34.50 .00 .00
34.5,0
Plan Check Total
8.63 .00 .00
8.63
Other Fee Total
1.50 .00 .00
1.50
Grand Total
44.63 .00 .00
44.63
LQPERMIT
m
NO EXISTING LANDSCAPE LIGHTING IN REAR YARD
NO EXISTING OVERHEAD UTILITY LINES IN REAR YARD
PATIO FURNITURE FOR ILLUSTRATION PURPOSES ONLY
LANDSCAPE -NOTE
1 - TO REMOVE ALL SOD AT LOCATION OF DECK
2• CAP AND RE-ROUTE ALL IRRIGATION IN SOD AREA
3- REPAIR ANY DAMAGE IRRIGATION LINE DAMAGED
DURING INSTALLATION OF GAS LINE
151, - Ir POLYPROPYLENE GAS PIPE
ELECTRIC CONDUIT
NEW WALK WAY NATURAL
GREY CONCRETE
CITY OF LA QUINTA
BUILDING & SAFETY DEPT. -
APPROVED
FOR CONSTRUCTION
DATE�'�7'�BY
INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WALL COMPLY WITH
SECTION 111- MANDATORY REQUIREMENTS
EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
TO THE POOL
POOL HEATERS I PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURERS
RECOMMENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
ALL DECKING EXPANSION XWS FOR REPRESENTAWN ONLY,
FIELD LAYOUT WALL VARY
EXISTING WALK WAY
1�
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BY OUTDOORLIVING CONCEPTS,
:D BY TESERRA
NEW LIGHT BROOM FINISH
CONCRETE DECKING BY TESERRA, DECK
LAYOUT TGEIE DONE ON SITE WITH OWNERS
EXISTING DRAINS TO BE USED IN DEG(
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GAS AND ELECTRICAL PROVIDED &Y TESERRA
LOCATIOW TO BE DETERMINE 8Y OUTDOOR LMNG CONCEPTS
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Buiiding 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA •92253 -4760) 777-7012
Building Permit Application and Tracking Sheet
Permit # �
W�.
Project Address: Yi�,,t.++. SA�ANh 7 rz�✓E
Owner's Name:.
A. P. Number.
Address: NC.tFo ������� ✓
Legal Description:
Contactor. 1
City, ST, Zip: Z
Telephone:
Project Description:
s Lrn!
Address: d
City, ST, Zip: : 223 e
fx:
Telephone::0 398 9Z ZZ y'/a :N
State Lie. 4: G / Z. g City Lic. #,
Arch., Engr., Designer.
co r
Address:
City,, ST, Zip:
Telephone:
x
State Lic. #:'' '
{ a
Construction Type: Occupancy:
Projebt type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: vy
Sq. Ft : # Stories:
#Univ:
Telephone # of Contact Person: 6 Z 6 2--3 /
Estimated Value of Project: Q Q O
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd'Rec'd
TRACKING
PERMIT FEES
Plan Sete
Plan Check submitted
Item
Amount
Strgctuial Calm
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cates.
Called Contact Person
Plan Check Balance.
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mec1121ilcal
Grading plan
Z` Review, ready for correctionstissue
Electrical
Sabcoutaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub: Wks. Appr
Date of permit issue
School Fees
Total Permit Fees